Science Vs - Coronavirus: A Story From the Front Lines

Episode Date: March 19, 2020

As Covid-19 cases rise in the U.S., healthcare workers are already struggling to keep up. In a different kind of episode, we bring you an interview with Dr. Antoinette Ward, who is leading Covid-19 testing at a major hospital in Atlanta — and finding ways to treat the rapidly increasing number of patients. This interview comes from iHeartRadio’s The Women. For more stories from those on the front lines, listen here: http://bit.ly/TheWomenPodcast Here’s a link to the transcript: https://bit.ly/3bczJHW   This episode was mixed by Adriene Lilly and Peter Leonard. Special thanks to Sonya Green, Gail Reid, and Jen Shipon. Fact checking by Lexi Krupp. Learn more about your ad choices. Visit podcastchoices.com/adchoices

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So we have jettisoned the season that we planned and instead we're going to be reporting on the coronavirus in the coming weeks. There's a lot of fear and dodgy information out there, and that means there is a lot of Science vs. Ig to do. If you have a burning question about the coronavirus, please email us at sciencevs, that's sciencevs, at gimletmedia.com. We'd love to hear from you.

Meanwhile, cases in the US have been going up and up. In New York State, we have 10 times more confirmed cases than we had about a week ago. Now there's more than 4,000. And this is inspiring a lot of scary headlines. But knowing these numbers, it's actually a good thing. For now, the confirmed cases are going up so quickly because we're testing more people. And that means we're starting to get a better handle on how many people are actually infected.

But other states around the US, they're still basically in the dark about infection rates. So today, we're hearing from a nurse in Atlanta, Georgia, who's grappling with this very situation. She's helped set up a testing site for a major hospital over there, but is still experiencing problems. Her name is Dr Antoinette Ward, and she has a doctorate in nursing. She was interviewed by a friend of the show, Rose Reed, who first published this on her podcast, which is called The Women. It's from iHeartRadio.

Okay, Rose takes it from here. When did it become clear to you, oh, this is going to be an issue here in my city and in my hospital? I think for me, that turning point is when I saw a lot of European countries, several decided to close their borders. And I actually do have some colleagues, and I've spoken to them. And one person in particular I spoke with, and he's now an emergency room physician. And he's based in Italy? He is based in Italy. He told me, he said, you guys just do not understand how big this is. Was that a phone call or an email exchange with your

colleague? It actually started out, I believe, with a Facebook post that I saw that they posted. And I remember saying, oh, okay. I haven't talked to him in a while. And we sort of went back and forth a little bit on Facebook. And I asked him, I said, is it okay that we talk for a moment? And he said, okay, sure. So we just talked very briefly. And he really told me, he said, you guys just don't understand what you're in for. This was probably a week ago, and he was very overwhelmed. So for me, I think I became very anxious at that point, saying we have to move and we have to move fast. So the decision was made pretty quickly that we needed to do something, and we had to figure out how to do it quickly.

So I would say within the past week, we decided we have to have some area outside of the emergency department just to try to see patients who are suspicious for COVID. So we did open an ambulatory COVID testing center. We set the center up literally within 48 hours. It's an entire clinic that we set up in 48 hours between providers, the doctors, nurse practitioners, and a care team really just sort of got rolling. We started testing patients and the numbers are just growing daily. It's just more and more people are coming in. So there's so many people that need to be tested. There's so many people that are sick. The numbers are increasing daily as we speak. So the number is rising and we have not as an area started active testing to even know that and to get a

grip on it. So we're very behind the eight ball around here as far as testing these patients. The people that are walking in, are they people who are nervous because they have cold symptoms or are they people who are exhibiting the symptoms of fever, cough, respiratory issues? We have a combination of all of the above. We have a lot of people who maybe have some upper respiratory symptoms that they may even have typically this time of the year and they're nervous. Then we have patients who are coming in who are genuinely sick and who've had genuinely real exposure. We have a lot of patients that we've had to put on ventilators. So we have the entire gamut and that's the hard part for us is sort of the triaging of what's going on with this patient who needs immediate care for the

symptoms they're having versus someone who's nervous about a friend of a friend with a party they may have attended two weeks ago. I'm wondering if you could describe what the testing center looks like. Is it set up in a parking lot? Is it a tent? No, it's actually two miles down the street from the emergency department. We took a building that was not being used as often. It's an older clinic. It has 16 rooms, a desk, a check-in area. So it looks like the clinic that you would go to to visit your primary care doctor or any other physician. Security at the door and you're handed a mask upon approaching. And have you been able to get tests easily and get the testing results easily?

