Health care workers have an increased risk of exposure to COVID-19.

Health care workers have an increased risk of exposure to COVID-19.

Health care workers on the frontlines of the battle against the coronavirus can’t practice social distancing with patients who require hands-on care.

That’s a stress they deal with at work, but also one they take home, knowing how easily this virus jumps from person to person. Health workers can’t help but put their spouses, partners, children and roommates at a higher risk, because of their own exposure to patients.

It’s an emotional toll on top of the burden of fighting a virus that spreads quickly and kills especially cruelly, and against which an increasing number of medical workers don’t have proper personal protection.

How are health care workers balancing the need to take care of patients, and the need to protect themselves and their families?

Produced by Lauren Markoe

Guests

  • Dr. Leah Braun Family Physician; La Clinica del Pueblo; @LaClinica2
  • Dr. Mark Delman Infectious Disease Specialist; Private Practice and Inova Fairfax Hospital
  • Jessica Volz Nurse Practitioner and Director of the Forensic Medical Unit; Adventist Healthcare Shady Grove Medical Center; @AdventistHC

Transcript

  • 12:00:02

    KOJO NNAMDIYou're tuned in to The Kojo Nnamdi Show from WAMU 88.5. I'm broadcasting from home. So welcome. Later in the broadcast we'll be discussing how the criminal justice system has adapted in the age of the coronavirus. Very shortly we'll be talking about how health care workers are dealing with the coronavirus pandemic. But first, this morning Maryland Governor Larry Hogan issued a formal stay-at-home order for all Maryland residents that goes into effect at eight p.m. Maryland has now surpassed 1400 cases of coronavirus in the state. And officials say that number is about to surge. Joining me with the latest is WAMU's Dominique Maria Bonessi. Dominique, thank you so much for joining us.

  • 12:00:43

    DOMINIQUE MARIA BONESSIThank you, Kojo.

  • 12:00:45

    NNAMDIDominique, what does the stay-at-home order Governor Hogan just issued entail for Marylanders?

  • 12:00:50

    BONESSIThat's right. Basically Marylanders should stay home in their homes unless they need food, medical attention or other essential services or needs.

  • 12:01:00

    NNAMDIAre people still allowed to leave home for solitary exercise or walking their dogs?

  • 12:01:05

    BONESSIYeah. So, you know, go walk your dog. Go for a run as long as you maintain, you know the six feet in distance from people. Also people, you know, if you have an emergency fix on your home, you have a leaky pipe as Hogan said today or you have some issue with your home, you know, Home Depot and Lowe's are still open. You can go to those stores.

  • 12:01:23

    NNAMDIThis sounds a lot like the guidance that's already in place across the region. What's the difference between this form of stay-at-home order and what we're experiencing now? Is the main difference enforcement?

  • 12:01:35

    BONESSIRight. So police will be enforcing the Centers for Disease Control prevention guidelines, which are asking everyone to avoid gatherings of 10 people or more. And this comes after a man in Charles County was arrested over the weekend for having -- I think he had two parties in Charles County with 60 people at his home, and he was arrested. He was the first person in the state arrested for that.

  • 12:02:00

    NNAMDIWhat are the repercussions for violating the order apart from being arrested that is?

  • 12:02:05

    BONESSISo violators can face a misdemeanor with a $5,000 fine and or one year in prison.

  • 12:02:12

    NNAMDIAnd you say the individual, who was arrested had two parties at his home each with over 60 people?

  • 12:02:17

    BONESSII believe it was each with over 60 people or it was, you know, it was over the 10 person limit.

  • 12:02:23

    NNAMDIWow. Is there any indication that other jurisdictions in our region are considering similar stay-at-home orders?

  • 12:02:28

    BONESSISo D.C. Mayor Muriel Bowser and Virginia's Governor Ralph Northam should be on a conference call with Governor Hogan today. And it's possible that those two regions, those two jurisdictions also might follow suit.

  • 12:02:42

    NNAMDIDominique, thank you so much for joining us.

  • 12:02:45

    BONESSIThank you.

  • 12:02:46

    NNAMDIDominique Maria Bonessi is a Reporter for WAMU 88.5. As I said, later in the hour how the criminal justice system has adapted in the age of the coronavirus pandemic, which has forced healthcare workers around the world to confront challenges they never imagined. So in this region, how are health care workers reordering their work and home lives to combat the virus. And how are they adjusting to a new reality were their commitment to caring for the sick may well put the people they love at risk. Joining us by phone is Dr. Leah Braun, a Family Physician at La Clinica del Pueblo in the District and in Hyattsville, Maryland. Dr. Braun, thank you for joining us.

