Mariel Lougee
Current city, state, country: Oakland, CA, USA
My profession: Medical Staff Physician
What challenges do you and your staff face on a daily basis: Misinformation. Even well intentioned and knowledgeable staff are scared and nervous and patients can feel that.
Testing. We are lucky that we have more testing than most but a majority of our testing is off site, 2-5 day turn around. Which is not so bad if you are a functional adult who can afford to be at home, isolated from family for that time. Only highest risk patients qualify for the rapid test.
As a physician predominantly for the homeless - we didn’t have a place for the homeless before COVID-19, so it’s even harder to find a place to isolate or quarantine them now. The highest risk patients are those > 65 or > 50 with medical comorbidities - that is almost ⅔ of our shelter population.
How is the staff coping with potential shortage of PPE? I will say our hospital kept a tight control of PPE starting upwards of 4 weeks ago, before other area hospitals - and thus it’s not great but it’s not as dire as elsewhere. Paint the picture for the scene if someone feels symptoms of Covid-19 and walks into the ER today:
Paint the picture for the scene if someone feels symptoms of Covid-19 and walks into the ER today: That scene doesn’t exist. You don’t make it into our ED if you think you have covid. What used to be patient parking and valet and a farmers market in the summer are now large tents in our clinic parking lot and in front of our ED. Only 1 entrance into the hospital. EVERY patient has to be screened and go through the screening team before you can register in the ED. If you have symptoms the tent doc will either test you or not and likely send you home presumed positive and told to isolate.
What is a normal day for you like before coronavirus? A normal day was doing clinics at the shelter managing primary care and doing street medicine/outreach walking the encampments - engaging folks on substance abuse resources, mental health, housing, and health.
What are your days like now? Answering frantic questions from patients, calming homeless folks who have nowhere to go and limited food resources - figuring out how to differentiate shelter cough versus “worrisome cough”. And checking my temperature when I wake up and before bed every night.
Describe the mood and amongst the hospital staff: Frenetic. I get a new email telling me there’s a new protocol or new workflow every 20-30min. When I hear my phone ding I now take a breath before reaching to read it.
What will things be like in 1 week? In 1 month? The truly worrisome time for me is in the coming weeks when my friends and colleagues get sick after taking care of the first round of patients. Those of us who are not normally in the hospital become the front lines. We talk daily about our surge color - greed, yellow, red. Today we are at green but I worry every day about what my role is when its red. In one month,I hope it’s better. I’d really like to be able to have someone professional make me a cocktail and a fancy dinner by then. I think i’ll need it.
Describe your daily routine before the pandemic and during: A normal day was doing clinics at the shelter managing primary care and doing street medicine/outreach walking the encampments - engaging folks on substance abuse resources, mental health, housing, and health. Now, it’s answering frantic questions from patients, calming homeless folks who have nowhere to go and limited food resources - figuring out how to differentiate shelter cough versus “worrisome cough”. And checking my temperature when I wake up and before bed every night.
This pandemic makes me feel like: Guarded and irritable. Not myself.
This pandemic makes me think: About our failed healthcare system and the way it disproportionately affects my patients.
This pandemic makes me hope/pray for: A change to our failed healthcare system. That perhaps it could be a costly and horrific wake up call.
If I had Three Wishes: 1. People start to trust healthcare professionals over TV. 2. We keep talking to our friends as much as we are now. 3. Paid sick leave
What I think of the government’s response: The federal response has been embarrassing and negligent.
Predictions for when this will get better/end: The truly worrisome time for me is in the coming weeks when my friends and colleagues get sick after taking care of the first round of patients. Those of us who are not normally in the hospital become the front lines. We talk daily about our surge color - greed, yellow, red. Today we are at green but I worry every day about what my role is when its red. In one month,I hope it’s better. I’d really like to be able to have someone professional make me a cocktail and a fancy dinner by then. I think i’ll need it.
What I have in my fridge/freezer and pantry: A pork shoulder, so much cheese.
Ways I’m coping: We so often tell patients that 30 min of walking 5x/week is good for health and reducing anxiety. I’d never walked the walk before last week. (pun intended)
Creative things to do with kids: There are great at home science experiments and even great experiments showing how infections spread, helpful ways to explain to kids why they’re stuck at home. And baking (which is just science experiments you get to eat at the end)
General advice/thoughts/anxieties to share with others: Choose one news source - limit the time on it, make it a reputable one. Your medical friends (at least this one) would actually prefer to talk through the pandemic or preparedness if you think that could help any anxiety. We much prefer hearing about that over your weird mole or rash you’ve had for a year.