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Writer's pictureThe Crafty M.D.

Grains of Salt: My Perspective on the COVID Pandemic



As of yet, I have mostly kept my feelings about the COVID pandemic to myself. As a radiologist, I cannot say that I am exactly "on the front lines". However, to say that I am completely without risk would be untrue.


I also have a guest interview from an essential employee who works in general merchandise, so I will pull some of that perspective into this as well.


So here we go, take it with a grain of salt.


First of all, in Radiology, we do see patients and we are a little bit more essential in helping fight this disease than you may think. CT is actually a lot more sensitive (albeit less specific) than the current laboratory tests. I believe the current sensitivity of the pharyngeal swab is ~63% (https://www.jwatch.org/na51116/2020/03/17/pharyngeal-and-nasal-swabs-may-not-have-adequate)


What this means is a CT can detect pneumonia when the test might be negative (sensitivity), but it cannot tell me that the pneumonia is associated with COVID if that makes sense. There is the added drawback that the scanner must be shut down for around 2 hours for cleaning after every suspected COVID patient. That means delays on scans for patients who may have something more acute to deal with, like a pulmonary embolism or stroke.



So, CT winds up not being as useful as one might hope. Kind of sounds like I'm defeating my own point. That is until you realize that nearly every patient that enters the hospital has some kind of contact with the radiology department. This is usually in the form of a chest X-Ray and is actually really useful in helping to diagnose and follow disease progression (see above for the progression you can see in just four days). The danger here is superimposed bacterial infection and ARDS. Radiology is kind of like the stage crew. We mostly work behind the scenes to help others shine.


But as I stated before, we do see patients. We do fluoroscopy or "dynamic X-ray" on patients to check for GI disorders. We do small procedures like joint injections and fluid drainage. Interventional Radiology does more advanced vascular procedures and biopsies. While a lot of the elective procedures have been cancelled, we still have patient contact. And the downside is, many times we don't get a good history from the floor and may be the last to know if a patient has C. diff, COVID, whatever.


The final point that I wanted to iterate before the interview below is that there is a disgusting lack of compassion for our healthcare providers. We are taken for granted at nearly every turn. And I'm not just talking about doctors. I'm talking about nurses, respiratory therapists, janitors, transporters, EVERYONE!


Would you send a cop into the line of fire without a vest? Absolutely not! So why would you send healthcare providers into a high risk zone without the proper personal protective equipment (PPE)? It's insane and it needs to stop.

 

INTERVIEW (my guest wanted to remain anonymous due to store policy regarding interviews):


Me: So I have to ask this question. Do you have any toilet paper or hand sanitizer?

Guest: (laughs) Hand sanitizer is practically always a no, regardless of when the truck comes in. But we do get toilet paper on every truck.


Me: How often do you get trucks?

Guest: Once a day.


Me: What have you noticed at your job that bothers you?

Guest: When it comes to social distancing, the store I works at has placed markers to indicate the proper social distance (6ft), but guests don't use them. Even after we point them out.


Me: Are you allowed to use any type of PPE?

Guest: Yes. Our store has allowed gloves and face masks. Especially for any high risk/ immuno-compromised employees.


Me: A lot of jobs haven't been allowing that, right?

Guest: Yes and no. If you ask for permission and are high risk, most places will let you. But you can't just show up with PPE for no reason.


Me: Our state is currently under a :shelter in place" order. How has this impacted some of your coworkers financially. Or, even you?

Guest: Everyone's hours have been drastically cut. Some people went from 26 to 7 hours. It's hard to make a living. A lot of people are hopeful the stimulus package will help. But the consensus is we still have to work, even if the state is on lock down.


Me: Is there anything I haven't asked that you want to share?

Guest: I just want to remind people that the retail employees are human and are scared to go out too. But they really want to help out their communities. So, please, if we're out of essentials, don't threaten to kill us or spit on us. It has happened. We wish we had it to sell. Some days we just don't.


Me: Thanks for your perspective. It's an important one that I don't think a lot of people get to hear.

Guest: Thanks for the opportunity.

 

While things have been getting pretty bad for people, there has also been a lot of good happening. I am part of an online discord ground for yarn crafts. Even there I can see people coming together to support each other. A lot of designers are making their patterns free so people have something to do while they are cooped up inside. There has never been a better time to learn a new craft.


Craft groups are even volunteering to make DIY face masks because there isn't enough PPE to go around. At the risk of sounding ungrateful, I'm not sure how useful these are without the power of N95 filtering and I will not be taking part. I have heard since PPE is so hard to come by, theses are being used to help keep the masks is good condition longer and might not be a bad idea. I just hope people sanitize them regularly.



Stay at home, practice good social distancing, and help flatten the curve. And above all, be kind to one another. America as a country has surpassed Italy in the number of cases at this time point in the virus spread. So, I fear, things will inevitably get a lot worse before they get better.



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