SOLA Editorial Board member Daniel K. Eng interviewed two doctors in California: an Emergency Department doctor and a pediatric hospitalist. They wish to remain anonymous. We have compiled their answers into this article and have lightly edited them for clarity and length.
This is a part of a series on Asian American Christian medical professionals who are working on the front lines to combat COVID-19. We hope these interviews and perspectives will help us to become more knowledgeable about the current pandemic so that we as Christians can pray more fervently and be a shining light within our communities.
Note from the doctors: Prior to answering these questions, we want to qualify that the opinions are personal ones and do not reflect any institutional perspectives/opinions. We also wanted to make sure to mention that the answers in no way are to replace professional medical advice, especially as the situation around COVID-19 continues to evolve.
1. What are you seeing in your hospitals these days?
First, we’d like to qualify that, being an Emergency Department (ED) physician and a pediatric hospitalist in California, our views are skewed towards the hospital perspective and our personal experiences in the state. Our overall volumes in the Emergency Department here are lower, which speaks to our community’s adherence to social distancing guidelines and instructions to utilize the ED for emergent issues only.
That being said, the patients that come in the ED are much sicker on the whole. With that, we have been intubating (the process of placing a breathing tube to have a machine breathe for a patient) more as well. This also means that we are hospitalizing patients at a higher rate and those who are hospitalized are requiring much higher levels of care, such as ICU care.
I also wanted to qualify that we are not yet at our expected peak. From speaking to my colleagues at other facilities in areas like NY or Louisiana, the EDs are very busy with the same number of higher acuity patients. Many facilities in other areas of the country are at maximum capacity and waiting rooms are inundated with patients.
2. What do you wish the general public would understand about COVID-19?
If you have mild symptoms, stay at home and self-quarantine. If your doctor thinks you should be tested for the virus, look into whether you have a local option for drive-thru testing, which is safer than testing in an in-clinic or emergency room setting. If you need to see your doctor in person, make sure you wear a mask and call ahead so that they can take the necessary precautions when you arrive.
If you feel short of breath, are having difficulty breathing, or feel very ill, it may necessitate a visit to the Emergency Department. It is important to remember that any visit to the Emergency Department or urgent care clinic may put you at risk for catching the virus.
3. What is the status of medical supplies? What is the situation with testing?
It is very true that there is a limited supply of ventilators in our country. It is also true that our country’s supply of personal protective equipment (PPE) is limited and this is felt in all hospital systems. My current hospital still has a sufficient supply of PPE and we are still able to protect ourselves.
However, all hospital systems have had to change the traditional way of practice for PPE. For instance, prior to COVID-19, the general practice was to change out your N95 mask every time you went in or out of a patient’s room that was on airborne precautions. Now, most hospital facilities are rationing the N95 masks to only have one per day, some even one per week or longer.
It is also true that the ability to test is limited in most parts of the country. The ability to test has certainly improved over the past several weeks. However, we are still not at a place where testing is ubiquitous and we can test whomever we want. If we have a suspicion that a patient has COVID-19 and only has mild symptoms, we are advising the patient to self-quarantine and to assume that he/she has the disease. We are usually only testing those who are very ill, or who are being admitted to the hospital.
It is important to remember that while testing on a larger scale can help prevent the spread of the virus from the public health standpoint, testing an individual person with mild symptoms will not help them get better any faster, as we currently do not have any proven treatments for COVID-19.
4. What does social distancing accomplish?
Social distancing helps minimize the spread of the virus and flatten the curve. The purpose of flattening the curve is to spread out the number of infected patients over a longer period of time so that our healthcare system can have enough staff and resources to take the best possible care of patients that need hospitalization, intensive care, and ventilators, rather than have a large number of sick patients all at once that would overwhelm our hospital systems.
5. How should we explain the virus to our children?
Be as calm and reassuring as possible, as kids will pick up on cues from you. Also, be honest. Avoid any language that may blame or stigmatize other people. How much you explain will depend on their age and ability to understand.
We have a young preschooler at home, who has inevitably heard that there is a virus outside. The way we have explained the virus to our daughter is that there is a bad germ called a “virus” that has made a lot of people sick. Most people who get sick from this virus will be okay, especially kids like you. But some people might get very sick. The virus spreads from person to person, even when a person doesn’t mean to spread it. This is why it is very important to wash our hands with soap and water, and important to cover our mouth when we cough or sneeze. This is also why we have to stay at home and we can’t see your friends in person. However, we can still spend time with your friends other ways (like through FaceTime or Zoom or on the phone). Staying at home will help more people to stay healthy, and allow doctors to take care of everyone who needs them.
6. In what ways can we support healthcare workers?
Please help to advocate with your local government to ensure adequate PPE is available for healthcare workers. Also, please continue to stay strong and practice social distancing. It really has made a difference to limit the number of people who are infected and to make sure our healthcare system has the resources to take care of sick patients.
As mentioned before, if you have mild symptoms, please stay home. Every time you go to the ED, you risk exposing yourself if you don’t have COVID-19, o
r you risk exposing others. If you have mild disease, you will likely be sent home and asked to self-quarantine. Currently, there are not enough tests to test everyone. In addition, I want to emphasize that knowing you have the disease is not the same as actually being able to treat the disease.
7. How can we pray for you and your patients?
Thanks for asking this question. Please pray for healthcare workers. A lot of us have been practicing distancing from our families to minimize our exposure to them.
Healthcare workers are exposed to the disease day in and out to the disease. Without adequate protective equipment, we are jeopardizing our lives. Healthcare providers are people too and there is certainly fear that we will catch the disease. With increasing reports of healthcare providers getting the disease and dying from it, it certainly heightens our concern and fear. Pray that our families will be protected.
Pray for our patients as well. Pray that for those with the disease, that they will be healed and that they will overcome the disease. Pray that patients’ families will be able to stay healthy and protected from COVID-19. Pray that families will be comforted if a patient is in the hospital, despite not being able to go to the hospital to see their loved one.
We should also pray for our government leaders to know how to mobilize our country to be able to treat the disease, protect our healthcare workers, and more importantly, how to minimize the spread of the disease. Pray also for the Asian American community especially amidst all the racism that is being directed towards the Asian American community.
Anonymous are two doctors in California: an ED doctor and a pediatric hospitalist.