This ER Doctor Says Her Hospital Was 'Treating COVID Patients Before We Knew We Were Treating COVID Patients'
Seattle was one of the first epicenters of coronavirus in the US—here's what it was like to work there.
On January 21, the US announced its first confirmed case of COVID-19—a man from Washington state in his 30s who had developed symptoms after returning from a trip to Wuhan, China. Just over one month later, on February 29, officials reported the first confirmed coronavirus death again in Washington, this time near Seattle.
Soon, Seattle became known as one of the epicenters of the coronavirus pandemic in the US, putting a strain on the hospital system there. "We were treating COVID patients before we even knew we were treating COVID patients," Sachita Shah, MD, an emergency physician Harborview Medical Center in Seattle, and associate professor of emergency medicine at the University of Washington, tells Health.
Dr. Shah began seeing patients come to the hospital with multifocal pneumonia—or pneumonia that affects multiple sections of the lung—in both lungs, but they didn't fit the initial profile of coronavirus patients. "They didn't really fit the criteria given to us of they haven't traveled to Italy so they couldn't have COVID," she says. "Very quickly we realized we were having local transmission just among people living in the community around Seattle."
Once the hospital realized they were dealing with community spread of COVID-19, things changed very quicky. "Hour by hour, and certainly every few hours, our protocols were changing about who we were testing," she says. Initially, the hospital was just testing those who showed fever and cough, but then pivoted to "screening for shortness of breath, and then we added COVID toes and inability to smell and all the different symptoms including just fatigue. Pretty soon we were screening pretty much everybody."
The influx of patients also led to issues regarding personal protective equipment and hospital safety measures. "We have all curtained rooms and the curtains don't reach the ceiling or the floor," she says. "It was a big push among our physician and nursing group to work with infection control and engineering to figure out ways to separate the patients, separate ourselves, put up plexiglass, put up plastic, anything creative to try to contain germs."
Dr. Shah had previous experience in dealing with highly contagious patients and the safety measures needed for those situations. "I do a lot of learning about diseases that we don't see her in America as much," she says, referencing her past knowledge about tuberculosis, malaria, and other infectious diseases. "With that background, especially being used to taking care of tuberculosis patients, I felt really comfortable in an N95 mask for hours or working in heat or not being able to eat or drink because I have a mask on."
Thankfully, things have changed dramatically in Seattle since the pandemic began. "We did, overall, I think a very good job as a community in Seattle and even in Washington state to flatten our curve initially," Dr. Shah says. But she's become increasingly worried due to relaxed restrictions. "I think people got tired of being at home, [with] nicer weather."
One of the biggest demographics that causes concern is young people. "There are a lot of young people who believe they won't get sick from coronavirus," Dr. Shah says—but their dedication to safety is especially important during a pandemic, especially without a vaccination or treatment. "It's really the only thing we can do to help save lives as a community—to wear a mask, do handwashing, stay home if you're sick—and if we can do them right, people's lives will be saved."
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