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Plenty Of Equipment But 'Risk Is There,' Says Charlotte ER Doctor Treating COVID-19 Patients

Carolinas Medical Center Main Complex, Charlotte.
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Carolinas Medical Center is the flagship hosptial of Charlotte-based Atrium Health.

So much comes down to hospitals in this coronavirus outbreak. Yet, unless you're sick or caring for those who are, it's hard to get a feel for what's happening inside. Dr. Bryant Allen teaches emergency medicine at Charlotte-based Atrium Health and also works in the E.R. He gives us an inside look. 

Lisa Worf: First, where are you right now?

Bryant Allen: Right now, I'm sitting at my house just having finished up Zoom calls with the kids. So, you know, life at home in the mix of life at the hospital.

Worf: And you're also teaching residents this morning as well, via Zoom, who are still working but still learning at the same time.

Allen: Exactly. Exactly. Trying to keep them up to date on everything. Both with coronavirus, but also with the general practice of emergency medicine.

Worf: So, it's been many weeks now since I imagine you first started seeing patients with COVID-19. What was it like then?

Allen: So it's an interesting time to practice because there's simultaneous excitement about being on the front line and being able to provide care to the people of Charlotte while also being concerned about contracting an illness that changes in the way we understand it on a near-daily basis. So, trying to keep myself as safe as possible, keep my residents and nurses and staff as safe as possible, and keep my patients as safe as possible while balancing the demands of everything that isn't COVID.

Worf: And do you have the protection you need to stay safe?

Allen: Yes. We've been incredibly fortunate. We as a faculty group, in combination with our administrative team and the health care system, have been able to get a big supply of PPE. One thing that's really helped us in the emergency department are the use of the elastomeric masks. Those are the full-face masks or the half-face mask that have additional filters to them. We had an outpouring of support from the community, giving us face shields. There was a school that 3D-printed a ton of face shields.

We've got that equipment, which is pretty awesome. And on a daily basis, we have a big group of physicians and nurses and administrators that are looking for the next supply. So as of yet, we have not had significant struggles. We don't foresee significant struggles with PPE. And I know that personally I feel safe when I'm at work. And I would be the first to tell you if I didn't.

Worf: How many patients with COVID-19 do you treat a day?

Allen: So, that's a bit of a tough question. Right now, we like to operate under the assumption that patients we treat from all kind of presentations may have a COVID-19 infection, either as the cause of their need to come to the emergency department or just in the background. That's why when I get to the emergency department, when my staff gets to the emergency department, we're donning the appropriate level of kind of minimal PPE, N-95 or greater, so that we are protected if we have a patient that we don't know has it but is there for a different complaint.

Worf: So, the hospitals are seeing many fewer patients with COVID-19 than they were expecting. But also people who normally show up in the E.R., it sounds like they're staying away. Does it feel less busy, then?

Allen: We are still busy. Some of that busyness is dealing with making sure that we slow down and use appropriate protective precautions, because things that may have felt like they moved much more quickly in the past seem slowed by the fact that you're being extra careful with your PPE or being very diligent about your evaluations of patients and making sure you keep everyone safe.

So, certainly, it's a different experience at work now than it was just a few months ago. But I think that that allows you to kind of focus on keeping yourself and everyone around you safe.

Worf: Is there a case or a particular day that has really stuck with you over the last few weeks?

Allen: There have been some days that I was exposed through a big number of what we call aerosolizing procedures. And so, I would say times that I've been involved in those are the ones that you step away from that shift, and you're like, "That risk is there. It was there." And so, then you just make sure you're doing everything appropriate. You're monitoring your symptoms, you're monitoring yourself. You're making sure you don't take other risks. It's that kind of nagging thought in the back of your mind that you're always -- there's always potential for exposure.

You're doing the best you can, which in our environment is leaps and bounds ahead of what other people are able to do because of our supplies. But, you know, it's there. It's that comfortable level of paranoia that keeps you focused and make sure you maintain your PPE.

Worf: I think I hear your kids in the background.

Allen: Yeah, they're downstairs. They were upstairs, right behind me. They finished their Zoom calls and are on to the next activities of the day.

Worf: Now, at first when this started, your wife and three sons, they moved out. But, you know, obviously, you're together now. What was that decision like to come back?

Allen: It was not easy. We know there's a risk. We know there's a risk when you go to the grocery store about being exposed. And because we're able to remain hyper-vigilant about any high-risk time that I have, being in the hospital, I think it improves our family wellness to have everybody at the same place.

Worf: What are you hearing from your colleagues, whether they're doctors or nurses or other staff, at the hospital?

Allen: So, I think one of the big things is that we feel safe presently, and I think that helps morale a lot. That was one of the biggest concerns. Now, you know, I think people are desperate to be able to go get a cheeseburger or be able to be out in public, and I think the new emerging question is: What do we think the future looks like? What do we think this summer and then the return of fall and influenza season? What does that look like for us? That's always an interesting discussion to get into because we're all playing soothsayer at that point — all trying to figure out what the future is with no great example to lead us.

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