An Austin ER Doctor To Her City: We're 'Depending On All Of You To Hold The Line'

Mar 30, 2020

Austin-Travis County has confirmed 200 cases of COVID-19 as of Sunday night. One person in the area, a woman in her 70s, has died from the illness. The city is far from the epicenter of the pandemic in the U.S.; places like New York City and New Orleans are reporting hospitals being overwhelmed.

But public health experts are warning that Austin could face similar problems unless residents limit their contact with others.

Jaime Jones is an emergency medicine physician in one of Austin’s major hospitals. (We are withholding the name of the hospital where she works for privacy reasons.) Jones has been an ER doctor for 10 years, working in Austin for the past five.

She spoke to KUT about what she is seeing on the frontlines of treating this disease.

Her account has been condensed and edited for clarity.

"There's many more infected."

When somebody comes in with a possible COVID-19 infection, we ask them about their symptoms: Do you have a fever? Do you have a cough or are you having any shortness of breath?

We have been asking people about travel history or known contact with somebody with COVID- 19. That's fading now because it's so prevalent in Austin. And we know that there's many more infected than the numbers of tested are showing. The hospital right now is not doing any testing of COVID-19 except on patients who are going to be admitted.

What I am seeing in most cases is patients who come in … and they say, "I was sick for a few days or in some cases up to two weeks. And then over the past few days, I've just been feeling more and more short of breath.”

The folks that we’re admitting with COVID-19, are mainly those who are having a lot of trouble breathing. Often we'll see things on their chest X-ray, some kind of haziness, some fluffiness consistent with a viral pneumonia. Their oxygen levels will be low, and that's what will prompt them to be admitted to the hospital.

They get breathing treatments if they're having any wheezing or if they have a history of asthma. Otherwise, they get admitted. If they need to be intubated, they get intubated and otherwise they're given oxygen. We have very little with which to treat this right now.

This is a young city, so probably our sample is a little bit skewed. But I am so far not seeing as many elderly folks who have this. I'm more seeing people in their 30s, 40s, 50s who are getting admitted to the hospital. So, it's not just an old person's disease.

"We don't know quite how exponentially this is going to grow."

I've been hearing a lot through colleagues who are on the coastal cities about what they're seeing there. It’s not like anything that we've seen in this country before. They are running out of masks. They’re using bandanas. They're running out of other personal protective equipment and reusing N95 masks for multiple days. They're having to put multiple patients on the same ventilator, which is really pretty unheard of. It’s not something you would ever think would happen in a first world, medically forward, developed country. But here we are.

I think that we could easily get there, and we may get there for a short time. We don't know quite how exponentially this is going to grow, but I'm hopeful that we have learned something of a lesson from watching the coastal cities start with this pandemic sooner than we. Hopefully [we] got things locked down in time that our curve will be much flatter much sooner.

There are minor fluctuations, but overall, it's an upward trend [of COVID-19 patients], which is what we are expecting and what we know will absolutely happen. Even with Austin in self-isolation and even if everyone does it perfectly, there is still hundreds, if not more people in the community that are infected and either aren't showing symptoms yet or their symptoms are mild enough that they haven't gotten tested or haven’t needed to come to the hospital.

If nothing changes in a week, I think that we're going to have large numbers of people admitted to the hospital. We're going to have people on ventilators. We're going to have more people who [have] died. Because, again, even if we all keep the quarantine perfectly, there is still those out in our community who are already infected, who just haven't gotten that sick yet.

I think the other question is, if nothing changes as far as our self-isolation procedures, where are we going to be in two or three weeks or in a month? And I think then we will hopefully be seeing the downward slope of this curve and be coming out the other side.

"We practice air hugs from a distance and blowing kisses."

Everything that I would usually use as a stress-coping mechanism, a lot of that isn't available. I can't go to yoga class and I can't visit with friends or go out and get a nice dinner. I'm doing more at home and I'm taking more walks. I'm reading the fictional literary equivalent of junk food, cooking more, and also trying to give myself permission to not be happy or be OK with it all the time.

I have a 4-year-old daughter, and right now she's staying with my parents up in Georgetown. She's been there for a little over a week. And I see them a couple of times a week outside always, at a distance always. [My husband and I] made the decision when this started, not knowing how often I would have to be at the hospital and what home life would look like here in Austin.

We just explained to her that there are some bad germs out there and that momma’s taking care of the sick people with bad germs but that germs like to jump, and so we don’t want the germs to jump from me to her. We practice air hugs from a distance and blowing kisses.

She's really happy … But it's really hard. It's hard to see her and not be able to hug her or to hug my parents. It’s also hard being on the frontlines of this and not knowing where the end is, you know — how long is this going to go on? And will we have the resources that we need to help people?

"We get pretty geared up."

Every time I go and see a patient who may have COVID-19, we get pretty geared up.

I wear a surgical mask, so it's not an N-95. It's just one of those paper masks with the ear loops. Over that I wear a plastic visor that attaches to my forehead and then comes down but is open on the bottom and I'll wear a disposable gown and gloves.

But we are also more and more trying to limit the use of personal protective equipment each day … We wipe down and reuse the visors throughout the day and we reuse the surgical masks, as well, as long as they haven't gotten dirty.

My hospital just [Thursday] moved to a policy where when you arrive in the morning, they check your temperature. They issue your surgical mask, and that is your mask for the whole day.

For the intubation, especially, we have special getups that have a helmet, a full-face hood and then a battery pack that keeps a positive filtered air going through your face hood while you're doing the procedure.

"We in the hospital are really depending on all of you to hold the line."

I think one of the things that stuck with me is how alone people are forced to be when they get this disease. You know, we're not allowing visitors in the hospital, which is the right thing to do. But when you're there and you're sick and you can't breathe well and you're scared and not having anybody who loves you with you is really, really hard.

As this gets worse over the next couple of weeks, which it is going to do, it's not a failure of the quarantine, of the self-isolation. We in the hospital are really depending on all of you to hold the line, because we don't have enough to treat this.

If we see too many sick people flooding the hospitals all at once, more people are going to die. Everything that you do, every little social contact, that matters. The more we can limit them, the better chance we have of coming through this as a community.

Got a tip? Email Audrey McGlinchy at audrey@kut.org. Follow her on Twitter @AKMcGlinchy.

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