Sunday, June 7, 2020

What Are Hospitals Like During the Covid-19 Pandemic?


Introduction

Today’s topic: what’s it like to visit an urgent care clinic right now, during the pandemic? What are things like at a hospital? And what’s it like to get a Covid-19 test? Unfortunately, I’m now in a position to report on all three.

I’m unable to type right now so I did something different: I recorded a vlog without having a script, and then transcribed the audio track using my phone. Please excuse whatever transcription errors I missed here.

Here’s the vlog version if you prefer that:


And now, with no further ado, the Q&A.

Why would anybody want to go near a hospital right now?

In my case, I had a pretty bad accident. I put off treatment for a couple days until it became clear that I needed it. Before I started making appointments I asked a buddy of mine who’s an MD, “Is this a really bad time to go to the hospital?” (Obviously he does this every day for work, and then goes home to his family.) He said, “You know, hospitals are really well-run: they’re kept very clean and they have protocols in place. It’s probably safer than a grocery store.” I agreed, and my wife made me an appointment at an urgent care clinic in Oakland.

Is it hard to get an appointment?

Of course this depends where you are, but in the Bay Area the hospitals etc. are really not doing much, as so many people avoiding these places. Getting an appointment was really easy.

Is the traffic lighter getting there, and is the parking easy?

Yes! Our drive to Oakland was done in record time. I don’t know about parking because my wife dropped me off—they aren’t letting visitors inside, you have to leave your patients at the curb. When we went to San Francisco for the second appointment (more on this later) it was even weirder because the Bay Bridge, which is normally, any time of the day, totally clogged up, was just smooth sailing. It’s kind of weird to see a city like San Francisco completely empty. I mean, normally there are horns honking, cars everywhere, people flagging taxis … in a more suburban area like Albany, where I live, it’s not that different from normal—you get more people walking but that’s about it. To see a major city seemingly abandoned like that is pretty eerie.

Is there a rigorous Covid-19 screening protocol before I can enter the building?

The first place I went to, I was able to go through the lobby and up the elevator on my own though they had a big thing of hand sanitizer as soon as you hit the lobby. At the entrance to the clinic on the second floor there was a guy with a table and he took my temperature and made me use hand sanitizer so he could make sure I’d done it, and he made sure I wasn’t obviously symptomatic before allowing me to proceed.

Will the person doing the screening make corny jokes to try to put me at ease?

Well, that’s going to vary but in my case the guy did. After taking my temperature he said, “Okay, 97.3 on your FM dial!” I wonder if he makes that joke with everyone. Actually though, it was pretty useful because if he said something like, “The New Alt: 105.3” or “107.7: The Bone” then I’d know I had a high fever, probably had Covid-19, and would be sent packing.

Do I bring my own mask or will they provide them?

I had heard they were going to give me my own mask but it’s kind of a Catch-22: until they hand you a mask you have to be wearing one. But after it’s been in the hospital I don’t really want the mask anymore, so I wore my skuzziest, dirtiest mask. At the urgent care Center in Oakland the guy had me switch it out and got me one of those cool rectangular blue ones that hooks behind your ears. I kind of wish I’d kept it but I pitched it with my old one. At the second place, the hospital, they were offering masks but I totally forgot to switch, so again I was wearing like my skuzziest mask, the one I’d dropped in the dirt, and wore it the whole time so I must have looked like some sort of derelict.

What social distancing measures will the doctors and nurses take? What kind of PPE?

Most of the time there was only one person in the room with me. Briefly there were two nurses in there but that was all right. The risk of infection, as I read recently here, depends on three things: your proximity; whether indoors or outdoors; and, how much time you’re in that proximity. If you’re closer than 6 feet from somebody, outside, on a trail, for like one second, you’re not going to give that guy Covid. So when I pass someone ten feet away on some trail and I’m not wearing a mask, and he looks over and scowls like I just sacked his ancestral village, I get a little testy. Two nurses in the room with me for two minutes at the same time, everybody wearing a mask … I’m not worried about it.

As far as PPE, the doctor wore a Plexiglas face shield, kind of like what a what a riot cop would wear but not quite as burley. It reminded me of the sneeze guard on a salad bar. So between that, and surgical gloves, and a mask, the doctor was well protected.

It’s actually kind of funny because my hand is pretty bandaged up and the doctor needed to check out my wounds, so she was trying to take Band-Aids off while wearing rubber gloves and she just couldn’t get anywhere. I was like here, let me help you out. How often do you get to help a doctor like that?

What’s the closest you had to get to anybody?

