An emergency room physician, who I interviewed recently, rented an Airbnb to protect his wife from the virus. He is now separated from his family, alone and fighting to keep safe in New York City, with limited resources and PPE  or personal protection equipment. When we turn what is vital to our physician's protection into an anacronym, PPE, it loses intensity and meaning. The words "personal protection" is also a misnomer ...

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When I was 18, I decided I wanted to be a doctor.  I wanted to help people.  I wanted to make things better for others.  So, I studied hard in college.  I couldn’t afford to pay for test prep classes for the medical school entrance exam, so I studied on my own.  I would lock myself in my room and study for six to eight hours at a time for ...

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It's 8 p.m., and I stumble into my apartment and fall into bed. Somehow, I avoided nodding off in the car driving home. I just finished a 36-hour shift, something I thought was an inhumane task. Somehow, I survived on two hours of sleep, incessant phone calls, pages, and a granola bar. This morning I saw a cat in my apartment, except I don't have a cat. I fumbled through patient care all ...

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In between snippets of conversation exchanged with my husband about how the first day of remote learning went for our 9 year old and whether the latest nanny was likely to quit given health risks associated with working in a two-physician frontline worker household in the context of COVID-19, we also discuss some potentially dangerous scenarios. The discussion is quite mundane, between what we are having for dinner and how ...

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As the medical director of a Midwest community emergency department that has yet to see the New York City-levels of devastation, I am begging hospital administrators across the country to begin leading their front line health care workers in preparation to meet the enemy head-on. It has become painfully clear in our hospital daily incident command briefings and discussions with our hospital leadership that no one is making decisions. The decisions ...

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Growing evidence suggests that the novel COVID-19 virus can be aerosolized.  To adequately protect employees, providers require not just “droplet,” but “airborne” precautions and the appropriate healthcare worker personal protective equipment (PPE). Appropriate PPE mandates an N95 mask. News reports for weeks have described hospitals working without the necessary protection for health care providers. This is the case in Boston-area hospitals, which are running short on these masks. One of the city’s ...

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I’ve been reading a lot of posts expressing disappointment with the way that COVID-19 has been covered in the media and worry about the economic consequences of prolonged social distancing. This is long, and you might not care, but here’s my perspective as a former ICU nurse that witnessed many deaths, a nurse anesthetist who is dealing with both the administrative headaches that go with dealing with this disaster and ...

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“It’s a strange time to be having a baby,” my patient said as she sat alone in her labor room. The state order to shelter-in-place in California had left her family with few options as her husband had to stay home to take care of their toddler. She is one of many pregnant women who do not have the choice to even consider a home birth due to her congenital ...

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Social distancing. It is a mantra that seemed to have been plucked straight out of obscurity for those who had never heard of it before just as the coronavirus pandemic dug its ugly claws into the fabric of American life. And since then, it has been perfusing our cultural ether for the last several weeks—aggressively occupying the webpages across the internet, leaping onto the headlines of newspapers, and frequently serving as ...

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My friends ask me how I’m doing.  The short answer is always, "We’re OK."  But the real answer is much longer. I feel a lot of anxiety these days.  It’s always there, sometimes with more intensity than others.  But a constant, ever-present, lurking beneath our routine. Like everyone else, sheltering in place is a component of it.  There are the combined aspects of keeping my four children entertained, keeping them from fighting, ...

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On Doctors' Day, my hospital celebrated our work by giving us each a pair of cheap headphones, and also announced the death of an attending. Though the personal risk to each of us was highlighted by the recent death, the administration did not give hazard pay, or PPE comparable to other countries', or even a guaranteed supply of isolation gowns. Just headphones a different color than the ones they gave ...

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On the front lines, America's emergency departments (ED) are currently in at the center of a crisis treating patients with COVID-19.  Emergency physicians and other clinicians are placing themselves and their families at risk. Yet, there is also another important crisis facing hospital-based EDs: surprise billing legislation. Certain forms of surprise billing legislation have the potential have a substantial and negative impact on how America’s EDs are supported, and our ...

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Testing for novel coronavirus is still a serious issue in the U.S. due to a lack of lab capacity, test reagents, nasal swabs, and even personal protective equipment for health care workers. Due to these shortages, the CDC is recommending that COVID-19 testing should not be performed on patients without symptoms and instead be prioritized for: 1. hospitalized patients and symptomatic health care workers, 2. patients ...

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In times of disaster, marginalized groups often become even further marginalized. Both those of lower socioeconomic status and those with disabilities often are left out of emergency planning, as is evidenced by the current COVID-19 pandemic. From access to testing to ability to acquire needed goods and services to triage policies being adopted from community to community, those with lower SES or ...

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During the influenza epidemic of 1918-1920, my great-grandfather, Ralph Norton Mitchell, was in the military. He helped stack the corpses of those who had died from the infection. I shudder to think about what type of personal protective equipment he used. However, his survival reminds me of a feature of all epidemics--some individuals have or develop immunity, and those who have immunity can “do the work.”

Currently, we are ...

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About a decade ago, I had my first doctor-client. And part of what they wanted to discuss was budgeting in order to save more. They just got new jobs and wanted some general planning for the sake of making good decisions. Software for budgeting and spending history didn't exist the way it does now. I wanted to provide the best help I could on this topic, and I knew about budgeting, ...

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This is a frightening time. The coronavirus is called “novel” because it is new, and what is new is often terrifying. We don’t know enough about our new microscopic enemy. Scientists, clinicians, and policymakers are all working tirelessly with limited data and learning along the way. Consider that many diseases that we regularly face have been observed, reported, studied, and treated for decades; some for centuries (although with less success than now). Novel coronavirus ...

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COVID has taught me many things in and outside of medicine.  Most importantly, it has taught me that the medical field is a family.  There is nothing that drives a family together like a crisis.  For those of us on the front lines, I’m raising a pint of the finest for you!  That “front line” not only includes the doctors, nurses, and staff caring for patients sick with COVID.  It ...

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“You are a hero! “ “Thank you for all you are doing!” It is overwhelming and tremendous; it is touching and heartwarming; it is genuine and sincere.  The outpouring of support and love for health care workers and first responders has been a bright light in the dark days of the coronavirus.  But I have been forced to wonder: What has really changed?  OK, before you get outraged by that statement, hear ...

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I am writing this a bit selfishly as part of personal catharsis, and it has been helpful serving that purpose and helping me better understand what I am experiencing. If, however, some of it strikes a meaningful chord or you have some critique or suggestions, then, of course, I am delighted to hear from you.

While we all are under stress, I have been feeling angst I ...

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