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“It doesn’t need to be, though. When we have healthier physicians, we have healthier patients, and when we have healthier patients, we have healthier physicians,” she explained.
“We have to remember that we can’t take care of our patients if we can’t take care of ourselves. My hope is that one of the things that comes from this terrible time is that nobody doubts whether a person is committed to the care of patients if they raise a concern about safety,” Barrett said.
Poorman said she agrees, emphasizing that the core principle of physician safety in this viral crisis boils down to saying no. “Doing nothing may be the hardest thing you ever had to do in your life,” she acknowledged.
“But during the Ebola crisis, many physicians did run in to help patients who were crashing, saying, ‘PPE be damned, my patient needs me’,” Poorman reported.
Then, as an Ebola responder once wrote, “they became infected and they infected others and then they died. They didn’t help anyone after that.”
That same responder stressed that “there is no emergency in a pandemic.” Let that be a mantra until this is over.
A central tenant, then, for all clinicians is to not become a vector of the disease themselves. This happened in China when healthcare workers did not understand what they were dealing with at first and had no protocols in place to protect themselves or their patients. As a result, initial rates of nosocomial spread in China were very high.
In Italy, an early epicenter of the pandemic, 74 physicians had died by the first week in April, largely because they lacked the PPE needed to keep them safe. And more than 2600 nurses have been infected with COVID-19, according to the International Council of Nurses, which is approximately 10% of all COVID-19 cases reported in that country.
At the beginning of April, Spain was reporting the highest number of COVID-19 infections among doctors and nurses anywhere in the world. At the time, approximately 15,000 healthcare workers were sick or self-isolating, which is about 14% of all confirmed cases of COVID-19 in that country. Spanish physicians and nurses have repeatedly complained that they don’t have enough PPE to treat patients safely, and government officials have acknowledged that the lack of PPE might have contributed to the high rate of infection among medical professionals.