  • 12:03:27

    DR. LEAH BRAUNThank you, Kojo, for having me.

  • 12:03:28

    NNAMDIYou work at a small non-profit clinic that operates in the District and Prince George's County. How have things changed for staff and patients since the coronavirus hit the area?

  • 12:03:38

    BRAUNSo this is an unprecedented time for health centers around the region. I think personally from my perspective and that of a lot of my colleagues the feeling of fear of going to work is something new for us. Not knowing what might come in the day. You know, we've put protocols in place to protect our patient and staff as much as possible. We're performing a limited number of in person face to face visits in order to protect our patient staff and trying to move as much as possible to telemedicine to be able to continue providing very important primary care and mental health services for our patients. This is just a new experience for all of us.

  • 12:04:22

    NNAMDIHow has this changed the way you personally work as a doctor? What precautions are you personally taking?

  • 12:04:29

    BRAUNSo in the clinic we have screening protocols in place for all of our patients that normally would call in for an appointment. And, you know, they'd walk through the doors. Right now we are screening people carefully for a fever, for a cough, other respiratory systems and encouraging patients, who have symptoms suspicious for COVID-19 to stay at home if their symptoms are mild. We're encouraging them to stay in touch with us if their symptoms get worse, and to, of course, go to the emergency room to seek immediate care if they have any concerning symptoms such as shortness of breath or other dangerous symptoms associated with COVID-19.

  • 12:05:07

    BRAUNWe're performing a lot of visits over the phone. We're staying in touch with our patients, which, you know, has been gratifying to be able to stay connected in that way either over the phone or video conference to be able to, you know, continue to keep our patients healthy as best we can right now, and to really take care of their chronic health conditions so they don't end up in the Emergency Room with an already overwhelmed system.

  • 12:05:33

    NNAMDIWell, Dr. Braun, you have two young boys, two years and four years old who cannot go to preschool anymore. How has your home life changed?

  • 12:05:43

    BRAUNSo drastically for sure. You know, I'm still going into the clinic, but also teleworking from home as is my husband. He works from home. So, you know, we feel fortunate that we're able to, you know, have them home with us right now. But certainly it's like many parents across the country are experiencing, you know, trying to maintain a full time job and care for our kids especially little ones, who can't really entertain themselves very well for very long is hard.

  • 12:06:13

    BRAUNAnd, you know, certainly the fear of getting them sick, when I come home from work or my husband sick is something that's changed my daily routine. I come home now. I leave my shoes off outside the house. I take my scrubs off. They go straight into the washing machine and really before I let anyone come near me, you know, to give me hugs and kisses when I get home. I'm getting in the shower to make sure I'm, you know, getting rid of every, you know, possible virus I may have come into contact with at work.

  • 12:06:43

    NNAMDIYou have at least one colleague at the clinic, who sent her child to live with relatives during the pandemic. Is that something you considered separating from your children for the duration?

  • 12:06:52

    BRAUNWe have talked about it. Yes, certainly a lot of my colleagues I know across the country have taken pretty drastic measures, you know, sending their kids to live with relatives. Our situation is difficult right now. You know, my parents would be the ones that would take care of the kids, but because they're in a high risk group being over 65 we've for the last three to four weeks distanced ourselves from them to protect them based on my exposures at work.

  • 12:07:19

    BRAUNSo, you know, sending the kids right now to live with them really wouldn't be an option. The incubation period for this virus is so long that even though we're asymptomatic right now we could potentially be infected and we wouldn't want to put my parents in harm's way. So it's definitely a difficult predicament.

  • 12:07:39

    NNAMDIJoining us now is Dr. Mark Delman, a Specialist in Infectious Diseases and Private Practice and at Inova Fairfax Hospital. Dr. Delman, thank you for joining us.

  • 12:07:49

    DR. MARK DELMANThank you very much, Kojo, for having me and I'm sorry I've become interesting enough to warrant this appearance.

  • 12:07:57

    NNAMDIWell, it is what it is. As a physician specializing in infectious diseases, have you ever seen anything like this coronavirus pandemic?

  • 12:08:06

    DELMANCertainly not in my career. Some of my colleagues who have been around longer compare this to early HIV Aids epidemic in terms of the same lack of information and the feeling of helplessness.

