Renegade Responders

The COVID-19 frontline heroes

April 2020

ICU Nurse Specialist

San Francisco
Currently I am given one N95 for the entire day, regardless of how many patients I see. Prior to this pandemic it was a strict requirement to change masks after each interaction with each patient. There were consequences for not changing PPE after each patient.
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Tell me a little about where you work and the types of patients you see?

I work in a San Francisco specialized COVID-19 ICU unit. The patients I am treating for COVID-19 are mostly middle-aged and are all intubated and sedated. We can have up to 7 in the unit at one time.

How do you feel about regular access to testing for frontline staff, does your union advocate for that?

Yes, I think that it is a vital requirement that all frontline staff should be tested. I am a member of the union, but I don’t know their stance on testing right now, to be honest I haven’t had time to inquire. I would like to be tested regularly though.

Are you receiving adequate PPE from each hospital?

I would have to answer no. Currently I am given one N95 for the entire day. Prior to this pandemic and before shortages, it was a strict requirement to change masks after each interaction with each patient. There were consequences for not changing PPE after each patient. Now I am being told its one N95 a day, regardless how many patients you are seeing.

Have you been in a situation where there was an immediate need for PPE, but none was available?

As of right now, that has not occurred. On the east coast with their lack of PPE and soaring figures it’s a different situation. However, we have not seen those extortionate case numbers yet here in San Francisco. It shows how important social distancing is in the early stages. The less strain put on hospital supplies and staff, the easier we (staff) can all keep safe and focus on treating patients. I am grateful for San Francisco’s early action.

How safe do you feel, are you nervous about the increasing reports of deaths of frontline medical staff?

Yes, extremely nervous. Thankfully, this has not been a problem in California from what I know of. However, the numbers nationally and globally are deeply concerning. I pray we don’t come to that here in California.

Do you feel others in your household are at risk to COVID-19 as a result of your work?

No, I take all necessary precautions to avoid anyone being at risk from me, but it’s a worry with my children.

Do you feel the media is overall representing/reporting on working conditions of frontline COVID-19 staff in an accurate manner?

From what I have seen on CNN and social media I think they are doing a tremendous job. Overall, people have been very supportive of medical staff.

How does this compare to the 2009 H1N1 pandemic?

We were very busy in San Francisco with H1N1 yet there was an extremely different morale in the hospital compared to today. People were extremely ill, but it was not as contagious as COVID-19 and we felt more in control. We used antiviral agents, such as Tamiflu. We knew it was more seasonal and we saw the end. With COVID-19 there comes extreme uncertainty.

Apart from obvious figures, how does the level of illness differ from COVID-19 to H1N1, from what you have seen first-hand?

Treatment was very different. We were able to treat people’s organ failures. As long as they were on an ECMO machine we more or less knew if they would survive or not. As I said, we had more control and were much more organized. ECMO machines (extracorporeal membrane oxygenation) saved a great deal of lives.

Are your colleagues very concerned and how many do you think have already caught the virus?

Yes, I would say that we are all very concerned. With COVID there is so much we don’t know. As I said, with H1N1 we saw the end and had the ability to treat patients. Whereas with COVID, who knows? And that is frightening for those of us who are on the frontlines. I know a lot of people who are very, very anxious.

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