Article

HSHS doctor describes COVID response as 'building an airplane' midflight

August Online

Rising to the Call
August 10, 2020

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Dr. Elleby

Dr. Erynn Elleby is a family practitioner with the HSHS Medical Group Family Medicine–Shiloh in Southern Illinois. From March to early June, she volunteered to work one day a week at one of the seven respiratory clinics Hospital Sisters Health System set up in central and Southern Illinois to screen patients for coronavirus and provide first line, outpatient care. HSHS closed the hub where Elleby worked once fewer people were testing positive for the virus and COVID testing became more widely available.

During the weeks Elleby was working at the hub, the virus took a toll on her extended family. She spoke with Catholic Health World Associate Editor Lisa Eisenhauer in mid-July about her experience and how she encourages mask skeptics to put on the face coverings that can help prevent the spread of the disease. Her comments have been edited for length.

I describe understanding COVID to my patients as "building the airplane while flying it." We've had to learn what works best, and how to keep people safe as we're going through the process.

The respiratory hub made patients feel safer when they were coming into our other clinics, knowing that people who had any kind of respiratory concerns were not being seen at these clinics at this time.

Since COVID-19 is a virus that can be passed via droplet or through the air, you have to ensure you're wearing the proper protective equipment when you're testing people. We had everything from hairnets, to face shields, N95 masks, gloves, gowns, shoe covers — so it was a little warm working at the respiratory hub.

I felt very safe working there. I'm grateful for that because I know there were other places around the country where people were testing patients for COVID and caring for patients who had COVID-19, but didn't have the proper PPE. That's definitely a scary situation. As providers, increased risk or not, we are going to care for our patients. That's what we were gifted to do.

When the hub started, there were just few of us who had volunteered. By the second week, we had lots of people who had volunteered to work. I would guess maybe there were 10 to 15 different doctors we could alternate between which helped to decrease our exposure. We would check in with each other and ask questions like, "Have you read about this new study?" or "Have you seen this data from the CDC?"

We also worked in close conjunction with the Illinois Department of Public Health. They were the ones, initially, who would give us clearance to test patients. (Because of a national shortage of tests), you had to meet a specific list of criteria in order to qualify for a test. If patients didn't meet that criteria, but had suspicious symptoms, then we would just tell them to self-quarantine and monitor their symptoms.

I think that was probably one of the most frustrating things about the respiratory hub for patients. They thought if they were going to the respiratory hub, then they were going to get swabbed for COVID. We had to explain to them that that's not the case. That was in the early weeks, and then as COVID progressed, we got clearance to make testing decisions on our own.

One of the trickiest things about COVID-19 is how infectious it is. It's often compared to other conditions like, SARS or Ebola which are very deadly conditions. While COVID may not be as deadly as those diseases it's just as, if not more, easily spread. That's something, I think, that we (as a society) don't really grasp. If we as a society do understand how easy it is to spread COVID, then we don't seem to care, which is unfortunate. Our society's overall resistance/indifference to wearing masks and social distancing worsens the spread of COVID. The more it spreads, the more people it infects, which will in turn cause higher rates of mortality.

I have not gotten the virus, but I've had multiple family members contract it in different areas of the country and with different levels of severity. I have a cousin who lives in the New York-New Jersey area who had very minimal symptoms and did just fine. I had an uncle in the Carolinas who contracted it and was on a ventilator for 20 days. It's a miracle he survived and he's doing well now.

In March, my father came down with COVID. My dad, thankfully, didn't have to be in the hospital for more than a day, but he had to ride out the virus over a two-week period at home. I worked with my family to help keep my mom and sister safe in a separate part of the house. My dad and I did virtual vital checks four times a day. I would talk to him over FaceTime to see how he was doing. He developed pneumonia and I treated that as well. When new data came out that said it's better for patients when they lie prone, which means on your belly, for some parts of the day, I told him, "Okay, Daddio, now you need to do this."

He came through like a champ, thank God. He's doing very well now.

As we started to see how COVID spread in our community, I counseled my parents and my family to minimize their time outside of the home, to wear masks and wash their hands frequently. Even after doing those things, my dad still contracted COVID. Now, I explain to patients, "COVID is something I don't want you to have to experience. I want you to learn vicariously, if at all possible."

COVID is unpredictable. I can't say, "Oh, definitely just because you're 22 years old you will only have maybe a few sniffles, maybe a fever for a few days and then you'll be fine," because I've seen 22-year-olds on ventilators. I've seen 22-year-olds not come off of ventilators. I've seen 75-year-olds come off of ventilators after 20 days. It's such an inconsistent virus and although we have trends that we can see, nothing is 100%.

I have conversations often with my patients to remind them of how important it is to not only be concerned about your individual health, but for the health of the community as a whole. If our community gets ravaged by COVID-19 because people choose not to wear masks and socially distance themselves, guess what, each of us will be significantly impacted by that. If our community is ravaged by COVID-19, it will be harder to go out to eat or to get groceries as readily. All of the conveniences that we enjoy will come to a halt if we don't have people working in those positions because they're sick with the virus.

I've had patients ask, "Can't you just write me a note saying I don't have to wear my mask while working at my job because sometimes I get a headache?" My response is, "No, you can take Tylenol for your headache. I'm not going to write you a note saying you shouldn't wear a mask during a global pandemic. That doesn't make any sense."

I was talking to one of my patients the other day who said, "There has to be at least some medical condition where I wouldn't have to wear a mask." I replied, "Well, the one that comes to mind right now is when you're intubated you don't need a mask." I have various patients with a wide variety of conditions — asthma, COPD, they're on oxygen — and yet they all can still wear a mask.

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