Keeping safe during COVID 19

[Money-Moniker]

First off, despite my join date I'm not a newb popping out of the woodwork during the crisis. I've been around for a while but haven't posted since 2018, here is the link to my old profile for which I've lost the password lol.

Anyway, the reason I decided to pop back in here is that I think people might be underestimating the risk to their own health from this novel form of SARS. While it's true that most healthy individuals under the age of 40 will probably have a very mild or even asymptomatic course of the illness, this is not always the case. For some reason that is currently poorly understood, between 1 in a 100 and 1 in a 1000 young, healthy individuals are not able to kick the initial insult and devolve into severe interstitial pneumonia between days 6-10 post symptom onset.

What's worse for us specifically is that there is anecdotal data out of China that healthcare workers have a higher rate of serious illness compared to others of similar age and health status. This is most likely due to working till exhaustion, being repeatedly blasted with high viral loads, and not initiating bedrest until symptoms become severe. Several physicians in their late 20s and early thirties have died in Wuhan. Not a huge number of deaths, but consider that merely having a severe course of illness leading to viral pneumonia increases your chances of pulmonary fibrosis and reduced pulmonary capacity for the remainder of your life.

Right now I'm an M4 and since I hustled to finish all my on-site 4th year rotations by February I'm fortunate not to have to step foot in the hospital and expose myself until residency begins in July. I'm under no delusion that this situation will be under control by then, so I've resigned myself to almost certainly catching this thing sooner or later. When I do start feeling sick, I'm not going to take any chances and will take all the rest I need to start feeling strong as an ox again before returning to my duties. As relatively young, healthy people our chances of getting over this thing unscathed are good, but they become less good if we don't give our bodies every opportunity to fight during these crucial first 10 days of mild symptoms. It's a personal decision but for me my health is paramount and I'll go to any length to preserve it.

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[Mass Effect]

First off, despite my join date I'm not a newb popping out of the woodwork during the crisis. I've been around for a while but haven't posted since 2018, here is the link to my old profile for which I've lost the password lol.

Anyway, the reason I decided to pop back in here is that I think people might be underestimating the risk to their own health from this novel form of SARS. While it's true that most healthy individuals under the age of 40 will probably have a very mild or even asymptomatic course of the illness, this is not always the case. For some reason that is currently poorly understood, between 1 in a 100 and 1 in a 1000 young, healthy individuals are not able to kick the initial insult and devolve into severe interstitial pneumonia between days 6-10 post symptom onset.

What's worse for us specifically is that there is anecdotal data out of China that healthcare workers have a higher rate of serious illness compared to others of similar age and health status. This is most likely due to working till exhaustion, being repeatedly blasted with high viral loads, and not initiating bedrest until symptoms become severe. Several physicians in their late 20s and early thirties have died in Wuhan. Not a huge number of deaths, but consider that merely having a severe course of illness leading to viral pneumonia increases your chances of pulmonary fibrosis and reduced pulmonary capacity for the remainder of your life.

Right now I'm an M4 and since I hustled to finish all my on-site 4th year rotations by February I'm fortunate not to have to step foot in the hospital and expose myself until residency begins in July. I'm under no delusion that this situation will be under control by then, so I've resigned myself to almost certainly catching this thing sooner or later. When I do start feeling sick, I'm not going to take any chances and will take all the rest I need to start feeling strong as an ox again before returning to my duties. As relatively young, healthy people our chances of getting over this thing unscathed are good, but they become less good if we don't give our bodies every opportunity to fight during these crucial first 10 days of mild symptoms. It's a personal decision but for me my health is paramount and I'll go to any length to preserve it.

I don't know of a single hospital in this country that would allow you to work if you start feeling sick right now.

 

[Mad Jack]

First off, despite my join date I'm not a newb popping out of the woodwork during the crisis. I've been around for a while but haven't posted since 2018, here is the link to my old profile for which I've lost the password lol.

Anyway, the reason I decided to pop back in here is that I think people might be underestimating the risk to their own health from this novel form of SARS. While it's true that most healthy individuals under the age of 40 will probably have a very mild or even asymptomatic course of the illness, this is not always the case. For some reason that is currently poorly understood, between 1 in a 100 and 1 in a 1000 young, healthy individuals are not able to kick the initial insult and devolve into severe interstitial pneumonia between days 6-10 post symptom onset.

What's worse for us specifically is that there is anecdotal data out of China that healthcare workers have a higher rate of serious illness compared to others of similar age and health status. This is most likely due to working till exhaustion, being repeatedly blasted with high viral loads, and not initiating bedrest until symptoms become severe. Several physicians in their late 20s and early thirties have died in Wuhan. Not a huge number of deaths, but consider that merely having a severe course of illness leading to viral pneumonia increases your chances of pulmonary fibrosis and reduced pulmonary capacity for the remainder of your life.

Right now I'm an M4 and since I hustled to finish all my on-site 4th year rotations by February I'm fortunate not to have to step foot in the hospital and expose myself until residency begins in July. I'm under no delusion that this situation will be under control by then, so I've resigned myself to almost certainly catching this thing sooner or later. When I do start feeling sick, I'm not going to take any chances and will take all the rest I need to start feeling strong as an ox again before returning to my duties. As relatively young, healthy people our chances of getting over this thing unscathed are good, but they become less good if we don't give our bodies every opportunity to fight during these crucial first 10 days of mild symptoms. It's a personal decision but for me my health is paramount and I'll go to any length to preserve it.

You'll be forced into quarantine if you show symptoms, so chill

 

[Money-Moniker]

^Let's hope so. All I'm saying is that the news out of Wuhan and now Italy shows that once hospitals are overwhelmed SOP like quarantining medical professionals with mild symptoms goes out the window. When you have entire floors dedicated to COVID patients and have to made decisions which patients to treat and which to leave to their own devices for lack of resources, don't be surprised if the leadership asks you to just "push through it" when you come down with something yourself.

 

[Mad Jack]

Medical students around here were cancelled. Betting that this becomes the norm

 

[Splenda88]

Medical students around here were cancelled. Betting that this becomes the norm

Same here...

 

[Money-Moniker]

News out of Iran that 15% of fatalities are people under 40. News out of Europe is that more than half of patients on vents are under 60 or 50 (depending on the country). Also talk emanating from Hong Kong that some recovered patients may have permanent lung damage, just like from the original SARS in 2003. Don't take this disease lightly, there is a significant chance you can get the serious course if you catch it, in which case you're at high risk for death or more likely permanent lung damage. (Also some evidence for renal impairment but that is something much less understood right now).

Fears mount in Iran over coronavirus deaths with 15 per cent of victims aged under 40

Iran has recorded its biggest single-day jump in coronavirus deaths and has acknowledged that some 15 per cent of the victims were aged under 40.

www.sbs.com.au

 

[Money-Moniker]

Another thing I'm a little worried about is our ability to stand up for basic OSHA protections as residents. We're already hearing that HCWs are being asked to engage in unsafe practices such as reusing masks, going into patient rooms without masks, not having access to N95 during aerosolizing procedures, etc. Hopefully this will improve as time goes on and manufacturing capacity ramps up, but it could equally go the other way, where growth in patient volume outpaces growth in PPE manufacturing capacity.

As an attending, you can always quit if you feel you are being told to place your health at risk. As residents, we can hardly do the same as quitting would almost certainly result in the end of our medical careers and financial ruin from which it would be almost impossible to recover.