Maureen Taylor is a physician assistant in infectious diseases at Michael Garron Hospital in Toronto.
I am a hospital front line worker who is not afraid to go to work.
That’s right. As week 10 of the COVID era draws near, I have seen dozens of patients with COVID-19 of different disease severity 5 or 6 days every week. I am not afraid to enter the room, help patients turn to lie prone, hold their hand, palpate their abdomen, squeeze their calf or hold a glass of water to their lips. I don’t fear I will bring COVID-19 home (I suppose it helps that I live alone). I don’t strip out of my clothes in the hallway and shower as soon as I get home. When the public health officials and the premier tell me I can expand my bubble, I’m going to see my children and grandchildren and I’m not going to worry about giving them COVID-19.
Reckless? Callous? Crazy?
Prepared. Careful. Trusting of the evidence.
Only healthcare workers with access to adequate personal protective equipment (PPE) and the training to use it properly can have my level of confidence that I am at very low risk of acquiring COVID-19 during routine patient interactions in a COVID ward. I have a surgical mask which I wear all day and access to a second if that one becomes soiled. Over that, I wear an acrylic face shield for eye protection, handed in at the end of the day for cleaning.
Before and after I put the mask and shield on, I sanitize my hands. If I touch something accidently, I sanitize my hands. If I touch a door knob, coffee cup, a stethoscope, I sanitize my hands. I have access to an N95 mask if patients are going to be intubated or placed on a high-pressure oxygenation device, situations that generate aerosols. I wear the surgical mask all day, even when I’m away from patient areas. I eat at my desk with 2 metres between me and my office mates. I wear scrubs at work and change into street clothes at the end of my shift. I have COVID shoes which I leave under my desk at work. Over the scrubs, I wear a washable gown and gloves which I carefully remove when I exit a COVID patient’s room, following the instructions laid out by my Infection Prevention and Control team. I trust them. I am putting my life in their hands, and they take that responsibility seriously.
I admit that back in mid-March, with my very first few patients with COVID-19, I hesitated. I didn’t attempt much of a physical exam and tried to maintain a distance of two metres from patients even when wearing PPE. I don’t do that anymore. Last week, I saw an older woman with COVID-19 whose daughter had just told her by phone that her husband died of the same infection in the ICU the night before. Obviously, the patient was bereft, and more than a little fearful, that COVID would claim her life too. I pulled up a chair, I held her hand, and I asked her to tell me about her husband, their 45 years of marriage, how they came to Canada and built a new life. I spent time with her that day and on the day of her husband’s funeral, which she had to watch via an iPad. I was where my patient needed me to be, and I was not afraid. I can do my job because I am protected.
I am grateful to the people who work so hard to interpret the evidence around the spread of this disease and provide guidance to frontline workers. I can adapt as the science evolves and the guidelines change. I am grateful that for now my hospital can provide me with the equipment necessary to keep me (and my non-COVID patients in the hospital) safe. I believe I am more likely to acquire COVID-19 infection in the community than in the hospital where I work. I have moved from fear to cautious confidence. I hope that I am seen as competent rather than heroic. This is who I want to be during the COVID-19 pandemic.