The Covid tests on my schedule are like the bread in a sandwich, first part of the morning and last part of the afternoon. It’s done like this to preserve PPE, a term sadly, everyone seems to know now. The positivity rate in our clinic is high — 30% — much higher than in the surrounding area. This is because our patients cannot afford not to work, even if the conditions are unsafe, even if they themselves are sick. They do not have the luxury of social distancing in their crowded homes, often with rooms rented out to strangers to help pay the rent. They are also Latino, for the most part, which puts them at greater risk as well. They tend to have comorbidities such as Type II diabetes, obesity, and high blood pressure, which may them more susceptible to the virus but undoubtedly makes it more dangerous for them should they contract it.
But today I am writing not about them, but about me. Which is selfish, I know. As I mentioned before, we have enough PPE, which is wonderful. Our medical director cares about our safety. We are directed to wear eye protection — face shields or goggles — as well as a medical grade surgical mask, to each and every encounter. When we are testing for Covid, we wear N95 masks, surgical gowns and gloves in addition to the eye protection. But still I worry. When positive results come back, I review the visit. Did I lift up my goggles just a bit to better see the computer screen? Was my mask gap-free all the way around? Did I remove the PPE properly? Did I avoid touching my face? Most of the time, after so many tests in a row, it is impossible to remember. And impossible not to worry about my own and my family’s health.
This is a second career for me. Being late to the game, I was never going to be in the ER or ICU. I wanted to be in community health. Far from being an adrenaline junkie, I take pride in getting to know my patients during a first physical and helping them on the road to better health. I like to cheer their progress and try to help them overcome the obstacles of chronic disease. It’s enough. Sure, it’s discouraging at times but the small victories are sweet.
That’s all changed now. We are encouraged to do virtual visits, which is sometimes difficult for our patients to manage. Still plenty of patients just walk in and sometimes, no matter how well the staff questions them, they only reveal their exposure to Covid and need for a test, to me. Who is not currently wearing an N95 and needs to back out of the room to get one along with a gown and gloves.
Of course this is nothing like what my compatriots on the front lines face every day. There aren’t enough words to express my admiration for them, along with the acknowledgement that I could never do what they do. This is about me (remember, I’m being selfish here) and my unglamorous and usually not life-or-death work-day. A day that used to be filled with physicals and pap smears and well-baby visits, with the occasional strep throat, UTI, or STD thrown in to jazz things up. Sometimes a grind, yes, but infinitely preferable to the current situation. What I did was important in its own way and I mourn the loss of that kind of routine health care. I hope in the not so distant future, the ability to deliver that kind of care returns.