The goal of “flattening the curve” regarding the novel coronavirus pandemic is to slow transmission such that we avoid seeing a large unmanageable peak of infections at once. It doesn’t necessarily mean that fewer people will be infected from start to finish, but it probably does mean that the outbreak will be extended to spread our resources out over a longer period to allow for replenishment. Simply put, we are trying as hard as feasibly possible to keep the disease from “going viral,” so to speak.
The most valuable health care resource that we have is our people. While many of the radiologists on my campus can work from home, our technologists are on the front line. These are the individuals who are up close and personal with the pandemic. Radiologic technologists must often move from ward to ward, taking x-rays on every type of patient in the hospital, including the emergency department, with no limit to whom they are exposed to. Ultrasound technologists work very closely with patients, typically spending minutes draped over them in close contact while they get their images. Technologists in MRI and CT are often brought patients with limited clinical history. Nuclear medicine technologists routinely handle vaporized chemicals that patients inhale to test their lung function. The dedication and sacrifice of these individuals cannot be overstated.
With the explosion of the novel disease, some radiographic findings associated with the infection have become known, but we must be cautious in interpreting these findings. Neither CT, nor ultrasound, nor radiography uncover findings that are specific for the infection, as the findings can often mimic other disease processes or other types of infections. We should not use radiology as a substitute for FDA-approved testing methods and reserve it for complicated infections instead.
Many facilities are taking a proactive stance by splitting their personnel into groups that stay together such that there is less likelihood that an entire department is exposed. In this way, designated crews work every other day or a few days on and a few days off. Some jurisdictions have enacted regulations to stop non-essential medical procedures. Nonetheless, people still have emergencies unrelated to the virus. Appendicitis hasn’t gone away, many Americans still use the emergency department for primary care, and some forms of interpersonal violence are increasing as a result of being cooped up. Unsuspecting asymptomatic hospital visitors and waiting room companions may be as great a risk to our hospital heroes as the patients themselves.
Still, I am reading tales on social media about workplace supervisors asking employees to come in even if they have a fever and, in at least one case, after exposure to a known novel coronavirus patient. We need to be careful. Our occupational health offices are stressed out. We need to be proactive about keeping the ill isolated and erring on the safe side.
This virus does not have a nationality or personality. It is a human disease, a disease that is likely to worsen according to our surgeon general, the federal face of public health in the US. As humans continue to live longer and choose to live closer to each other in urban settings, new infectious diseases will take advantage of these snowballing population densities and crop up in greater frequency. The next one may be deadlier, spread more easily, and/or remain indolent for a longer period, evading detection before millions are carriers. What we are witnessing right now very well maybe just an audition for something worse. Please keep this in mind after this current situation has abetted.
I have seen a few restaurants converted to take-out only in which management has taken the responsible step of marking 6-feet-apart lines on the floor with limited entry into their facilities. As our economy has taken a hit, I implore my physician colleagues and those with greater means to be as generous as safely possible to the business owners who are suffering but trying to stay afloat.
How can the general public help our health care professionals? We must stop stealing protective equipment from hospitals. Our health care workers need these things, not only to protect themselves, but they use it to prevent spread to other patients. The noble individuals who dedicate their lives to health care will come into contact with many vulnerable people in the course of fighting the pandemic. Please follow guidelines about who should come to the hospital and who should not. Communicate with your primary care doctor and employee health resources. They may instruct you to stay away from the hospital and seek testing through another means if appropriate. If you have non-emergent concerns, please look into telehealth options for treatment.
Just realize that in order to preserve our best options to fight the novel coronavirus, respect the individuals who signed up to work on the front lines to protect the public at large. The life they save maybe yours, but this may not happen for weeks or months. They have others to help in the meanwhile.
Cory Michael is a radiologist.
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