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I'm an ER Doctor And Here's Why COVID Will Get Much Worse

This Philadelphia doctor explains why we need to prepare for the second wave of coronavirus.

I am an Emergency Medicine doctor in Philadelphia and when COVID-19 cases started to appear here in March, we were not prepared. There was a general lack of testing and resources. I myself came down with COVID-19 in March. In spite of being a frontline doctor with a known COVID-19 contact and significant symptoms, it still took repeated calls to my public health department and the aid of a colleague to get tested. I finally received my positive test results several days later when I was admitted to the ICU.

Prior to this, when I asked the county health official why the approval of my testing took so long, she said that they had very few tests and had to enforce strict requirements. Compare this reality to President Trump's assertion that same week that "anyone who wants a test can get a test." That was not true. We were not prepared back then and we are not prepared now. Read on to learn why, and to ensure your health and the health of others, don't miss these Sure Signs You've Already Had Coronavirus.

We Lacked Resources—Using a Trash Bag As Protective Equipment

As the pandemic worsened, the DHHS Inspector General conducted a survey and found that most hospitals reported severe shortages of personal protective equipment (PPE) and other critical supplies. The administration decried this as "fake news" and fired the Inspector General. When confronted in March with the alarming lack of testing and significant lag a failed CDC test kit had caused, President Trump stated "I don't take responsibility at all." 

The reality here in Philadelphia is that we lacked resources, PPE, and COVID-19 testing. Our health department was overwhelmed and most tests were sent to private lab companies that often did not result for 5 or more days. Not only did the federal government fail to provide resources to us locally, but there were numerous reports of federal agents seizing vital supplies en route to hospitals. My hospital resorted to rationing masks to one a day and we essentially ran out of gowns. We had to reuse disposable gowns and at one point I actually wore a trash bag as protective equipment while seeing patients.

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You Must Deal With Both the Economy and the Pandemic

During this pandemic, President Trump has refused to wear a mask in public, minimized COVID-19, and insisted on premature re-opening. Here in Philadelphia, as we tried to flatten the curve in April, most of our ICU beds at my hospital were filled with COVID-19 patients and our morgue was twice capacity. If we had opened and not flattened the curve, the system would have been completely overwhelmed and many more would have died. Still, there are those that insist the cure is worse than the disease and that the country needs to reopen. By doing this, we create a false binary choice – you can choose the economy or public health. Of course, the economy cannot function if there is a widespread and deadly pandemic. You must deal with both.

As of today, the United States has more COVID-19 cases and deaths than any other country in the world. Though the case numbers here in Philadelphia have significantly decreased since the peak, new viral hotspots are occurring in states and case numbers are rising in many jurisdictions. Many states that reopened prematurely and in spite of the warnings of public health experts experienced dramatic increases over the summer. 

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The Winter Is Coming

Even though the first wave of this pandemic has not yet subsided, a second and potentially worse wave is coming. This winter, I am afraid of what we will see in the ER. As occurs every year, winter will herald a surge of seasonal influenza, respiratory syncytial virus (RSV), seasonal gastroenteritis and pneumonia. This seasonal increase taxes the resources of the Emergency Department every year. On top of this, we will also likely see a surge of COVID. It may be a very difficult situation that will stretch our limited resources. We know that influenza transmits more easily in the dry air of winter, and this may be the case for COVID as well. If so, we may have an even more significant spike in COVID-19 cases while dealing with the expected surge in seasonal disease.

The choice is not the economy or health. Ignoring the virus and failing to respond will just kill more Americans and prolong the economic pain. Only by addressing the virus can we finally go back to our normal daily lives. 

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We Need a National Plan

We need a national plan and a unified message. I hope that the President recovers from COVID quickly and resumes his duties with a new realization of the severity of this healthcare crisis. Perhaps through his personal experience, he will understand that a unified national response is required to truly address this issue and prepare for a difficult winter. As for yourself: To get through this pandemic at your healthiest, don't miss these 35 Places You're Most Likely to Catch COVID.

Darren P. Mareiniss, MD, FACEP is an Emergency Medicine Doctor who also practices critical care. He has published multiple articles on pandemic response and helped write the Maryland ventilator allocation guidelines. Dr. Mareiniss is currently practicing Emergency Medicine at Einstein Medical Center.

Darren P. Mareiniss, MD, FACEP
Darren P. Mareiniss, MD, FACEP is an Emergency Medicine Doctor who also practices critical care. Read more about Darren