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Primary health care providers across the country are sounding the alarm over the rationing of protective equipment and the lack of rapid response to COVID-19 tests – and some even do so in quarantine.
Physicians in distress and other health professionals have been excluded from the pandemic response because they suspected cases of coronavirus. They are at home with their quarantined spouses and children, but as a sign of the decay of the response to the coronavirus, some doctors do not know if they are actually infected.
“It’s pretty frustrating to see celebrities and basketball players being tested the same day,” said Dr. Damian Caraballo, a Tampa emergency doctor who had been quarantined for a week before learning that he was negative. “But if you’re a doctor or a nurse, you can’t get tested [immediately]. You wait six or seven days to know your results. “
Full NBA teams have already been tested for the coronavirus. The Brooklyn Nets paid a private company to get the tests and learned that four players were positive. Politicians are tested and find quick results. Senator Mitt Romney, R-Utah, was tested on Monday and got negative results the next day. Vice President Mike Pence and his wife were tested and apparently received negative results within hours.
Meanwhile, Caraballo, 39, and at least one of his colleagues had been quarantined at home and presumed to be infected by one of the COVID-19 patients he had treated in the emergency room. He joined other health professionals across the country, saying the lack of N95 respirators and other protective equipment is a dangerous embarrassment that will lead to more doctors out of service and unable to treat the virus. rapid spread.
Not only is the shrinking supply of masks, gowns and gloves putting health care workers at risk, but the lack of widespread rapid response tests means doctors don’t even know which patients entering their hospital should be isolated, say the doctors.
Patients can enter the emergency room without any symptoms of coronavirus, for conditions such as a broken ankle, and they are not isolated. Doctors are not necessarily suitable for asymptomatic patients for reasons of rationing. But the danger is that patients are still infected without obvious symptoms and that unprotected health care professionals are at serious risk, doctors say.
Dr. Haig Aintablian, President of the American Academy of Emergency Medicine Resident and Student Association, said that up to 100 emergency residents were quarantined nationwide and that the two main factors were the lack of rapid tests and lack of personal protection.
“This is a complete mess, and our government is not doing enough to resolve this problem,” Aintablian told Fox News.
“I have heard from many people across the country that administrators are refusing them appropriate PPE (personal protective equipment), possibly due to a huge shortage,” he said. “Some residents are given an N95 mask to use for weeks at a time. We all know that these masks are for single use, and using them multiple times can not only spread viral particles but also prevent their protective function from our interns. “
Doctors in the country have various personal protective equipment. Some say they have enough equipment now, but have to ration their masks because they don’t know when the re-enactments are underway. Doctors want to be able to perform on-site tests with results in less than an hour so that they can accurately isolate patients and protect themselves.
Dr Purvi Parikh, an immunologist in Manhattan, works in a clinic treating patients with allergies, asthma and immune deficiencies – a population that is more at risk for COVID-19. But his office has run out of N-95 masks and robes and every time they try to place a new order, it is canceled.
She had to reuse her N-95 over and over again last week. It is also in its latest box of less protective paper surgical masks. They had to lock the rest of the surgical mask supplies after a few boxes were stolen.
“I basically just sprayed the outside [of my N95 mask] with Lysol and hoping for the best, “said Parikh.” All doctors share advice on how to sterilize something that is not intended to be sterilized.
“These are disposable items that you are supposed to use with another for each patient, while we use it for similar days,” added Parikh.
However, she considers herself lucky.
“People are jealous of me when they hear that I have one [N95]. It’s crazy like that, “she said.
As more and more health care workers are quarantined or tested positive across the country, doctors said that without the proper equipment and tests, more of their ranks will be eliminated.
It is not known nationally how many health care workers have so far been quarantined or tested positive.
But the statistics available give a bleak picture. In Ohio, approximately 16% of COVID-19 cases are healthcare professionals, Cleveland.com reported Wednesday. And in Italy, France and Spain, more than 30 healthcare professionals died from the coronavirus, and thousands more had to self-isolate, the The New York Times reported Tuesday. In Spain, almost 14% – or 5,400 people – of the country’s confirmed coronavirus cases are healthcare professionals.
In the United States, at least two emergency physicians, one in New Jersey and one in Washington State, were infected with a coronavirus and were in critical condition, the American College of Emergency Physicians announcement March 14.
Tuesday, Kious Kelly, assistant director of nursing at Mount Sinai West in Manhattan, died after contracting the new coronavirus, the New York Post reported. The lack of protective equipment at his hospital was so severe that the nurses were carrying trash bags.
Parikh, the Manhattan doctor, said that the record for health workers was “heartbreaking” and particularly tragic when professionals use office supplies to make masks just to do their job.
“It’s very scary because it could be me or any of my friends,” said Parikh after learning of Kelly’s death.
“If we lose our health staff, who will take care of all the patients?” she says.
Caraballo, whose family of five was quarantined for almost a week before their negative test result, called the “lack of protective equipment and the lack of who is sick” a storm perfect “.
