I am an ER doctor, and my husband is a pediatrician. This story starts two weeks ago when COVID-19 was first changing all our lives. I am a travel doctor and was returning home. I saw a few patients that I was sure had COVID-19 (later confirmed). Fortunately, I worked in one of the rare ERs that had enough PPE, and I had worn it with each of those patients, so I wasn’t too worried. Little did I know what was coming.
Returning home Sunday afternoon, exhausted after working 7 of 8 days, I worried about bringing COVID-19 into our home. Neither of us had active symptoms, but we decided to sleep in separate rooms and use separate bathrooms for two weeks until my possible incubation period ended. This proved to be a crucial decision that kept one of us well. Monday morning, my husband went to work feeling fine, but by that evening was achy and could barely keep his eyes open. By Tuesday morning, he was clearly ill, sleeping all day and suffering from body aches when he woke. There was still no fever or cough. When I checked on him that night, he asked if one of his calves felt cold. He had paresthesias, a sensation he also described as an ice cube in the middle of his back. The next morning, an article came out about a local nurse with similar symptoms that had tested positive for COVID-19. We decided he needed a test for COVID-19, and the health department agreed. He hasn’t left our house since that day.
I had already initiated the second phase of strict home infection control/quarantine on Tuesday. I wore a mask and gloves every time I went into the “hot zone” (our bedroom/his prison), used bleach solution daily on common surfaces/doorknobs, and ran the dishwasher/washing machine on sanitize. For the next several days, my husband continued suffering from body aches and debilitating fatigue. I took him meals and fluids (while masked and gloved), but otherwise, we lived separately in the same house. COVID-19 was confirmed Saturday, three days after his test. That was eight days after his “prodrome,” 3 hours of cough and aches he remembered from 2 days before I came home. The next day, day 10, he seemed to be improving, making it outside for a few minutes and holding a short conversation! We had our first scare a few hours later.
That night, I woke to knocking on my bedroom door. My husband stood there, masked and gloved, saying he couldn’t breathe. His breathing was fast and labored with an oxygen saturation of 88 percent (98 percent or above is normal). His lungs sounded clear, but he wasn’t moving enough air. As doctors, we weren’t going to the ER unless I felt he couldn’t breathe without support, so I started thinking about how to open his lungs and remembered the incentive spirometer (IS), a device that encourages slow deep breaths to force in more air. I got in touch with a nurse practitioner friend and monitored him closely overnight. My friend left the IS at our door several hours later. We managed to stay out of the ER. Now he is making improvements but still gets short of breath talking or with even small amounts of activity. There have been several repeated scares when he was struggling to breathe, and I almost took him to the ER. He is a young, healthy person. Day 15 and quarantine continues.
I never imagined COVID-19 would enter our house this way. My job is much more “high risk” for exposure. My husband did not have any definite sick contacts, and he had not traveled. He got sick before community spread was confirmed in our area. Dealing with the threat of this virus at work and now in my home has been a double whammy. I have not been able to hug, kiss, or even touch my husband in almost two weeks. I wear gloves and mask just to look in at him. I think about every move I make, every object, surface, and doorknob in our house that must be cleaned daily. I can’t even have a conversation with him because he gets short of breath after a couple of minutes. Every day is lonely, even though I’m not alone. Every day I remain healthy and without symptoms is a victory. You do not want this invisible enemy in your home. You do not want to watch someone you love struggling to breathe, wondering if they will end up hospitalized on a ventilator, dying scared and alone. With Easter fast approaching, my fear as a physician is that those who don’t know anyone that has been infected will think it’s OK if “just their family” has a traditional family dinner, or “just a few families” have an Easter egg hunt. That would undo all our social distancing efforts and the curve we have all worked so hard to flatten. It would bring New York’s nightmare into our own towns.
Soon I will be clear from quarantine and back in the ER. I don’t want to stand, covered head to toe in PPE, over your terrified loved one telling them we must sedate them, paralyze them, and insert a breathing tube. Put yourself there: it must be the worst kind of fear, lying helpless and alone on a cold, hard stretcher struggling for air. I don’t want to pronounce your loved one dead after our valiant efforts fail. My plea is for Americans to maintain social distancing, stay home, and avoid the ER unless it’s necessary. It is working, but we must keep up the fight. I have practiced emergency medicine over a decade, and we never have as health care professionals asked the public for anything. Well, now we are asking, and your choices as a person, as a community, city, and state matter. It is quite literally life and death.
Raina L. Shanks is an emergency physician.
Image credit: Shutterstock.com
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