Dr. Walton is a clinician at Brigham Women’s Hospital. He’s also CEO and cofounder of Build Health International, a nonprofit organization helping to build healthcare infrastructure in impoverished communities
n 1990, the Federal government declared March 30 to be “National Doctors’ Day,” enshrining into law a day that had already been unofficially celebrated since 1933. Now more than ever, this is a moment worth observing, as physicians across the United States find themselves on the battlefield against the COVID-19 pandemic.
I’m not very political and this whole situation has made me very political. We’re a rich country, why are we rationing? We spend trillions of dollars on the military to go to war in other countries, but now we’re fighting a war here and not getting that level of support. It’s only a matter of time before every hospital has no space. It’s inevitable if the spread continues. We don’t allow visitors now, and I’m finding it very sad. We have a 30-year-old on a ventilator and he’s dying alone.
I come at this from a different angle. I have worked in global health for a long time. I was in Haiti during the cholera epidemic and in Sierra Leone during the Ebola epidemic. This is the first time in dealing with an epidemic that I’ve encountered shortages. We’ve always had the appropriate PPE in the places I’ve worked. Here we’re reusing our N95s. We’re reusing our goggles and face shields. I think our PPE shortages are going to compound and get increasingly worse.
My fellow hospital physicians and I were a little blindsided by how fast it’s moved and how deadly it’s been. I think one of the major fears we physicians and nurses have is the lack of personal protective equipment and the fact that healthcare authorities are not considering that the virus can remain airborne for 3 hours after an aerosol procedure, despite a Harvard research letter strongly indicating that that is true.
This disease is as formidable as they come, but so is our team. Part of my job is to make sure they have what they need to meet this challenge, and their safety and morale is front of mind for us all. Our system has met similar challenges in the past, whether it was Ebola in New York City or Super Storm Sandy before that.
Because of my prior outbreak experience, the extent of respiratory virus disease spread isn’t necessarily shocking to me, but the amount of misinformation and lack of acceptance of sound public health interventions is . Governing authorities and the public need to heed the message of aggressive social distancing and isolation so that we can prevent more cases in the community and limit the risk of severe illness in vulnerable patients.
Dr. Kim is a doctor with the California Department of Corrections. As far as he knows, nobody in his nearly 3,000-person prison has been infected with COVID-19, but it’s impossible to know for certain, given how few test kits the prison has. My job is to make sure that the front line is supported as much as possible with resources. We already have over 50 patients under investigation for infection and 20 confirmed cases, whom we’re treating with some of the drugs we hope will work. To prepare for the surge in patients, we’re progressively retrofitting spaces throughout the hospital and campus. For example, the dental school offered up its clinical training space. Thankfully, I haven’t had to isolate myself from my family.
Dr. Fox is an urgent care physician for Multicare Immediate Clinic in Burien, Washington, which is near Seattle. This state has been the site of over 3,700 COVID-19 cases, with over 170 deaths. Every day I open up my email and I am inundated with information. I sort through and check in with my colleagues elsewhere in the country to try to pool information, so I can best take care of my patients. My practice has changed a lot since COVID-19. We have an HIV program for kids and young adults, and we’ve been calling and texting them regularly, but holding off on having them come in unless there is an urgent need.
Social media is really sort of hyped up and I think it creates a lot of anxiety. Just looking at the real-time facts, you know, I think mitigation has been pretty successful. But I guess the big concern I have is about the unintended consequences of this social distancing continuing. I would expect to see a lot more anxiety, a lot more depression, and domestic violence and abuse. We’re not really hearing much of that yet.
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