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Thu Mar 26, 2020, 02:39 AM

What Happens If Health-Care Workers Stop Showing Up?

Unless the country does dramatically more to provide them with the equipment they need to do their job safely, it risks disaster.

March 24, 2020


Thomas Kirsch
Emergency physician

The morning before my shift, I try to stay busy with emails, writing, cleaning the house, anything really. If I sit and think about it too long, undisturbed, I get nervous. Iím afraid to go to work, and yet Iím told I must. The flitting anxiety swells as I pull on my scrubs and head to the car. The streets are empty. I drive alone into the epicenter. It peaks when I first step through the door into the jumble of patients in chairs, stretchers, and beds crowded around our cramped workstation, staff jammed together discussing care, writing notes, calling reports. Then I start, surrounded by my colleagues, and am too busy to think about it. The fear is as much for my family and friends as for me. Probably more. Iím a physician who works in an emergency department in Washington, D.C., and the coronavirus is spreading.

I worked in Liberia at the height of the Ebola epidemic, in the fall of 2014. After only a few months, many nurses, doctors, and community health-care workers grew sick and died; most of the rest quit; and the entire health-care system collapsed. Every hospital and clinic in the country closed. We donít ever want that to happen, no one does, but we need to act now to protect health-care workers from making that awful decision.

The COVID-19 pandemic is certainly not Ebolaóthe case-fatality rate is perhaps 1 percent, not 50 percentóbut it raises an important practical and ethical question: How much risk do health-care workers have to take? Or, more bluntly: How many of us will die before we start to walk away from our jobs?

This is not a rhetorical question. In the SARS outbreak in Toronto, Canada, in 2003, 44 percent of all infections were in health-care providers. Two nurses and a physician died. In Arkansas, four of the first 12 COVID-19 patients were health-care workers. Last Sunday, the American College of Emergency Physicians reported that two ER doctors with COVID-19, the disease caused by the coronavirus, are being treated in intensive-care units.

More: https://www.theatlantic.com/ideas/archive/2020/03/were-failing-doctors/608662/

Good Read

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