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ER Doctor In Seattle, An Early COVID-19 Epicenter, On The Challenges Ahead
Tuesday, March 24, 2020
NPR's Ari Shapiro talks to Dr. Sachita Shah, an emergency physician at Harborview Medical Center in Seattle, about the challenges of the coronavirus response for hospitals and doctors.
ARI SHAPIRO, HOST:
Seattle had one of the earliest outbreaks of COVID-19 in the U.S., which means doctors there have been on the frontlines of this battle the longest, dealing with issues that other parts of the country are preparing for now - a flood of contagious patients, shortages of important supplies.
Dr. Sachita Shah is an emergency physician at Harborview Medical Center in Seattle, and she's with us now.
SACHITA SHAH: Thank you.
SHAPIRO: Can you just start by telling us what the ER is like these days?
SHAH: It's dramatically changed. We were primarily a Level I trauma center before COVID, taking care of the five-state region, including Alaska, of trauma patients. We were also the county hospital taking care of our city's most vulnerable populations, a lot of the homeless. And I just worked yesterday, and pretty much all of my patients are in respiratory and contact precautions now. They are coming in...
SHAPIRO: Meaning when a doctor wants to interact with them, you have to put on a full kit. What does that mean, exactly?
SHAH: Yes. Yeah, we have to put on a gown, gloves, mask, eye shield.
SHAPIRO: And do you have enough beds and ventilators for all the patients who need them?
SHAH: We have enough ventilators at our hospital. One of the other hospitals in our region has closed, and it ran out of ICU and ventilator capacity.
SHAH: Other hospitals are getting full. We do have several patients on the vent with COVID. I think the main problem has been that they are staying on the ventilator for quite some time.
SHAPIRO: So as new patients come in, there just aren't enough for the new patients as well.
SHAH: Right now, we have enough. But we just - we have no idea the numbers that are coming. We saw a sharp uptick yesterday. We also know we have supplies, but we don't know when we'll have resupplies.
SHAPIRO: Yeah, I was just going to ask about protective gear. You describe everything that you have to wear when you interact with those patients. Do you have enough of that?
SHAH: Here in America, we're used to using things once and throwing them away. That is no longer happening. We are wiping things down and reusing the things that are safe to reuse. And we still have enough as of today, but it's being strictly controlled. We just - I just got off a two-hour phone call meeting with 50 colleagues and our infection control leadership about PPE, which is personal protective equipment.
SHAH: They have to control it to make sure we have enough. We don't want to run out. But also, we're holding our breath walking by curtained rooms where patients are in precautions with masks...
SHAPIRO: You are holding...
SHAH: ...That are under their chin.
SHAPIRO: ...Your breath as you walk by a room with a COVID-19 patient in it. How afraid are you of catching this disease?
SHAH: I think our colleagues are afraid of - for our patients. We're afraid for each other. I'm afraid for myself. I'm a single mom. I'm afraid to leave my kids without a parent. This week, we started taking care of our own. You know, our - some of our residents are sick, some of our nurses. So it's - that's kind of hitting home, I think, this week for all of us - just that a proportion of us will get sick. This is a disease of health care workers, too.
SHAPIRO: Of course. And as a single mother whose children are also home from school, are you taking extra precautions when you get home and, of course, you want to go hug them?
SHAH: Yeah, they're sort of used to not touching me when I get home from working at a trauma center.
SHAPIRO: Oh, wow.
SHAH: They're 6 and 7, so they're very cuddly. But we've all been trading stories of our post-work ritual. And I'm pretty meticulous. I change once at work into other scrubs that are clean. I don't leave my shoes in the house at all. I strip pretty much naked, run straight to the washing machine, throw everything in and then run straight to the shower and do a head-to-toe before I interact with my family. And pretty much all of us are doing that. Lots of the bearded guys in Seattle have shaved their beards so they can fit into an N95 mask.
SHAPIRO: How will anybody know that they're in Seattle if the people with beards have shaved?
SHAH: (Laughter) I know.
SHAPIRO: So do you have advice for doctors in other parts of the country that are just starting to see the outbreak and might be a few weeks behind where Seattle is right now?
SHAH: I would pass along the advice that I've heard colleagues from Italy and Spain give us - is just get ready. It's going to be bad, and it's going to take a lot of patience. It's going to take a lot of working with infection control. And you'll not feel protected enough. It feels like being in battle without armor. But we have fortitude, and this is what we trained for in emergency medicine, and we'll get through it. But it's hard.
SHAPIRO: Do you see your hospital heading toward a breaking point, or do you think you've passed the peak of cases? Like, where do you think you are?
SHAH: We absolutely have not passed the peak. I think we're just beginning to see who got infected two weeks ago. People are staying home for several days with symptoms, and they're coming in when they're really sick. We just had a shelter-in-place order put forth yesterday, so we won't even see the benefits of that for a couple weeks. So...
SHAPIRO: Dr. Sachita Shah, an emergency physician at Harborview Medical Center in Seattle.
Thank you for the work that you're doing and for speaking with us about it.
SHAH: You're welcome. Thank you. Transcript provided by NPR, Copyright NPR.View this story on npr.org
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