Doctors are not invited to be perfectly adapted to asymptomatic patients due to the scarcity of masks and health workers may then fall ill and transmit them to others. Because the tests take so long, the infected people unknowingly spread the virus “exponentially”.
Health care professionals interviewed by Fox News for this article made it clear that their views were theirs and did not represent the hospitals or the institutions that employ them.
But doctors across the country were sending an SOS message that the lack of armor, leadership and information in the war on the pandemic was causing great anxiety for healthcare workers.
“Everyone is on the edge of their seat. … Online, it’s a barrel of powder. I mean I’ve never seen [health care] suppliers so anxious in my life, “said Caraballo.
Caraballo’s nasal test swab was sent to California where he had to wait for the results for 6.5 days. He was frustrated to see other countries – like South Korea – having generalized tests and their doctors wearing what look like space suits to treat patients, he said.
Meanwhile, the The Centers for Disease Control and Prevention (CDC) advise physicians who face a shortage of masks to use a bandana or scarf to treat COVID-19 patients as a last resort. Maskless healthcare professionals in contact with a COVID-19 patient are asked to stay away work for 14 days, setting a scenario for many more doctors and nurses to be absent from the front lines.
“The CDC’s recommendations sound like we are in a third world country,” said Caraballo.
The White House Coronavirus task force has been working for weeks to increase the supply of protective equipment and the availability of tests, but field providers say the relief did not come soon enough. The next big problem is the shortage of hospital ventilators when a community is overwhelmed with sick people who need to be hospitalized.
Congress is about to pass a nearly $ 2 trillion stimulus package that should also send aid to hospitals, but front-line workers say they can no longer wait for help. It passed the Senate unanimously on Wednesday and is due to be voted in the House on Friday morning.
Lack of testing, scarcity of personal protective equipment and changing medical advice has taken its toll on front-line workers, many of whom face the added stress of children at home at school and at home. nursery.
“It’s very chaotic and very scary. In many ways, we feel a bit helpless, “said Dr. Amy Cho, an emergency room doctor in Minnesota and a mother of four.
Nearly three weeks ago, Cho’s independent medical practice was advancing to set up driving tests in one of their emergency care facilities in the Twin Cities area, but the effort had to be canceled due to lack of masks for health workers, she said. .
“The situation is really hopeless,” said Cho. “We don’t have the opportunity to test. We don’t know how prevalent it is in our communities because there have been no surveillance tests. So we don’t even have the capacity to make an educated guess. We fly blind and the direction changes again and again. “
As she and her colleagues treat patients with COVID-19, they are well aware that they can become sick themselves. Already, a doctor with whom Cho had symptoms but returned after a negative test.
“I am friends with everyone I work with. I’m worried. Statistically, what will happen is that my team members will die and it will happen because they are at work and they are doing their job, ”said Cho. “And I’m very terrified of it.”
Some health care workers have rejected the CDC’s guidelines as being based on scarcity of resources and not on science. Although CDC guidelines recommend protective equipment when managing COVID-19, some professionals have taken matters into their own hands – especially since COVID-19 patients may not have any symptoms of disease.
“You walk into a hospital, you have no idea who has this disease unless everyone has been tested,” said Dr. Christian DiPaola, a Massachusetts orthopedic surgeon, who – like many health workers health in recent days – – describes the hospital as a “battle zone” because it is the most likely place where health professionals will come into contact with a COVID-19 patient.
DiPaola therefore decided to wear his surgical equipment at all times to the hospital – an operating room hood, a mask, scrubs, goggles and a disposable jacket. “I stand out,” he admits.
The slogan “flatten the curve” is quite extinct, says DiPaola, because it assumes that the capacity of the health system is stable. But in reality, if teams of doctors and nurses are quarantined or fall ill, the capacity of the health system will be greatly diminished. If a nurse tests positive, for example, 20 other health care workers she has been in contact with can also be immediately quarantined.
“I don’t know if I’m a carrier so I want to protect my patients,” said DiPaola, who is the head of the organization’s medical team. www.endcoronavirus.org. “And I don’t know which patient is positive and by the time we discover it or even suspect it, it could have contacts with several people within the system. My guiding principle is thus analogous to the universal precautions conveyed by the blood which we let’s practice in the operating room: Suppose everyone is positive and act accordingly. “
Maryland emergency doctor Dr. Jason Adler, husband and father of two, said frontline health workers are struggling with their own mortality and mental health.
Adler is concerned for all levels of healthcare workers, from lab technicians handling COVID-19 swabs to workers who clean hospital rooms after procedures.
“We will probably be infected. Some people will do better than others, but it will likely happen. As an emergency room doctor, I think the likelihood is very high, “said Adler.
The ambiguity and uncertainty surrounding the virus has taken its toll and emotions can mount at home, on social media and by email.
“I am concerned about the mental health of our front line health workers,” said Adler. “… we need a purge valve, and I worry about front-line workers, and many Americans, who just don’t have one at the moment.
“It is difficult,” he said. “We run into fires and do not move away from them. But at the same time. It is very precious to recognize that this is not normal.”