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Emergency Doctor On How Her Work Has Changed During The Pandemic

MARY LOUISE KELLY, HOST:

Just get ready; it's going to be bad. Well, those are the words of emergency room doctor Sachita Shah from when we first interviewed her back in March. Dr. Shah works at Seattle's Harborview Medical Center. In March, they had enough ventilators - barely. They had enough masks, but they were having to reuse them over and over. Shah told us, quote, "it feels like being in battle without armor." Well, with the death toll in the U.S. now about to hit 200,000 people, we wanted to circle back to Dr. Shah and see how things are going.

Hey there. Welcome back.

SACHITA SHAH: Thank you.

KELLY: How are things going? How is the situation in your hospital, in your ER today compared to where you were this past spring?

SHAH: Well, COVID and caring for COVID patients has become sort of just part of our new life. We have a whole section of our emergency department that's now dedicated to taking care of patients with flu-like illness and ruling them out for COVID or, you know, known COVID patients who are coming back and getting sicker. And donning and doffing our protective equipment and how to reuse it appropriately is becoming routine. I think our numbers in Washington state are improving. But obviously, nationally and worldwide, it's a complete disaster.

KELLY: You know, it's both stunning and, I guess, entirely to be expected to hear you describe the situation with COVID-19 as routine, as - you've gotten used to it. Y'all are figuring it out.

SHAH: Yeah. And the thing that I worry about and the thing that's most different is health care worker resilience. You know, we're strong. We train in emergency medicine for this. We serve as witness to all the tragedy of the community working in a trauma center. We're the canaries in the mine of public health. And so when there's a contagion or a public health disaster, we're sounding the alarm bells.

And, normally, spring in a trauma center is kind of our chill season. We get to stop taking care of flu patients and get ready to get our new interns and get ready for trauma season, which is what we call summer. And this spring was really busy. And then this summer, we've had a very busy trauma season with more penetrating trauma and gun violence. And then August and September, which are traditionally beautiful months in Seattle, have turned into smoke and fire season. So we've had some pretty horrific cases, being a regional burn center for adults and children. So I've seen a lot over the past six months. And I just worry that, like, 2020 can't keep going like this (laughter).

KELLY: Yeah. Before we move on from that, the air quality in Seattle has been horrific because of the smoke from the wildfires. I mean, aside from just presenting more patients, does that complicate your work with COVID patients?

SHAH: Actually - so everybody started coughing and having sore throats and red eyes. Unfortunately, those are also symptoms of COVID. So we had a lot of patients come in for testing, which - I think it's great to test everybody, but we did have kind of an influx of people requiring testing because the symptoms are so similar.

KELLY: How are y'all doing on supplies? When we talked to you in the spring, as I mentioned, you had enough ventilators. You had enough beds. You had enough masks. But you were - like, with masks, you told us you were wiping them down and reusing them 'cause you didn't have enough to wear a fresh one with every shift. How are you doing on that front?

SHAH: We are still going through a process to reuse our N-95s. We don't wipe them ourselves. Now the hospital is taking care of repurposing them. And then we use them a few times, and then they get discarded. And we have moved to a universal masking policy, which has been great because most of my patients that have had COVID-positive tests have recently been asymptomatic - come in with another complaint, and we're approaching everybody now with a mask and face shield and gloves so that we are protected, even if our patients are asymptomatic and wandering about the world and then come in with a different complaint but have COVID.

KELLY: Right.

SHAH: So that feels safer. I feel like we have armor (laughter).

KELLY: What about the plan for the overlap of what's expected to be, you know, yet more COVID cases and the flu season upon us?

SHAH: Yeah, that is what is weighing on literally everybody's mind right now in health care - is if people can get vaccinated for the flu - if they were on the fence, this is the year to do it because it's pretty impossible to distinguish the symptoms from one another. And testing for both takes hours upon hours, and it really does change our ability to have any flow through our emergency department because patients can't go anywhere until we know if they have the flu or COVID.

KELLY: Well, Dr. Shah, thank you once again for taking the time to talk to us. We appreciate it.

SHAH: Thank you.

KELLY: That is Sachita Shah. We've been checking in with her every few months since this pandemic has unfolded. She's an emergency physician at Harborview Medical Center in Seattle. Transcript provided by NPR, Copyright NPR.