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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