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The doctor is used to taking care of other people.
On a normal day, she’d be seeing patients at a community health center in Rhode Island — leaning in close with her stethoscope to listen to their lungs; peering down the backs of their throats and tap, tap, tapping on their bare bellies. Many of her patients have chronic health problems — diabetes; high blood pressure, asthma — and persistent socioeconomic challenges.
But for now, this primary care doctor is confined to a solitary bedroom in the basement of her home. She relies on family to cook her meals. They leave plates of food at the top of the stairs.
The doctor — who asked that we only use her first name, Diane — is among the roughly 2,500 people in Rhode Island who have been instructed to self-quarantine because of exposure to the coronavirus, according to the state Health Department. (Data on the number of health care workers in self-quarantine was not immediately available.)
As of Friday, state health officials reported that 203 people in Rhode Island tested positive for COVID-19, the illness caused by the coronavirus. And 75 of those people — 37% — are health care workers. (That could include people who work in doctor’s offices, dental offices, pharmacies and hospitals.) Health care workers represent a “significant majority” of those tested so it’s expected that they would account for a high proportion of those who test positive, Joseph Wendelken, a state Health Department spokesman, said in an email. “We have not seen any clusters in health care settings,” he said.
State health officials have prioritized testing health care workers because they are considered among those at highest risk for contracting and transmitting the virus. “Our members are reusing and over-using personal protective equipment so…that is a major concern,’’ Ray Sullivan, a spokesman for the United Nurses & Allied Professionals Local 5098, said in an email. “We have shared that concern with Governor Raimondo and appreciate her efforts to marshall additional resources.’’
Diane, the doctor who is self-quarantined in her basement, said she learned that she had been exposed to the virus last Sunday, while hiking near a lake in Swansea, MA. Her cell phone rang but she didn’t recognize the number so initially she didn’t pick up. “But the third time I saw the number I thought, well, I should probably get this call.’’
The caller from the Health Department said someone at the center where she works had tested positive for COVID-19. “I was instructed to go into quarantine,’’ she said. When she returned home she packed a bag and moved into the basement.
“The first 24 hours was a little rough,’’ she said. Her husband and two college-age children “weren’t used to feeding me,’’ she said. “And I wasn’t used to…being dependent on others for providing food. So I went to bed hungry the first night and woke up hungry.” The next day, she texted her family a document called “Mom’s feeding schedule.” She assigned her husband to make her breakfast, her daughter to do the mid-morning snack and her son to make her lunch. And it was “all hands on deck” for dinner.
“I’m learning how to ask for nurture,’’ she said, “and they’re doing a wonderful job of stepping up and being creative and caring for me.”
She said she’s not worried about getting sick; she feels fine. But she is worried about her patients. She is working 12 to 15-hours a day, providing “tele-medicine’’ via phone. The other night, she said, she got a call from a patient with severe chronic obstructive pulmonary disease (COPD) and was having trouble breathing. “And normally this would have been someone who I would have wanted to see,’’ she said. But an in-person visit would have meant a trip to the hospital emergency room, which they both hoped to avoid. “So while we’re talking on the phone, I’m really listening to how the patient is pacing their breath, and how many words they can string together without taking a breath. Is the patient talking in full sentences…?
She thought the patient might have been having a flareup of COPD. Or she could have COVID-19. “We don’t know,’’ she said. “But I’m treating anyone with any respiratory symptoms as if they might.”
As a precaution, she told the patient to self-quarantine. That’s especially hard for a lot of the health center’s patients who don’t have a separate bedroom where they can sleep or who share one bathroom. “Almost everyone says, ‘I can’t do that’ or ‘how am I going to do that?’ And I say these are the recommendations. Try to do the best you can.’’
She said she’s felt encouraged by the way people are helping each other, picking up groceries for elderly family members or neighbors. Her goal now, she said, is to get through her quarantine so she can get back to the health center and see patients.
The health center where she works, like so many others, has been running low on personal protective equipment. “We had almost no N95 masks,’’ she said, referring to masks designed to protect against aerosolized particles. And “we’re really trying to make our surgical masks last,’’ she said. “So as a result, you know, we weren’t using them routinely.”
That left her vulnerable to exposure to the virus. “If I had been protected,” she said, “I would not be in quarantine right now. I’m quite confident of that.”
-Lynn Arditi, health reporter, larditi@thepublicsradio.org