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First Person

First Person

Things to Think about Before You Get COVID-19 from an Emergency Physician Who Has Been There

Mosley, Mark MD, MPH

doi: 10.1097/01.EEM.0000731724.93302.4d
    COVID-19, coronavirus, pandemic

    I began to have upper back pain, a little bit of a sore throat, and some tightness in my chest around 2 a.m. on July 1 while on shift. At 6 a.m., I checked in for testing. All results from outpatient testing at our hospital take three to five days or longer.

    But I have a friend in the lab, and I still wouldn't know what my COVID-19 results were if I hadn't pulled some strings. My friend called later that afternoon. “Sorry, buddy,” he said. “You're positive.”

    It was the start of a dark and lonely week.

    I kept a journal while I was isolated alone for 10 days to give myself something to do without losing my mind, but I also wanted something for posterity for my family. And I wanted to turn a bad moment into a gift for the people with whom I work.

    Maybe telling my story can prevent others from getting this and guide them if they do. We call it “burning manure” in Oklahoma: You make heat, light, and something fertile out of excrement.

    1. Make a contingency plan of where you will stay if you get sick. Do that today.

    2. Discuss what the others in your home will do, particularly if they are elderly, children, or have chronic illness. Do that today too.

    3. Consider that choosing to live with others while ill may make them close contacts who require 14 days of quarantine or 10 days of isolation if they are COVID-19-positive.

    4. Do not count on the health department helping to figure out who your close contacts were for the 48 hours before you developed symptoms. A week after testing positive, the health department had not contacted me or interviewed any family members, nor had they done any contact tracing of people I might have infected in our ED.

    I am shocked at how little guidance anybody provided during this process. I was working and potentially exposing our staff and the sickest people in our city! This should scare all of us.

    5. Consider what medications you will take if you get sick. These may become less available if COVID-19 cases continue to explode. Buy them now. I took ibuprofen as needed and half of a Lortab at bedtime and prn for really bad myalgias—the myalgias are ugly. I took caffeine in over-the-counter migraine pills for my chest tightness; that seemed reasonable because it is related to theophylline, which used to be just about the only medication we had for wheezing. I took it slowly with a cup of coffee.

    6. Discuss the value of having immediate one-day outpatient testing for family members and close friends who may have to take care of others or who have events that need attention.

    7. Be aware of what worker's compensation pays for a high earner in your state. Staff from worker's comp and short-term disability companies who you don't know will ask for details about your exposure and close contacts, including patients, while your brain is in a fog.

    Someone named Amanda asked me to email her my test results. I have nothing to hide, but when I asked if that conflicted with HIPAA, she acted like that was an odd question. “This is our standard operating procedure,” she said, “and we are not subject to HIPAA.” Really?

    You have to figure out how to get a paper copy or an electronically secured copy of your test result while you are in isolation and cannot go to medical records, and then you have to figure out how to send it by a nonsecured means to Amanda. I understand they need confirmation, but I am the three-millionth guy to get this, and this is the process?

    8. Write a journal or take notes even if you are not ill. This is a unique moment in your life and in history that should be reflected upon and saved for future generations.

    9. Always use a face shield or goggles at work in addition to your mask. I believe face shields may become a community standard because of their comfort, visibility, ease of cleaning, and higher safety. Consider buying one now.

    10. Think about death (a little). It is a great motivator to be vigilant and kind.

    Dr. Mosleyis an emergency physician in Wichita, KS.

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