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THREAD on my new op-ed in WaPo
1/ I spent the last 2 weeks on clinical service in our emergency room #covid19 pod.
Caring for patients was tough, but it was even tougher knowing that sending them back home would likely mean infecting their families. https://www.washingtonpost.com/outlook/2020/04/21/isolate-home-coronavirus-quarantine/
1/ I spent the last 2 weeks on clinical service in our emergency room #covid19 pod.
Caring for patients was tough, but it was even tougher knowing that sending them back home would likely mean infecting their families. https://www.washingtonpost.com/outlook/2020/04/21/isolate-home-coronavirus-quarantine/
2/ So many patients shared the exact same story- index case was a healthcare worker or other front line worker who got sick on the job. They tried to take care of themselves at home; got more ill; family tried to both avoid them/help them; family got sick as well.
3/ This was particularly devastating when it ended up that a son or daughter accidentally infected their parents, some of whom were old and had comorbidities, became critically ill, needing admission +/- a ventilator; some even dying within a couple of days. This was really hard.
4/ Over time, I realized that asking people to home isolate when they are sick is cruel if they don't have a way to safely do so.
I saw people in tears because they didn't want to infect their families. Discharging them home meant 3-4 more cases would be back in days.
I saw people in tears because they didn't want to infect their families. Discharging them home meant 3-4 more cases would be back in days.
5/ Getting this wrong has a high chance of worsening health inequities.
People living in cramped spaces are more likely to be from challenging socioeconomic backgrounds- people who already are having more severe disease because of our failed and discriminatory systems.
People living in cramped spaces are more likely to be from challenging socioeconomic backgrounds- people who already are having more severe disease because of our failed and discriminatory systems.
6/ Some places are repurposing spaces- Boston has done that with our convention center, turning it into 1000 bed field hospital (500 reserved for homeless #covid19 patients).
New York and SF have used hotels, and I know that many dorms are empty and may provide space.
New York and SF have used hotels, and I know that many dorms are empty and may provide space.
7/ In China and other places, centralized isolation was a key part of their strategy to slow down clusters at home, which were noted to be an early driver of their outbreak in #Wuhan
Singapore, w/ a new resurgence, has also used a major expo center as a field isolation facility
Singapore, w/ a new resurgence, has also used a major expo center as a field isolation facility
8/ I think that all states should really be making sure they have central isolation options for people who can't safely isolate at home (the more people in less space, the more likely you can't safely isolate).
This should *not* be mandated, bc it can really harm families.
This should *not* be mandated, bc it can really harm families.
9/ There are many situations in which isolating away from home is just completely unrealistic (people who are the sole caretaker of their loved one, for instance); these situations are immensely tough and hopefully family and community support can fill some gaps.
10/ Thanks to @washingtonpost @cshea4 for giving me space to talk about this critical issue-- one that I think most places are dropping the ball on. I wrote this one night well after my shift because writing is a part of advocating for your patients.
Don't waste that chance
Don't waste that chance
