WATERTOWN — Here we sit on the precipice of the unknown. Up here in the north country, we are in the lull before the COVID-19 storm.
Schools are closed. Many businesses are closed. People are avoiding the hospital, which demonstrates good social understanding of the situation.
The hospital I work at has a plan. The emergency room group that I work for has a plan. New York state is surprisingly responsive.
Everyone is working together and thinking outside the box. Health care is being re-created, and the plans are reasoned and reasonable.
New York City is at war. Buffalo and Rochester are not far behind. The north country hopefully has another 10 to 14 days to prepare, but no battle plan survives contact with the enemy.
Some issues are foreseeable. Personal protective equipment will not always be available. The doctors, residents, nurses and staff are healthy, and we will work to stay that way by conserving supplies.
Doctors, nurses and staff from closed offices will be moved to areas where they are needed to supplement or replace ill co-workers. Some medications may not be available; hopefully, we have alternatives. We may not have enough ventilators for the critically ill, so we are planning for that horrendous possibility.
Some issues are more difficult to foresee. Have the larger political/community/parochial decisions over the last decade led to a situation that minimizes our effectiveness in response to this pandemic? Will temporary nurses come to work or move on to a higher bidder?
Will doctors who do not live in the north country want to come to work in a battlefield? Will health care systems coordinate responses? I hope the answer is “yes.”
Mostly, my job only entails existential risk. I am nervous and honestly frightened.
I have dealt with this by planning with colleagues here and elsewhere. I have purchased a good amount of durable protective equipment, so I will never be without it.
Whatever personal protective equipment I would have needed can be used by a nurse or staff member. I sleep in our camper because the breathing machine I use for sleep apnea increases my family’s risk of catching the novel coronavirus from me.
My family is a risk to the community because of my job, so we are being strict with quarantine apart from health care-related activities. I have reviewed literature on COVID-19 and ventilator management for acute respiratory distress syndrome. I wash my hands.
I am writing this to share with you but also as catharsis for me. Everyone is responding differently.
My wife, her friends and the community have organized a mask and gown making enterprise. They are supplying cloth masks to medical offices, nurses, EMS and nursing homes.
My advice is for everyone is stay home. Go nowhere. Do not pump gas. Do not buy coffee out or order take-out.
When you are forced to go out, batch your trips and limit the duration. Wash your hands. Do not touch your face.
Make small talk with your neighbors at a good distance or on the phone. FaceTime is awesome.
Take time to marvel at the beauty of spring in your own backyard. Pray for seasonality to the virus, medicine that works and speedy production of a safe, effective vaccine.
If you get sick, stay home. Do not rush to the hospital or doctor’s office.
Take acetaminophen (Tylenol) for fever. Despite what you may have read on the internet, if you have normal kidney function, are under 60 and are not on an ace inhibitor or blood thinner, then you can take ibuprofen (Motrin) for fever as well.
If you are having trouble breathing, chest pain, severe symptoms or a bone sticking out of your skin, go to the hospital. If your symptoms are fever, shortness of breath, cough, diarrhea or if you think you might have the coronavirus, call before you arrive for instructions.
I am decidedly apolitical, but there is some discussion about “reopening” America from Washington. I have heard this repeated by people who should know better.
Here we are in New York at the beginning of the beginning for the American COVID-19 story. This will clearly be a stress test for our country.
Will financial pressures outweigh human life? Let us hope not; I don’t ever want to choose who gets a ventilator and who doesn’t. Ask the Italians; they wish more had been done sooner.
I am proud to know and work with a fantastic group of doctors, residents, nurses and administrators. We are doing what we can with what we have. As my friend Dr. Aaron Campbell said, “Good or bad, this is why we do medicine.”
Dr. Dave Flint is an emergency room physician at Samaritan Medical Center in Watertown.