Knowing that Mayo Clinic in Jacksonville, Florida would soon see the impact of COVID-19 reach their community, AMA member Devang Sanghavi, MD, began preparations in February. But even with proper precautions in place, he has found that it is a daily struggle to balance caring for patients and ensuring his family is safe at home too.
“We started hearing reports that this was now coming to Italy and then getting a foothold there,” said Dr. Sanghavi, an intensivist and medical director of the medical intensive care unit at Mayo Clinic in Jacksonville, Florida. “That's when we realized that we would be seeing it in America sooner rather than later, so we started our planning and setting up our team and putting responses in place.”
While on night shift, Dr. Sanghavi went to the hospital and found that they had their first suspected COVID-19 patient in the emergency department. With planning and processes in place, they started their response team.
“From that day onwards, it was like a series of multiple night shifts that I did personally,” he said. “When you are dealing with an unknown bug, so to speak, there is risk for transmission to yourself and potentially you can give that bug to your family. I had a plan put in place—sort of quarantining myself at home.”
While completing shifts at the hospital, Dr. Sanghavi needed to think of ways that he could protect his family from the risk of exposure to COVID-19.
“I separated myself from my family,” he said. “I was sleeping in a different place in the house, away from my family, taking a shower and everything there.”
Additionally, “I would take an extra pair of scrubs to the hospital,” said Dr. Sanghavi. “I would participate in taking care of the patient and then ultimately taking a shower at the hospital, changing into the new pair of scrubs and coming back home.”
Upon arrival at home, he eats dinner separately and sleeps in his own room away from his wife and seven-year-old son. This continues while he is on service and few days following “to ensure that I was not symptomatic,” he said.
Learn more from the AMA about how doctors can keep their families safe after providing COVID-19 care.
Even while taking extra precautions to protect himself, his colleagues, patients and his family, Dr. Sanghavi began to have symptoms himself.
“I was lucky enough that Mayo Clinic had its own testing,” he said, adding that he was “the first one to get the testing done in the drive-thru testing.”
“For my sake, it was negative, and my symptoms went away. It was mostly an upper respiratory infection, but it was a scary feeling,” said Dr. Sanghavi. “I was wondering whether I had COVID-19 myself or not.”
“This is the call of the duty. We train for this and we are prepared to fight this menace,” said Dr. Sanghavi.
“We deal with these patients very closely. We do procedures like intubation, bronchoscopy and other things, which generate a lot of aerosols. We obviously have enough PPE at our facility, and we don and doff PPE appropriately. We take all our precautions, but still there is that risk of getting exposed.”
That’s when Dr. Sanghavi had a conversation with his wife about the situation and that it can very likely happen to them. “We need to ensure that we have that kind of isolation and quarantine in place at home. I have a young boy and I don’t want to give it to him as well,” he said.
Continuing to feel scared
Being prepared for a surge at work is beneficial, but it does not eliminate the fear that many physicians feel as they leave work to go home to their families.
“To be honest, I would say that I am scared eternally because we don’t know a lot about this disease and certainly, for the first time in my life, I feel that there is a realistic chance that my colleagues and I will get exposed to this disease despite whatever precautions we can take,” said Dr. Sanghavi. “It may not happen in our health care setting, but there is a realistic chance of it happening in community spread as well.”
“It’s a fatal disease in some instances, so I’m personally scared, but I have to balance that with the responsibilities of being a front-line intensivist,” he said. “I have an obligation to work to take care of these patients who are affected by this disease and to keep the morale of my team in the hospital high.
“It’s a difficult balancing act, but you have to do it. You have to rise up to the occasion,” said Dr. Sanghavi. “This is a once-in-a-lifetime kind of event that will change health care and our world in more ways than one.”
The AMA and the Centers for Disease Control and Prevention are closely monitoring the COVID-19 global pandemic. Learn more at the AMA COVID-19 resource center and consult the AMA’s physician guide to COVID-19.