  • 12:08:24

    NNAMDIYou say you are not surprised that this pandemic is happening. Why?

  • 12:08:30

    DELMANI think in my field it was always the taught and expressed wisdom that it was a matter of time. I think, you know, the world had a couple of close calls over the past several decades, which really should have made it obvious that something worse will come. And even with this epidemic I think we -- as we eventually get beyond it I think we should be preparing for the next one.

  • 12:09:07

    NNAMDIHave you had patients who have tested positive?

  • 12:09:11

    DELMANWe have both for the practice and obviously at the hospital I think most hospitals in our area are at this point dealing with a significant number of positive patients.

  • 12:09:24

    NNAMDIDo you have adequate protection to do your job safely? Are you reusing face masks?

  • 12:09:31

    DELMANI do feel that we have adequate equipment at this time. The hospital administration and the staff are working very hard to ensure that that continues to be the case. And we're looking into multiple options and multiple modalities, but at this point I feel that we are well supported and we have the proper equipment.

  • 12:10:00

    NNAMDIWhat about respirators, other equipment for patients who are hard hit by the virus, is there enough?

  • 12:10:07

    DELMANI may not be able to give you -- or I'm not party to that information. We have not had any shortages at this point. And preparations are being taken.

  • 12:10:22

    NNAMDIAllow me to go to Melissa in Silver Spring, Maryland. Melissa, you're on the air. Go ahead, please.

  • 12:10:27

    MELISSAYes. Hi, I'm a nurse with National Nurses United. And I really think we need to look at this situation holistically. If nurses are not being given -- if hospitals are not giving us the equipment that we need, we're more likely to pass it on to our patients, to pass it on to our families. And I know hospitals have been going by the CDC guidelines, which have been vague and lax I mean, in my opinion and I think it's due to the scarcity of protective equipment.

  • 12:10:53

    MELISSAThe government and corporations have an obligation to protect workers and patients. And they need to deploy every resource possible. We've already seen this in New York and New Jersey and other hot spots. I know the Mt. Sinai hospital system in New York City is seeing 30 to 40 percent of its nurses being infected right now. You know, nurses are trying to not be around their families. If they're lucky enough to have a basement to have an attic, they're trying to stay away. And I would like to talk about my personal -- what I've been going through in my hospital.

  • 12:11:26

    NNAMDIGo ahead.

  • 12:11:27

    MELISSAThat's MedStar Washington Hospital Center. It certainly has not been willingly implementing these safety precautions. NMU nurses have had to pressure the hospitals do this and we've received a lot of pushback and a lot of intimation. And personally last week I felt hopeless. I'm a shop steward. I had so many people coming to me. Amanda, I need your help. I need your emotional support. What are we going to do? And I felt suicidal as a ER in my hospital. You know, we're feeling hopeless, but with our union we feel like we have more support. We need more money, paid sick leave. You know, if this is going to go on for a long time. Nurses are getting sick. Yeah, and the CEO of MedStar Health that's Kenneth Samet -- he actually makes millions of dollars.

  • 12:12:11

    NNAMDIWe're running out of time very quickly and obviously you're in a very difficult situation. You mentioned suicide. For people who are having problems like that the National Suicide Prevention Hotline's number is 800-273-8255. Melissa, thank you very much for sharing your story with us. Good luck to you. We're going to have to take a short break. When we come back, we'll continue this conversation. Still taking your calls though 800-433-8850. Do you feel the hospital where you work is doing enough to protect you from coronavirus? I'm Kojo Nnamdi.

  • 12:13:04

    NNAMDIWelcome back. Later in the broadcast we'll be talking about how the criminal justice system has adapted in the age of the coronavirus. Right now we're talking about how workers in healthcare are dealing with the coronavirus pandemic. We're talking with Dr. Leah Braun, a Family Physician at La Clinica del Pueblo in the District and Hyattsville, Maryland. Dr. Mark Delman is a Specialist in Infectious Diseases in Private Practice and at Inova Fairfax Hospital. Mark Delman, it's my understanding that your father and brother are both physicians in New York, the epicenter of the pandemic. What are you hearing from them?

  • 12:13:37

    DELMANThat's correct, Kojo. And, you know, during this epidemic we've sort of stayed in close contact and sort of shared experiences and have shared concerns and anxiety for each other. My brother is currently in quarantine. He's an ER Physician and Urgent Care Physician in Queens. He developed some symptoms and is currently waiting for his results, but he is feeling reasonably well.

