Emergency medical and critical-care team members are canaries in the coal mine. When we are understaffed and overworked, when there is no staff to triage patients, when more and more patients are piling up at the emergency department door, the system breaks down, then people break down. You can borrow ventilators (until you can’t) and make more personal protective equipment (we hope). You cannot magically produce more nurses, respiratory therapists, physicians or other professionals.
My colleagues and I witnessed the physical and emotional devastation of the health care work force in Wuhan, China; in Italy; in New York. Health care workers were catching the coronavirus on the front lines, getting sick, getting their families sick, dying. We saw them suffer the lasting scars of feeling helpless in the face of this new coronavirus, unable to save their patients or themselves. We did what we could to prepare ourselves for when the pandemic would hit our community, knowing it was just a matter of time.
A group of us from a variety of backgrounds began building a coalition called HCW Hosted to help local health care workers find quarantine housing to isolate from our families. We have since added other services: health-status monitoring, emotional-health support and psychological first aid. These support services have helped fill some of the gaps our employers and government infrastructure have failed to address. But even if every city and town had an organization like HCW Hosted, that would still be only part of what is needed to mitigate the impact of Covid-19.
I get angry when I see people refuse to wear a mask or physically distance from others or stay home when they could because it is inconvenient — or as a political statement. If you do not wear a mask and physically distance, you are putting yourself and others in harm’s way. You are putting us in harm’s way. Then you will expect us to risk our lives to save you. And it’s not just we whom you ask to risk our lives, but our families as well. What you are saying to people like me and my team is, “Your life and the lives of your loved ones do not matter to us; you are disposable.”
I am willing to sacrifice for the greater good of the public. I took an oath to that effect when I became a physician. But the public has to sacrifice some too if we want to get through this as safely as possible — social scientists call this “health citizenship.” It means contacting your elected representatives and imploring them to follow public health science when they set policy — and voting out those who won’t. It means demanding the health care systems protect the well-being of staffs. And yes, it means wearing a mask, staying home when possible and practicing physical distancing so that our hospitals and care facilities are not swamped and we are not overwhelmed.
Your sacrifices of comfort and convenience make a difference — for your family, your neighbors, your health care workers and your access to quality health care in the future if you need it. I hope you don’t visit me or my team in the hospital anytime soon, but should you need to come see us, we want to be available and able to provide you the best possible care.
To do that, we need you to be part of our team.
Bradley A. Dreifuss (@dreifussmd) is an assistant professor of emergency medicine and director of rural and global emergency medicine programs at the University of Arizona College of Medicine at Tucson.
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