No, we have not. It's not been very easy at all. We're very concerned about running out. We're in touch with the state very regularly. We in touch with lab core with quest we're you know doing everything we can to get tests from different places wherever we've pulled all the tests that we have so no it's not easy it's an ongoing conversation and that's our biggest fear is what happens when we run out and waiting for more. And results right now vary depending on where, who's doing the test. Our local state level is, they do the test in batches daily. They can only test so many people a day. So, getting test results is not easy at all. When the test is run, we have to check with the state and ask them, you know, have you ran this test? We sent you yet. They'll tell us yes or no. They'll tell us when the date is. So no matter

how efficient we are, we'll still let someone else's mercy. We're working on developing an in-house testing and hopefully we'll have that up and running. We've been told within a week or so that will help us quite a bit. And is it just a swab? What does the test look like? The test is actually very similar to a flu test. The one that we're doing, it's a nasal swab. It's a little bit uncomfortable. And we use this alone for better of like of describing it. It's like a lone medical Q-tip.

And we go up and get a nice sample, twirl it around a little bit, wait a couple of seconds, and we pull out. And then we do an oral swab also. Go all the way back in the throat so we make you gag a little bit. Yes, it's somewhat uncomfortable. I've made a few people cry in an effort to make sure we're getting a really good sample. It's okay. No one complains. They know it's with love.

They do. What does a sick patient look like? Well, generally for them, it is, I'm having my yearly allergies, ducking nose, maybe a headache, but then they'll say, you know, in addition to that, I'm having some shortness of breath and I just don't feel well or I'm tired. And this is not generally how it is for me when I have allergies. And sometimes they may report a very small fever, maybe 100 and no fever at all.

It's just they don't feel as well as they normally do with these same symptoms. The person with asthma may say, I've used my inhaler for the past week. I'm still extremely short of breath. I have this cough that I usually don't have. It's more so that I can't control it as I normally do. It's generally people who have comorbidities or illnesses already going on, but they say, you know, this time it's just not getting better, or this time it's worse than what it normally is. So we go ahead and we test those patients, and a lot of them have been positive. The scary part for us is when they retrace their steps, they don't have known contact with anyone else that's positive. So

many of them have no idea who they may have gotten the coronavirus from. The facility that you have set up at your hospital, the special area for those who are critically ill from coronavirus and COVID-19, what do they look like? Those people, they're sick. Some of them are on ventilators. Many of them are running high fevers. They have shortness of breath. That's the special isolation area. We actually used the same area for Ebola patients before.

I know that in Italy right now that family members aren't allowed to visit because of the just sheer volume of patients, but also because they don't have enough protective gear for visitors. I'm pretty sure we will get to that point shortly. What makes you say that? Well, you know, we're trying to hold on to our protective gear also. There's a limited amount. We don't know, you know, when we'll get more gear. We're running through it quite a bit. So at the same time, we have to be very cautious that we have what we need to take care of our patients. After the break, we hear about all the crazy steps that Antoinette has to take to keep herself safe

when on the front lines of this pandemic. Welcome back. As cases of COVID-19 are spreading around the United States, healthcare workers are trying to keep up. Today, we're hearing from Dr. Antoinette Ward, who's been setting up testing at a major hospital in Atlanta. Antoinette is being interviewed by Rose Reid. How are you keeping yourself safe? How have your protocols changed in the last week? Oh my gosh. So we've changed quite a bit, especially when I'm working in the COVID clinic. The way that it works there is we wear two masks. We wear an N95 mask.