  • 12:14:08

    NNAMDIHow about your dad?

  • 12:14:09

    DELMANHe is an Internal Medicine Physician. He will be turning 70 in a couple of months. So obviously we have a lot of concern for his well-being. And his practice, he has transitioned to telemedicine mostly, but he is still practicing at a nursing facility. And I think New York is very hard hit. And the stories from the ER are quite concerning.

  • 12:14:41

    NNAMDIAlso joining us is Jessica Volz, a Nurse Practitioner and Director of the Forensic Medical Unit at Adventist Healthcare Shady Grove Medical Center in Rockville. Jessica Volz, thank you for joining us.

  • 12:14:53

    JESSICA VOLZThank you for having me.

  • 12:14:55

    NNAMDICan you tell us about your work at Shady Grove Medical Center and how it has changed since the coronavirus pandemic?

  • 12:15:03

    VOLZYes. It has changed quite a bit in that our unit is a part of and works very closely with the emergency department. So we have really focused on and are beginning to even more focus on cross training our nurses what we can do to support other areas of the hospital. But at the same time be sure that we can care for our population, which works with those who have been abused or assaulted.

  • 12:15:36

    NNAMDIDo you have the gear you need to protect yourself? Are you reusing masks?

  • 12:15:43

    VOLZAt this time we are fortunate here at Shady Grove Medical Center that we do have the equipment that we need to keep our patients safe, to keep the staff safe. But we are meeting on a daily basis at least to keep track of that equipment, learn how we can better utilize that equipment. And this has really been an experience that I have never had working in healthcare for over a decade in the comradery in the hospital that we are all really working as a team.

  • 12:16:23

    NNAMDICan you compare this crisis to any you've experienced as a nurse before? I know you said you'd never experienced this kind of comradery. But what previous crisis may you have experienced?

  • 12:16:36

    VOLZI would say that this is really unprecedented. This is not like any other crisis that I have experienced throughout my career.

  • 12:16:48

    NNAMDIWhat are you most worried about and how are you dealing with the stress?

  • 12:16:56

    VOLZI am most worried about really my work team and my home team, I call them. I have a family with three children and my husband is in law enforcement. So we are both working as usual. But now have our kids at home and then also caring for the people that we work with. And in the hospital I think a lot of people are used to working with their regular team. But this is as I said really an opportunity for all of us to come together and try to work to help other areas of the hospital that maybe we wouldn't ordinarily interact with as much.

  • 12:17:39

    NNAMDIYour children are older than Leah Braun's in elementary and middle school. What adjustments have they had to make during this crisis? And how are they coping?

  • 12:17:51

    VOLZWell, I really have to say that we should definitely acknowledge that the kids that are children of health care workers, first responders, they make sacrifices every day. And I think the sacrifices of the people that are providing the care and the service are often acknowledged. But that the sacrifices the kids make necessarily aren't. We've explained to our kids that this is a really unique opportunity for them to directly impact the lives of other people. And I think they're taking that very seriously. And are proud of the fact that they can help even if it's by picking up some extra chores at home and doing a little bit more than they ordinarily would to help us out.

  • 12:18:39

    NNAMDIHere now is Kevin in Washington D.C. Kevin, you're on the air. Go ahead, please.

  • 12:18:45

    KEVINHi, Kojo. Pardon me. I just wanted to talk about the stress of being a doctor in these times. I'm actually a house call doctor, podiatrist. And I've had to limit my practice for several reasons. One I didn't want to bring anything to a patient. I primarily see seniors, and I take care of one, my dad. So I've been dealing with the guilt of not being able to see my patients.

  • 12:19:21

    NNAMDIAnd you not being able to see your patients in person?

  • 12:19:25

    KEVINRight, right. You know, podiatry is very hands on. So we can't do a lot of telemedicine. So I've had to limit greatly, who I can see. I'm primarily seeing only very urgent cases or emergencies. So that is very stressful when you're to, you know, overly burdened with patients now to only have, you know, maybe one or two a day.

  • 12:19:58

    NNAMDIAnd you say you're also caring for your father. Is your father ill?

  • 12:20:03

    KEVINNo. No, no. That's the point he's not.

  • 12:20:05

    NNAMDIOkay.

