Have you ever played a game with a six year old? If you have, you can probably relate to the experience of feeling like the rules are being made up as you go and are subject to change at a moment's notice to better suit said six year old. Now imagine that game is not a game, but a real life scenario with life or death consequences. Are you starting to feel stressed? Anxious? Panicked even? Well, that is what it feels like working in healthcare right now, in the midst of the Corornavirus crisis, here in the United States.
Since 1946, the Centers for Disease Control (CDC) has been the guiding force behind widely adopted standards and protocols for dealing with various communicable diseases in America. We look to them for precautions and safety measures to protect our country from outbreaks of things like measles, influenza, HIV, tuberculosis, and even Ebola when that became a potential threat here in 2014. Healthcare workers rely on their advice to know how to best keep themselves and coworkers safe when providing care to patients with transmittable and life-threatening conditions. All in all, the CDC has been a trusted name in what to do to prevent an epidemic. So, what happens when the gold standard of disease control suddenly starts making recommendations that are decidedly and definitively sub-standard?
If you follow the news at all right now, you are well aware that one of the biggest issues facing healthcare workers in the midst of this pandemic crisis is an overwhelming shortage of personal protective equipment (PPE), including surgical masks, N95 respirator masks, face shields, goggles, isolation gowns, and even gloves. After speaking with colleagues, I can assure you that far more than we are afraid of this virus, we are extremely frustrated by this utter lack of protection. We watch the news and see healthcare workers from other countries donning full protective gear including what we collectively refer to as “the hazmat suits”, while we who work here on the front line in hospitals and clinics are being told there aren’t even enough surgical masks to go around.
Even more frustrating and mind-boggling, is the willingness of the CDC to issue or change safety recommendations on a whim to downplay and distract from the seriousness of this shortage. Over the past three weeks this has caused massive confusion and contention not only in the medical community, but also in the general public, as conflicting information has been shared, retracted, and then reiterated. For example, about three weeks ago when all of the COVID-19 news started breaking, the CDC released a statement essentially saying that regular surgical masks should not be used to prevent a person from contracting the virus, but rather to prevent a sick person from passing it on. That statement is not problematic in and of itself, but it became a problem when contradictory advice was given to healthcare workers regarding the efficacy of surgical masks. According to the CDC’s most recent statement, surgical masks do indeed provide sufficient protection for the healthcare worker treating a COVID-19 positive patient, and moreover, patients need not wear a mask unless they are being transported. The fact of the matter is, we all know that only one of those statements is true.
According to recent studies, the warnings of prominent infectious disease physicians, and the World Health Organization, COVID-19 can remain airborne for up to three hours under the right conditions. This means that standard surgical masks just aren’t good enough for healthcare professionals who face imminent exposure. In fact, the Occupational Safety and Health Administration (OSHA) states that respirators are necessary to adequately protect any individual who comes within six feet of an infected person. So why haven’t we all adopted that practice?
Unfortunately, instead of stepping up to protect employees and advocating for the safest possible measures, this constant flip-flopping has only allowed hospitals and clinics to cut more corners when it comes to precautions, putting healthcare workers at increased and, dare I say, unreasonable, levels of risk. All medical personnel from physicians to aides have been forced to abandon normal operating procedures and adopt unsafe and ineffective PPE practices, including the reuse and even sharing of “single-use” masks and gowns between coworkers. This behavior puts not only the employees at risk, but also non-Covid-19 patients who come in contact with those employees who could be carrying the virus on their unprotected clothing and skin. Unchecked, it will send us into a cycle of infection that we will be helpless to stop. Sick patients will infect healthy employees, who will then infect their coworkers, patients, and family members, who will then infect others they come into contact with, and it goes on and on until there aren’t enough healthy providers to care for all of the sick patients.
When you choose a job in the medical field, you do so acknowledging and accepting a certain amount of risk, but you also do so knowing that you have protocols and equipment in place to minimize those risks to yourself and those around you. Currently, we lack the knowledge, skills, and equipment to deal with this virus in a way that minimizes our risk, and neither the CDC nor the healthcare systems are doing anything to improve that situation. At this point, it feels like we are being sent into battle without any armor, and the scariest part is that the enemy we are fighting doesn’t stay on the battlefield. It follows us home and it threatens our family, our friends, and community.
At this point we are all left with unanswered questions, feeling vulnerable and angry, and being forced to choose between our family, our health, and our job. Right now we can’t protect all three. So, what do we do now? The answer to that question will be written in history. Will we be remembered as the generation of medical professionals who stood strong, protected and advocated for one another, and successfully fought the greatest pandemic of the century? Or will the legacy of American healthcare in the year 2020 be that we kept our heads buried in the sand until s*** hit the fan and we had to wing it?
