Dr. Lawrence Ong says he has a contingency plan for when he’ll inevitably get hit with the coronavirus. He’ll retreat to the family nursery while his wife and three small children hunker down in the rest of their Los Angeles home. If things get really bad, he’ll have them escape to the safety of his parents’ or in-laws’ houses.
The Long Beach Memorial Medical Center anesthesiologist knows that every day he reports to work on the frontlines of the pandemic could be the one that gets him sick and endangers his young family. So he’s already preparing himself—psychologically and logistically—to be separated for months from his loved ones as COVID-19 threatens to overwhelm the region’s hospitals.
“This is our reality,” Ong said in an interview. “This is an existential threat, and we’re seeing it every day.”
At this moment, no Memorial employees have been diagnosed with COVID-19. Still, Ong is not alone in his fears of being felled in the workplace or in his deepening worries that the personal protective equipment being provided to healthcare workers is inadequate to protect them and their families from the highly contagious virus.
Like other hospital health-care workers here and across the nation, Ong believes it’s just a matter of time before he and many of his co-workers become ill, dangerously eroding the ranks of those confronting the exploding numbers of COVID-19 patients.
In fact, a review of social media posts and interviews with Memorial doctors and nurses, many of whom requested anonymity to speak candidly, reveal a growing unease about their personal wellbeing.
Among other concerns, they worry that a national shortage of respirators and masks—as well as conflicting information on what gear is required to prevent infection—will lead to employees getting sick.
Some also acknowledge that they are struggling with the mental and emotional strain of working with COVID-19 patients. As a result, they’re taking leaves from work, using up vacation hours or forgoing pay altogether to stay home and avoid becoming infected. Some say they might not return at all.
“I cry everyday that I leave,” confided one Memorial nurse who works in the intensive care unit, where the worst COVID-19 cases will likely end up. “I can’t even think about having no PPE (personal protective equipment) because I already feel so stressed about the volume of patients we are going to get and I lack confidence in there being an appropriate number of nurses to take care of them.”
Another longtime Memorial nurse, who has taken a leave from the hospital because of the virus, is “terrified” by reports from colleagues back at the hospital about a purported lack of protective equipment. “I’m not sure if I can go back if it doesn’t get better,” the nurse said.
In the face of an uncertain PPE inventory, Ong created a homemade air purifier respirator he saw online. It’s the kind of protection he thinks should be worn when patients are being intubated for a ventilator, a procedure that can create aerosolized droplets when a tube is inserted in a coronavirus patient’s throat.
Full isolation suits, like those seen being worn in news reports by doctors in China, South Korea and Italy, can cost thousands of dollars. Ong says his team has only one of these kinds of hooded respirators for a team that typically consists of four people. That means the other three could be at risk for the aerosolized virus during intubations.
Ong built his respirator hood out of a plastic bag, rubber band, plastic tubing and an oxygen tank. Instructions in a photo posted on Facebook last week noted that a visor could be crafted out of a plastic soda bottle or food container.
“You kind of feel like you’re on your own,” Ong said. “I don’t have a whole lot of faith that organizationally someone is looking out for us or understands what our day looks like.”
In an email to the Post on Friday, Memorial said there currently is no shortage of personal protective equipment and that it is following guidelines from the Centers for Disease Control and Prevention. The email said that hoods like the one Ong built from scratch are currently not included in CDC’s recommendations.
“At this time, we have the supplies that we need to care for our patients,” the hospital said. “Every care team member is wearing protective equipment in patient care areas and we are being very diligent in how we use them.”
But guidance from the CDC has been fluid. In previous weeks, for example, the CDC recommended that paper surgical masks should be worn around COVID-19 patients. This week the agency shifted its stance, saying that healthcare workers should use the more secure N95 masks, an item that has been in short supply nationally.
As of today, there also seems to be varying, uncoordinated responses among hospital staffers who’ve treated patients they suspect may be infected. One nurse said that half of a team that worked on a suspected coronavirus patient later self-isolated, while the other half returned to work. The patient’s test came back negative 12 days later.
Memorial said there is no protocol for employees to quarantine after working on potential COVID patients if proper PPE is being worn.
Some healthcare workers say that better communication between the hospital administration and its employees could ease lingering doubts and haunting fears among them about whether they’re being safely protected in the workplace. They want to know crucial information such as whether respirator masks are sufficient, as well as the daily levels of supplies.
Dr. Brett Rosen, a local emergency physician who works in hospitals from Culver City to Long Beach, said he bought his own industrial grade respirator mask because he didn’t want to depend on a hospital to provide it for him.
Rosen said that getting a positive COVID-19 case sends “a jolt through your body” because of its highly contagious nature. He said that it takes a certain sense of humor to work in the emergency room but that the typically fun staffers these days are somber with an apparent sense of impending doom.
“We all signed up to do this job,” Rosen said, “but nobody signed up to be a martyr.”
The Washington Post disclosed last week that the government had received reports of more than 60 infections among U.S. healthcare workers, a number likely to grow as more patients are hospitalized and testing is expanded.
Ong said that if significant numbers of workers are infected by COVID-19, it could be disastrous for those remaining on the job, who would likely be working every day, even if they had just completed a 24-hour shift. “If you’re on call,” he said, “you should assume you’re coming in.”
To confront this potential problem, states are dropping restrictions so that doctors and nurses can work across state lines. This could clear the way for infected employees to be quickly replaced with qualified professionals.
Beyond the hospital walls, Ong said it’s the public at large that can make perhaps the single biggest contribution to the lives of their hospital workers by social distancing and staying home.
“While leaving your house might give you a momentary relief of cabin fever,” Ong said, “it could cost someone their life.”
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