We wear a face shield over that. And then we're wearing a gown, two sets of gloves, hair bonnet, and covers our feet. And so the N95 mask is not to be taken on and off. So we take our gowns off and re-robe for every room. So it's called doffing and downing. So we take everything off and put it back on for every patient. So could you imagine doing this about 30 times a day? In the meantime, everything you do, every step, you have to wash your hands. So we're washing, washing, washing our hands 24-7. I walk in the room with gloves on. I introduce myself to the patient. I

do not shake their hands. I have some paperwork in my hand. I put it down. I take that glove off. I wash my hands. I put gloves on again, do a nasal swab and an oral swab on them, select that swab, take the gloves off, wash my hands. So every step of the way of everything you do, you're washing your hands and you're putting back on gloves again. And then you take off the gown once the patient has left the room. There's a lot of costume changes. Yes. But the N95 mask, we do not take off. There's a shortage of that. So we literally keep that mask on. And you only take that off lunchtime when we eat. So take yesterday, for example, I started, I saw my first patient at 8 a.m. I think I ate lunch at 1.

So mask on from 8 to 1. I take the mask off, go to the bathroom, drink water, eat pretty quickly, finish charting on patients, start over again, put a new mask on at 1.30, and I saw patients until 7.30 last night, I believe, and that's our routine all day. So I'm working with a team of, it was only the three of us yesterday. Everybody chipped in. We worked really, really hard. We're asking everyone to work extra shifts already. We're asking them to work longer shifts. We're asking them to be away from their families. All of the school systems in Metro Atlanta are currently closed, so we're switching shift times around to help our

colleagues with small children. We're sharing babysitters. We're offering, I have an 18-year-old. We're offering them up as babysitters, the ones who are experienced babysitters. We're doing everything we can to support each other. And how long do you anticipate this level of patient intake and volume to go on? How long is your team preparing for? We're actually in it for the long haul. We have daily huddle meetings, and I actually have one today,

where we Skype or Zoom each other and we talk about this. Currently, we're planning for the next six months. Six months? Yeah, we're planning for six months. We have to. We're here. Yeah, we plan for the next six months. When we hope things will get better in those six months,

but we have to think about the long haul of taking care of our patients, our staff, the aftermath of this. So we're planning to, you know, definitely take care of patients that long and to take care of each other that long. We don't know what's going to happen after that. But that's the language that we're using. This is affecting everybody, but especially for those who are healthcare professionals, they're literally putting their bodies on the front line. How are you grappling with that? I'm going to be honest with you. It's a struggle. It is definitely a struggle of how do you stay happy? How do you keep your peace when there's a lot going on?

There's a lot of people who are very anxious. And to be realistic, there are people that are dying and some that will die. This has not begun to hit its peak yet. So it's very much a struggle for me right now, if I can be honest with you. I do have an 18-year-old who's a senior in high school. Most of her events have, at this point, have been canceled. We don't even know about senior prom. My heart goes out to her. Does she already have a dress?

She's already got a special dress we ordered and paid a lot of money for. She's made a lot of plans, though. We don't know how that looks. You know, this is her senior year. A lot should happen for her right now that may not even take place this year. Is there one thing that you think listeners should really know about and take to heart when it comes to preparing for the next few months and, you know, taking social distancing seriously and making other choices for themselves and for their communities?

For me, I think a big take-home message would be we have to take care of each other. We have to take care of our neighbors. We have to take care of each other's kids, of our elderly. We have to call people that we haven't called lately. We have to check on each other. That's going to make the difference for all of us. We absolutely have to take care of each other. what I do. I wouldn't trade it for the world. But I'm also a mother, a daughter, a sister, a partner, a neighbor. So every aspect of my life, I'm thinking, who do I need to call? Who haven't I seen recently? Do I need to make sure they're okay? And of course, we have to practice social distancing, but it does not mean that we cannot reach out to each other. This interview is from Rose Reid, and it's from her podcast, The Women, by iHeartRadio.

Rose will be interviewing more women from the front lines, and to find her podcast, search for The Women Heart. We'll add a link to our show notes. Next Monday, we'll be back digging into the science of this pandemic. This episode was mixed by Adrian Lilly and Peter Leonard. Special thanks to Sonia Green, Gail Reid and Jen Shippen. Fact-checking by Lexi Kraut. I'm Wendy Zuckerman.

I'm social distancing. And I'll fact you next week.