It’s still dark when Candice Meck, MD, gets up and starts getting ready for work. She puts on a protective mask before picking up her six-month old son and sitting down to breastfeed him. This will be the calmest moment of her day before she starts her shift as an emergency doctor in Chicago, where she rotates between three hospitals. But it’s a moment of only semi-normalcy. She’s still wearing a mask, and she hasn’t been able to kiss her baby in three weeks. She says goodbye to her husband before she leaves. She hasn’t kissed him in three weeks either.
When she gets to the hospital, she puts on more protective gear: a plastic blue gown that covers her scrubs, plastic shield, hair cover, rubber gloves, and another mask, this one an N95 mask, which has a tighter fit than surgical masks to better protect the nose and mouth. “I get one N95 mask per shift,” she says. “If I do what’s called an aerosolized procedure, which means putting a patient on a ventilator, it could contaminate the mask because the virus is spread through the air. Then, I’m allowed to get a new one.”
Fortunately, all of the hospitals where Dr. Meck works have been steadily stocked with supplies, but Dr. Meck says she doesn’t see how that will last. “Everyone is using gowns and gloves,” she says. “The doctors, nurses, techs, cleaning services… It’s going to go by quickly. We’re going to run out.”
In the past, people coming into the ER were a mixed bag. Peppered between patients with heart attacks and strokes (the critical cases that emergency rooms are deigned for) were other kinds of patients that helped mix things up. “Remember all the teens who would come in for STD testing or patients complaining about chronic back pain? I miss those guys,” is a standing joke Dr. Meck makes with her colleagues.
Now, no one comes into Dr. Meck’s ER unless they truly, absolutely have to. Looking at the floor every day, she knows exactly why all these patients are here.
On the front lines in one of the most at-risk states
As of April 2, there have been 6,980 positive COVID-19 tests in the state of Illinois. One hundred forty one people in the state have died from the disease. This makes it one of the states with the highest number reported cases (behind New York, California, Michigan, and Florida), according to the Centers for Disease Control and Prevention (CDC). In the U.S. as a whole, there have been 213,144 reported cases of COVID-19 and 4,513 deaths from the disease (as of April 2).
“Some people come into the ER with symptoms and don’t think it’s a big deal. Others are very scared and their loved ones are scared,” Dr. Meck says.
People who are symptomatic—meaning they had a fever, dry cough, or shortness of breath—are tested right away at Dr. Meck’s hospitals, but that wasn’t always the case. “At the beginning of March, we had to go through the Illinois Department of Health, so getting the results took four or five days,” she says. “Sometimes, you just never found out if a patient tested positive or not. Now it’s done in-house so we get the results within 24 hours.”
However, Dr. Meck says she still faces limitations with testing. “A lot of people come in saying they have been exposed to someone who has tested positive for COVID-19 and want to be tested. But unfortunately in Chicago, as in many places, we only have [enough tests] to give to patients who are presenting with symptoms,” she says.
“I remember one man who was 60 years old and his fiancée had tested positive. He works as a mailman and several of his colleagues had tested positive as well,” Dr. Meck says. “He was scared because he knew this virus was especially dangerous to the elderly, but I couldn’t actually give him a test because he didn’t have any symptoms.” In those cases, she tells patients to act as if they do have COVID-19—isolate themselves from others, and come back if they start having severe symptoms.
“What’s so terrible about this virus is that it is very isolating. You can’t have a loved one by your bedside. They can’t hold your hand or comfort you.”
Dr. Meck doesn’t like to think of those early days, when patients were sent home without knowing if they were positive. “Looking back to the first week of March, I remember clearly having multiple patients come in who I now know must have been COVID-19 positive. But at that point, we thought it was just like every other virus and didn’t take it as seriously. It wasn’t until the end of the second week of March that we realized it was a pandemic.” (The World Health Organization officially declared the disease a pandemic, aka a global outbreak, on March 11.)
If someone tests positive but are in stable condition, they are sent home and told to self-isolate. But if a patient tests positive and is having trouble breathing, they are admitted to the hospital so they can have access to a ventilator. Either way, Dr. Meck says recovery is lonely. “What’s so terrible about this virus is that it is very isolating,” she says. “You can’t have a loved one by your bedside. They can’t hold your hand or comfort you.”
Multiple patients Dr. Meck has tested have been positive for COVID-19, and not all of them have survived. “There are some people who just don’t have a strong enough immune system to fight it off,” she says, thinking of patients with congestive heart failure or with cancer.
Helping others in spite of fear
It isn’t just the patients who are scared. Dr. Meck is scared, too. “When I signed up for emergency medicine, I knew I was going to deal with infectious diseases like meningitis, for example. But I’ve never actually been fearful of a patient until now,” she says. “This is a highly contagious virus and I’m afraid. I’m torn between wanting to be a good doctor and providing care for the people who are most vulnerable, and wanting to be a good mom for my new baby. I could never forgive myself if I passed this along to my husband or baby and something were to happen.” It’s why she wears a mask when changing diapers, breastfeeding, and stops herself from smothering her son’s cheeks and neck with kisses the way she did when he was first born.
Dr. Meck says her family is her support system, but so is everyone she works with at the hospital. COVID-19 hasn’t tempered the sense of humor Dr. Meck and her colleagues have, which they use to get through the days. “There’s definitely times when someone needs a moment to herself, just to breathe or cope in whatever way that’s needed, but the emergency room is a great place to work because we’re all on the same page. We still have fun. We still make jokes,” she says.
While Dr. Meck, and the thousands of doctors, nurses, first responders, techs, and hospital cleaning staffs, are on the front lines fighting COVID-19, she says that this is something the world is going through together and everyone plays a part. “My husband has his part, our baby’s daycare has their part by shutting down and keeping the kids safe, journalists have their part sharing needed information…We’re all in this together,” she says.
If you aren’t sure what your part is, Dr. Meck is assigning you one, assigning everyone one: Stay home. Take this seriously. “I know social distancing really sucks,” she says. “But if we can all just adhere to the rules for a couple months, it will be worth it. The sooner we do this, the sooner we’re out of it.”