Dr. Rajiv Bahl talks about life as an emergency medicine physician in the midst of the COVID-19 pandemic.
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The emergency department and its staff are known for being able to handle almost anything that comes their way. The emergency department is both the front door to the hospital healthcare system and the safety net when all else fails.
If your primary doctor can’t see you, their office tells you to go to the emergency department. When you’re in dire need, 911 dispatches paramedics to take you to the emergency department. When you don’t know where to turn for your health, you turn to the emergency department.
As an emergency medicine physician, I understand this. It’s part of the job to take care of those during their time of need or when they don’t know where to go — even in pandemic situations when other work environments are closing.
There is no way to avoid the news about the coronavirus. Every day there are new cases, governmental actions, and advice on what to do if you are concerned you have the virus.
As the illness and anxieties increase, the topics of conversation have shifted with my patients, friends, and family. I used to regularly get questions asking about the tales of trauma but now an overwhelming number ask me about the coronavirus. There’s an underlying anxiety where many just want to hear that it is going to be okay.
When the news initially broke about the virus, patients wanted to get checked out “just in case.” Some didn’t have any symptoms, but the fear of the unknown was looming.
Some attributed the signs of a sore throat for just a few hours to the potential of the virus.
The symptoms that people normally would have just waited on brought them to the emergency department in waves. With just a few hours of symptoms with no other risk factors, it was hard to find a culprit let alone physical exam findings, but the conversation about coronavirus was many times what patients were looking for. Patients were scared, and they turned to the emergency department for help.
The simple requests of just wanting to get checked out are turning into demands for testing. Some with symptoms, many without.
As the virus continues to spread and offices, schools, and even theme parks begin to close, many have employers demanding that they get tested. It can stem from something as simple as having a child at home with a cough and the parent’s employer requesting them to get tested before they come back to work.
These additional pressures, for many patients without symptoms, are putting unnecessary pressures on the healthcare system. In some communities there currently are not enough tests available to casually test everyone who wants one.
As the public hears more about the virus and ways to protect themselves, my colleagues and I go to work on the front line treating and testing patients.
There are daily algorithms, meetings, and conversations on how to best treat patients — not only on a patient-by-patient basis, but how to prepare and manage larger pressures to the overall healthcare system as the number of infected patients begins to increase.
Many urban emergency departments and hospitals are already operating at maximum capacity — and with this virus, those hospital pressures are only going to rise.
Some physicians are starting to wonder if there are going to be enough testing kits, ventilators, or even protective equipment for those taking care of patients. Just as masks, disinfectants, and paper products are limited in stores, there are limited quantities in hospitals. There are even questions around what is going to happen if many of the emergency room, infectious disease, or critical care physicians or their families get infected.
Despite all the precautionary measures, there is still a likely chance that I personally will contract the coronavirus.
Many emergency physicians experience upper respiratory infections during the winter months as invariably a patient will cough or sneeze on us. This is a known risk to the job.
Fortunately, with the information we have today, my likelihood of dying or becoming critically sick from the coronavirus is low as I am considered young and relatively healthy. Protecting those who are older in the healthcare community is important to ensure we have their help and knowledge as the virus progresses.
As healthcare providers, we sometimes take part of our jobs home — both mentally and physically. The front line of healthcare becomes the general public when we leave the hospital.
My wife, who is pregnant with our first child also works as a physician assistant in the ICU, and this is the nature of our lives. There are added hazards with our jobs, and while we are passionate about patient care, healthcare workers need the public’s help in keeping healthy as well.
Although there are lingering questions, the mantra for many physicians is the same — continue providing care of patients like normal, no matter their concern.
Though, if you are not experiencing advanced symptoms — you should be avoiding the emergency department.
Just because the coronavirus is the most popularized health concern of the day, heart attacks, strokes, and other traumatic injuries still come in the doors of emergency centers. There are a limited number of beds and resources, and the public’s mindful use of facilities is important during this outbreak.
Being pragmatic in understanding the severity of your condition can truly make an impact on others. Unnecessary use of paramedics for mild or chronic conditions hurts the overall healthcare system. It slows emergency personnel who are trying to care for those that are critically ill, and it can deplete resources such as masks and respirators that are already on back order in some healthcare environments.
If you are concerned, there are coronavirus hotlines for each state — many times associated with your local hospital facility. Also, this could be a great time for many to use telemedicine to quickly speak to a physician about your concerns and decrease the burden on emergency departments for mild virus symptoms or even chronic conditions.
As an emergency medicine physician, I am asked regularly if patients should worry. While I would like to say that they shouldn’t worry at all, the reality is, being prepared proves more fruitful than being under prepared. There are number of variables that are unknown with this virus however prevention and mindful utilization of healthcare resources are key — not only for yourself but other vulnerable populations as well.
Dr. Rajiv Bahl, MBA, MS, is an emergency medicine physician, board member of the Florida College of Emergency Physicians, and health writer. You can find him at RajivBahlMD.