My PSA on COVID-19 testing: UNLESS it’s a life or limb threatening emergency (eg you need oxygen or ventilatory support), DO NOT GO TO, OR GET ROUTINE COVID-19 TESTING IN AN ER!!!
What a week it’s been — I’ve worked the past 10 days in 7 different ERs in NYC. Every site is figuring out their own version of PPE, testing capabilities, IT workflow, screening rules, approach guidelines; signs all of us are still deriving some kind of meaningful order out of all this chaos. Outside field tents are going up, corridors are being sealed, surge capacity has begun. And since I can’t ignore the elephant in the room, I’ve cancelled all travel and will not commit to any trips until this madness blows over, hopefully by the summer.
As per diem (having the flexibility to pick up shifts whenever + wherever I choose and when there is the greatest need in NYC), I‘ve ironically been working more shifts than I ever had expected to now that so many of my ER colleagues are already calling out sick or being furloughed due to exposure to COVID-19: The writing is on the wall.
So where I’m doing my part in this pandemic, I urge that you to also do yours; we can still prevent a total collapse of our healthcare system if you can do one simple thing: unless it is a life or limb threatening emergency and/or you need oxygen or ventilatory support, STAY AWAY FROM OUR EMERGENCY ROOMS DURING THIS PANDEMIC. And PLEASE TELL EVERYONE that too.
“But what about testing? Isn’t more testing better?”
Ah but it doesn’t work as well when you come to the ER —
Let’s say you had no symptoms (or at best mild symptoms from something else), or had some other non-life or limb threatening concern, and you don’t have COVID-19 but came to the ER anyway. Or let’s say you came just for screening or a work clearance. So we then swab you and send out a test, but during the time you got on the subway, registered at triage, waited to be seen, or waited for discharge papers, you THEN unknowingly became exposed to someone else who actually has COVID-19 — whether it was a sick patient shedding all that virus in the ER, a visitor, the guy sitting next to you on the bus, the work note you got that could act as a fomite, another worried well waiting for their test, or a healthcare worker who was just exposed to COVID-19.
A few hours (or days) later, you then get the callback saying that your test for COVID-19 came back negative when you actually just caught it from riding public transportation or arriving to a high volume area like the ER. Guess what? You’re now falsely reassured with a false negative result, which means you’re less likely to self-quarantine, and it ruins the whole point of screening in order to prevent unnecessary further community spread. Multiply that by an exponential factor, and now we’re intubating your grandparents or your immunocompromised friends back-to-back the next week. You might end up fine at the end of all this, but the person next to you — someone you love — might end up on life support.
So tell everyone you know to stay away from our ERs and let us take care of the ones who truly need our help. Wait for the home test kits or go to the drive-thru’s when they become available. At least at home or in your own private vehicle can you get screened both accurately and minimize exposure to others and yourself.
Finally, us emergentologists trained years for this so please let us shoulder most of your worrying; your panic makes it much harder for all of us. You can also make the world less shitty by not doing things like panic buying, gathering in crowds, and further spreading this virus to 80+ year olds and the immunocompromised whom I then would have to intubate next week. Please don’t make us get to the point where we have to ration care by choosing who gets to live and who dies — there are fewer than 10,000 ventilators/breathing machines in NY State, and fewer than 160,000 in the country (to put that into perspective, health.ny.gov models expect 89,610 patients in NY State and over 740,000 in the country who would require ventilators/breathing machines during a severe 6-week outbreak on the level of the 1918 influenza pandemic). That scenario would be unforgiving.
Every little bit counts.
P.S. don’t forget to wash your hands with soap. 🤙
P.P.S. Don’t be racist. And don’t be a dick.
Now heading back to work for day 11 of 11!