Actions taken by politicians for the past several weeks (it's mid-April) have done incalculable damage to the world economy and healthcare organizations across the globe. Every waking minute, television, radio, and the Internet are saturated with reports of everything from hard facts to rumors that are repeated until they take on the aura of truth. It is truly impossible to separate fact from fiction. It is also impossible to determine whether actions are prudent, fear driven, or driven by political calculation. Regardless of what is going on in political and journalistic circles, nurses, physicians, facility managers, clinical engineers, housekeepers, food service workers, and so forth must continue to provide care for everyone who needs hospital care.
Hospital admissions have been modified by deferring elective surgeries, by routing some cases to outpatient care, and by expanding telemedicine services. What has not changed is that people who experience a heart attack, a stroke, or serious accidents still need the same hospital care. These are the people who have filled intensive care units during the 40+ years I spent working in the healthcare industry. They did not go away as part of modifying services. The challenge facing everyone in the hospital business is how to create spaces capable of supporting COVID-19 cases with serious complications.
Although I am no longer working as a member of a healthcare team, it seems to me that hospitals should have as part of the emergency management program contingency plans for nuclear, biological, and chemical events. The COVID-19 event is certainly a biological event just as the H1N1 (swine flu) pandemic of 2009-2010. During that time, I was part of a local hospital task force that followed sound emergency management principles to manage opportunities for people arriving with flulike symptoms to come into contact with other patients and employees. A good number were admitted. I am sure some died of complications related to an H1N1 infection or from the combined effects of already existing diseases or conditions and the H1N1.
I do not remember a national shutdown being discussed, although an estimated 60 million cases occurred in the United States. In addition, on the basis of follow-on studies, the Centers for Disease Control and Prevention estimated 274 000 hospitalizations and 12 500 deaths were attributable to H1N1.
COVID is the third pandemic of roughly the past century. The first was the Spanish Flu of 2018, the second was the swine flu, and now, it is COVID-19. Of the three, the Spanish Flu was, so far, the most deadly. Although each organism has its own properties as an infectious agent, the biggest difference this time around is the speed of the spread of rumors and misinformation about COVID-19 through social media. Perhaps, the effect of this on people could be labeled as the first “panic-demic.”
As with the 2 pandemics and seasonal flu events, COVID-19 will pass. Whether it becomes a regular seasonal visitor remains to be seen. What will not pass is the everyday healthcare requirements of patients such as those I mentioned earlier. As “primum non nocere or first do no harm” is a fundamental of bioethics (it is not in the Hippocratic Oath, as stated), these patients must not suffer or be deprived of the resources they would normally have access to during this time.
Clinical engineers, facility managers, housekeepers, and the legions of other support service staffs of hospitals play a critical role in ensuring a safe, reliable environment of care is maintained for all staff and patients. Whether it is the daily sanitizing of the floors and walls of the environment and the equipment that comes into contact with patients or maintaining, operating, and repairing the equipment and systems used to support patient care, these healthcare team members play a vital role.
We hear a great deal about first responders, doctors, and nurses as heroes for working directly with infected patients. Every day, many of the support service staff also work in close proximity to the same patients. They are no less heroes. I salute them all.