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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/">https://www.washingtonpost.com/outlook/2...
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/">https://www.washingtonpost.com/outlook/2...
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& #39;t have a way to safely do so.
I saw people in tears because they didn& #39;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& #39;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& #39;t safely isolate at home (the more people in less space, the more likely you can& #39;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& #39;t waste that chance
Don& #39;t waste that chance
