So I'm going to try to update pretty regularly now to give y'all some insight into the front lines here re:coronavirus
Today (3/15), I got to work and everything felt was different and more serious than it did a few days ago when I was on the streets last. Got my "you don't have a fever" sticker and was updated on our new PPE policy, which seems to change daily. Had my first patient who I'm pretty sure has it. He had just gotten off a cruise ship (to Mexico and back) this morning, he looked like ####, his lungs sounded terrible, he had a fever/cough/vomiting, etc. Did my gown/goggle/mask combo and told [Coworker] not to get in the back with me to minimize people getting into contact with the patient.
Just found out a few hours later that he ended up testing negative for flu.
As it has been explained to me, people who test positive for the flu have approx 2% chance of testing positive for COVID-19. Therefore: if you're positive for flu, you're negative for corona. If you're negative for flu, then they decide whether to test you for COVID. In New Orleans, there are only maybe 100 or so tests available to each hospital so they are really having to selectively test people. This patient in question is being considered presumptive COVID positive.
At NOEMS we are out of disposable gowns due to national backorder. Services that are not currently out of gowns will be soon. Yesterday, we were supposed to wear gowns on any call that was suspected COVID. Today since we are out, they just changed the policy so now we are wearing them if we administer some sort of nebulized aerosol treatment (ex: albuterol for asthma/wheezing). Most of the COVID patients are wheezing and would it would be indicated that they receive one of these treatments. My guy this morning was wheezing but I didn't give him a treatment because his oxygen saturation was fine and he didn't have any respiratory history.
All of the emergency rooms at every hospital are pretty much completely full. NOEMS has a policy that we implement in cases like this called "rotation" which is us literally just going down the list of hospitals in order. Normally we really only go on rotation during Mardi Gras, when we have an overload of random drunk people to deal with. Rotation is not normal and we've been on rotation since about 10 am.
I am currently listening to an all-staff conference call about COVID-19. We've never had a conference call before and there are a plethora of technological problems lol some things never change.
So basically: everything continues to be a mess. It will continue to be a mess. Don't go to the hospital unless you are straight up dying. There aren't enough testing kits nationwide, so if you try to get a test, you'll probably just accidentally get exposed to coronavirus in the waiting room.
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Yesterday (3/16) was pretty much more of the same. All the hospitals are beyond capacity. Still on rotation with no signs of stopping. Most ER waiting rooms have people with fevers of 103 not getting rooms because there are no rooms to put people in. I've been picking up more and more people with all the signs and symptoms of CV and they're like "I feel terrible" and I'm like "I'm sorry, there's really not that much I can do" and it sucks!
There was one person that I picked up out of his home where I looked at him and was thought to myself "you're a goner" and am fairly convinced that he is likely to die in the hospital and never to return to his house. This is not the first time that I've had this thought in my career but it is the first time I've had this thought under these new circumstances. It's a sobering experience.
But amongst all this CV disaster, people still have other medical emergencies that also never stop! Sunday night I ran a really ####ed up miscarriage call that went sideways that was pretty upsetting. Shootings are down (for now) but for whatever reason people have been hitting pedestrians a lot this weekend.
I'm off today, taking today as a well deserved rest. I don't know how many off days I'm going to realistically have coming up in the future because as my coworkers begin to get sick, they'll probably end up activating us and forcing us to work on our off days (like a hurricane activation). They already unilaterally cancelled all vacation requests so all of my vacations that I've been looking forward to are now not an option.
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Yesterday (3/18) was both better and worse than I expected. The day started out pretty slow, and then rapidly returned to the new regular #### show. Absolutely had patients yesterday who are going to come back positive on their COVID tests. The problem is that we technically never know for people who don't have the obvious symptoms. Had a patient with a temp 103.8, a new personal record for me for someone not having a heat stroke.
People often call us to their house to "get checked out just to be safe" but the problem is that, besides being not particularly helpful bc we can pretty much only check your vitals and do an EKG, is that they have now completely rendered their self-quarantine useless by having us come into contact with them. It's very much like inviting a vampire into your house. I am absolutely a vector and now you have summoned me to your home and I'm in your house, accidentally transmitting it to you and spreading germs all over you and your stuff while you're already sick/elderly/immunocompromised. There's really nothing I can do about it, if we get a call, we have to respond. And I feel so bad because it's mostly people who have fallen through the cracks of society (poor people, people of color, elderly people, drug users, people experiencing homelessness, undocumented people, single moms, people without health insurance or transportation, some combination of the above) and don't have health care beyond 911 who call us for this sort of thing and they are, of course, the people who are likely to be susceptible to this whole thing. They are ALSO most affected by the impending local economic decimation. We here in New Orleans rely on the tourism/food/drink/entertainment industry for a large part of our economy. Everything is currently shut down, and we are rapidly approaching a complete economic disaster. There are no jobs and no money. Most people in New Orleans are already living paycheck to paycheck and there is currently essentially no plan for how to alleviate that. I know I'm going to be absolutely fine, money-wise, throughout this whole thing because I'm an "essential employee." But I'm really worried about everyone else.
Also: Worked my first suspected COVID code (cardiac arrest) yesterday. We're still out of gowns so I had a pair of safety glasses (my own personal ones from when I was in construction) and a ####ty N-95 mask (that I'd already been using for the past three calls). I don't want everyone to get the wrong idea here-- I work codes pretty regularly, it's all part of the territory. But this was a particularly bad one. It was a million degrees in this house, I was pouring sweat, I couldn't breathe through my mask, we had to pull this woman out of her house, I got and pulse back and lost it multiple times, I was worried about getting droplets on me, I got my hand stuck underneath a piece of equipment at some point, a family member was legitimately speaking in tongues at the ambulance as we were trying to load the patient up. They called it (stopped resuscitation efforts) at the hospital but idk if they're even going to test her for CV. The numbers are real skewed, it's hard to get accurate data when they're not testing people.
My captain pulled me aside at the end of the shift and told me continue to stay safe and continue to look out for [Coworker] and that he was proud of me and I almost cried.