  • 12:20:06

    KEVINAnd I don't want to bring anything home to him, because I've been out in the public. So when I do go out I try to, you know, I go into another entrance into the home. And sort of, you know, take everything off and into the washing machine, take a shower before I even, you know, interact with him.

  • 12:20:31

    NNAMDII do understand.

  • 12:20:32

    KEVINYou know, I'm still always nervous whenever you go out.

  • 12:20:36

    NNAMDII do understand, Kevin. And thank you so much for sharing your story with us. It's why I am broadcasting from home, of course, and our producers are also working from home at this point. So thank you again for sharing your story. Mark Delman, you also have young children at home boys 5 and 10 years old. Who takes care of them when you're at the office or the hospital?

  • 12:20:56

    DELMANSo my wonderful wife is working from home. And she is balancing her important work and keeping me sort of functional and able to go to work every day. And then she's navigating the various distant learning tools and activities and keeping the boys occupied. So credit goes to her.

  • 12:21:25

    NNAMDIHow much do they know about your work and how are they faring?

  • 12:21:29

    DELMANWe've tried to not have any secrets about what the situation and what's going on. So particularly with my 10 year old I've had some almost scientific level discussions about the epidemic and certain statistical aspects of it. We're monitoring them for signs of distress and I haven't seen too much of it. I would much prefer them to think of this as a strange vacation rather than -- and then just in retrospect to understand the gravity of the situation.

  • 12:22:09

    NNAMDIAllow me to go to Jane in Fairfax, Virginia. Jane, you're on the air. Go ahead, please.

  • 12:22:14

    JANEYes. Hi. So I have a question for the panelists. I have a daughter, who is an employee at the MedStar National Rehab Hospital. And I'm just curious why the guidelines CDC and MedStar are so different for health care workers than they are for the general public. So if a therapist tests positive or has symptoms and waiting for a test, they're told to come back to work three days after any symptoms. Whereas general public, you're supposed to self-quarantine for 14 days. And how does that not expose patients and other employees? And I'm just wondering why these guidelines are such a, you know, substandard for health care workers.

  • 12:23:06

    NNAMDIDo you know, Dr. Leah Braun?

  • 12:23:09

    BRAUNSo that's a very good question. You know, in the last few weeks, you know, the CDC has changed certain guidelines, which is really reflective of both the lack of personal protective equipment and impending shortages and also the potential shortage of health care personnel. So in many situations some of these decisions are being made not necessarily based on scientific fact. But in the situation in which we find ourselves, which is impending lack of personal protective equipment. And also lack of personnel to continue being in the hospitals and taking care of patients.

  • 12:23:49

    NNAMDIDo you have a plan should you become infected, Dr. Braun?

  • 12:23:53

    BRAUNI do. We've decided that if I were to become infected I would stay outside of the house. I would stay somewhere else apart from the family. I think the concern, though, is that, you know, because of the incubation period I could potentially be sick and already be infected for several days before symptoms start, which is why a lot of health care providers have already preemptively removed themselves from their homes and are separated from their families. But we do have a plan in place for if I were to become sick and it would be to stay away from the family.

  • 12:24:26

    NNAMDISame question to you, Dr. Delman.

  • 12:24:28

    DELMANSo the basement awaits me if I do develop symptoms. And early on we had the conversation of should I just preemptively just move down there and avoid contact with the children. And I think -- we made the decision that it probably would be more difficult for the kids if we chose to proceed that way. I think there's no right answer. I think my colleagues come to me with this question almost on a daily basis. And sort of, this is who I have at home, what should I do? And I think everyone has to go through that mental calculation. I'm not sure there's one correct answer.

  • 12:25:13

    NNAMDIAlmost out of time, but quickly John in Alexandria. What would you like to say, John?

  • 12:25:18

    JOHNHi. I wanted to say a couple of things. First I have a little --

  • 12:25:24

    NNAMDIWe only have about 15 seconds left, John. And I know you wanted to talk about what day today is.

  • 12:25:29

    JOHNI have the doctors on my mind praying they don't run out of time to find the right mix. Then we can fix whatever got us into this bind. Happy National Doctor's Day and to all the health care workers out there.

  • 12:25:40

    NNAMDIIt is National Doctor's Day today. Thank you for your call, Kevin. Thank you, Dr. Braun, Dr. Delman and Jessica Volz for joining us. We're going to take a short break. When we come back, the criminal justice system, how its adapting. I'm Kojo Nnamdi.

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