We’re not getting the protection we need from our hospitals: One American doctor on the frontline of COVID19 speaks out
Dr. Chonn Ng
A lot of doctors are being told to remain silent and just work, save lives. But how can we save lives when we can’t protect ourselves from getting infected with the coronavirus?
Sometime in January, a colleague and I began to worry about the coronavirus. We thought something was really going on, something that was prompting what posed as draconian measures in Wuhan, China, like measuring everyone’s temperature. This was not just a simple flu outbreak.
By February, it had spread to other countries and people were testing positive in the U.S. Despite several reports of how dangerous and insidious the virus was in other countries, the lack of preparation in my own hospital was glaring. By early March, doctors decided it was time to start buying equipment we would need to protect ourselves. In the beginning, I was a bit skeptical, but as time went by and cases began to mount in other countries, it made more sense, even for our hospital in Indianapolis, which seemed far from everything.
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I had many reasons to be careful. My husband died in January from cancer, leaving just me to support my 6-year-old daughter. While I work, my mother-in-law takes care of my daughter in California. I live between California and Indiana, commuting for work on a plane. I am not going to bring home this virus to them, or get sick or die myself. I am not going to leave my daughter alone.
So my business partner and I looked at what the doctors in China and Italy were wearing, what was being reported in the literature on the new virus, and we tried to buy those things for ourselves. We bought things like full face respirators, gowns, goggles, masks — anything that would cover us from head to toe, as the doctors we watched in other countries seemed to be doing.
By early March, our hospital had begun to treat coronavirus cases. Another doctor in our hospital started wearing a full protective suit, and the hospital sent him home, saying he was being erratic, emotional, and scaring their patients. It was not an isolated incident. I was in discussion groups with doctors from other states who were worried about the same problem. Around the country, just like at our own hospital, administrators said if they let one doctor wear protective equipment then everyone would have to wear it. If everyone was wearing masks and other protective equipment, it would acknowledge the kind of danger this virus posed for our hospital. And it would add costs to buy the gear for the hospital.
All of a sudden a few weeks ago, perhaps 80 percent of the patients I was seeing were people who had some COVID-19 symptoms, and we were tasked with figuring out if they had the coronavirus. Symptoms vary greatly: from diarrhea and vomiting, to someone who has lost their sense of taste and smell, someone who has a fever, who has a dry cough, to problems breathing. Those who are vomiting, or having trouble breathing are the patients we would admit, because they needed IV fluids or oxygen or other assistance. If all a patient had was a fever, for instance, a sample would be collected from them to be tested for coronavirus and we would send them home. When the test results became available, something that could take five or six days, the hospital called the patients at home, telling them to quarantine themselves if they were positive and return if things got worse. Until then, a preliminary diagnosis is made based on symptoms, or chest x-rays, or a CT scan.
The hospital’s thinking at the time was, since we don’t know if they have COVID-19, we would just go ahead and wear a surgical mask, which doesn’t protect us from the virus. We need at least an N-95 mask, or a respirator mask, but that is not what the hospital was providing. The hospital wavered on how they were going to protect us and that hasn’t changed. On my own, I went to a hardware store and purchased p95 respirators, just in case we were told we could not use our 3M professional respirators. The gear me and my colleague had purchased weeks earlier to protect ourselves from the coronavirus had become essential.
I was only present at the initial stage of admission, seeing each patient once and passing off the care to my colleagues. My colleagues then managed a patient’s care until discharge or in some cases death. The patients were as young as 22 and as old as 93 years old. Almost all were aware of the pandemic, and actually appreciated it when we doctors wore the protective equipment. The only patients who seemed to be “scared” were the ones most easily confused and had underlying dementia and Alzheimer’s.
When I walk into the hospital now for work, I am already wearing a long sleeve shirt, neck gaiter, mask and goggles. Before sitting down, I wipe down everything in the office I may touch — the chair, the keyboard, the phone, the cupboards, the bathroom door — with disinfectant wipes. Only then, do I lay my backpack down, sit down and begin to take my mask and goggles off.
Listen to our latest episode: OnSpec/Pandemic • Alone but not Lonely
When it’s time to go see a patient, I gauge what protective equipment I need prior to seeing them. If I was told they may have COVID19 symptoms, I put on a full Air Purifying Respirator, or PAPR, something used for treating patients with highly lethal and communicable diseases like tuberculosis. It continuously pumps purified air into the mask, making sure the high pressure inside means the virus particles outside don’t enter and come near your mouth, or eyes, or nose. I then put on a gown and gloves to protect myself and the next patient I have to see. If I’m told they have no symptoms and are here for emergent surgery or failing liver, I put on a p95 respirator and gown up.
In early March, I was approached by a like-minded physician who reached out to a 3M sales person and asked for respirator, gloves, boots, and coveralls.
I am lucky because I work nights, when the hospital administrators who are unhappy with our protective equipment are not around to say I am frightening the patients.
I always thought health workers themselves would have a say in how they treat patients. But right now that’s not what’s happening.
Doctors should not have to fight for proper equipment to do their job. There is an obvious shortage of healthcare workers during this pandemic, and part of that reason is a fear that we are not being given the proper tools to work with during this crisis.
I am scared more than ever as a single mother. Who will pay for everything to raise my daughter when I cannot work? If I am too sick or I die, who will take care of my daughter?
I am not alone in this. All healthcare workers worry about what happens to their families, to those who depend on them, if they become sick with this virus.
Listen to our latest episode: OnSpec/Pandemic • Alone but not Lonely
The only comfort I have now is what I have done to protect myself. I have what I call the “apocalyptic coronavirus suit” if I am told to work around the clock, like many other health care workers are being asked to do around the country. It’s the kind of suit you see on television, or in a movie. It’s that or possible death. It seems like a no-brainer but try telling the bureaucrats who control hospitals in this country.
Dr. Chonn Ng, M.D., is a nocturnist physician. When not battling COVID19, she tries to be the best single mommy to her daughter Teagan, and volunteers at An Lanh clinic in Irvine.
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