Obviously the doctor was right in there, dabbing with this very cool goop called MediHoney, which has some kind enzymes in it that kind of eat up the bacteria that might be growing the cuts. Kind of like putting maggots in your wound except smaller. So she was kind of close, but I not for very long. The most uncomfortable part was when I went across the hall to radiology. The X-ray tech had to position me with the backdrop and everything, and I say uncomfortable not because I thought he was going to give me Covid-19 but because he was asking me to put my bad arm over my head and all these other horrible things. That took a while too, but it was a giant room and he’d frequently scurry behind the control console to not get radiated, obviously.

How come every single member of the medical profession (except for the doctors) has tattoos now?

I don’t know why, but they all did, like, to a person, and one of the nurses had like this really cool tat on her forearm that looked like a face but it was like really well done. It was kind of distracting because I kind of wanted to say, “Wait, can you hold still for a moment, because I want to peer into the eyes of this person staring out from your arm.” But of course I didn’t want to waste her time or anything. Maybe this is just a value-add, you know … giving you something interesting to look at during your treatment.

Do you feel like you’re taking medical resources away from Covid-19 patients or people injured during protests?

Short answer: no. Again, there’s nobody in there, no one is scheduling elective surgeries right now. It’s just starting to get a little closer to normal but there were more staff than patients by a huge ratio. It was totally dead in there, just going through the empty hallways, like a ghost town. It’s almost like when you’re trying to support your small business so they don’t go under ... I’m giving this hospital some business. (Not that I would have chosen to, honestly.)

Do you think it’s in good taste to use terms like “dead” and “ghost town” under the circumstances?

Aw, lighten up!

Is the service really quick now, since you’re practically the only patient in there?

Oddly, no. I thought this X-ray thing was going to be pretty quick but I was there for hours. It was like usual: you’re seen by the nurses, then they leave, then the doctor comes in, leaves, comes back, then they’re ready for you down at X-ray, then you wait for those results to get sent to the doctor, then the shift changes and whatever and you get a new doctor, so I was sitting around for quite a while. I’m not sure why that is … maybe they’d sent too many of their staff  home.

Do they still give you a ridiculous orders like taking your shirt off well in advance of the doctor showing up so you have to sit there in an over-air-conditioned room for like 45 minutes shivering with no shirt on for no good reason?

Yes.

Is there any consequence whatsoever in completely ignoring the instruction to remove your shirt well in advance of the doctor actually showing up?

None whatsoever … I sat there with my shirt on. I’d planned ahead and wore a shirt with snaps down the front so when the doctor showed up, I popped down all the snaps in a row and whipped the shirt off in a jiffy. It’s important for patients to advocate for themselves.

Did everybody you talked to in both medical facilities ask you if you smoke or if you have ever smoked?

Answer is yes: all of them did. I got this question constantly, just as I did last time I was in the hospital for a broken femur.

Why do they ask this?

I’m glad you asked because I’ve posed this question too. The answer is, smokers just don’t heal very well from this kind of thing. Smoking doesn’t just wreck your lungs and your respiratory system—it stresses your entire body and puts it on the back foot no matter what it’s trying to recover from.  So don’t smoke!

Is it hard to schedule a surgery right now?
                                                                      
Hopefully you’ve never had to schedule a surgery but normally it’s a bit of a hassle, this little dance you do over several phone calls with the surgery scheduler whose full-time job is figuring out this puzzle with surgeon’s time so tight. But this was a piece of cake. The orthopedist recommended surgery, I agreed (I’m not going to second-guess the person who went to medical school) and he’s like, all right well, how about Tuesday?

Do they make you get a Covid-19 test before you can have an operation?

Yes, they actually will operate on you in a part of the hospital where there’s nobody with Covid-19, to limit any chance of exposure. So you have to get a test.

Is it hard to get an appointment for a Covid-19 test for an upcoming surgery?

Nope! Again, a piece of cake. They put in the order on Thursday and I got an appointment for Friday. So if you’re looking to get a Covid-19 test and you’re not getting any luck, just go get in a bad accident and injure yourself, and Bob’s your uncle!

Do you have to go to the same tent where all the symptomatic people are to get your test?

That’s a great question, because obviously you don’t want to be exposing yourself to the virus. Fortunately, they have a whole tent setup for asymptomatic people, which is pretty cool of them.

Do they really have a drive-thru Covid-19 test, and will they really serve you microbrews on tap there?

Two-part answer: yes, they really do have a drive-thru Covid-19 test, but no, they don’t serve microbrews on tap, at least not here. Maybe in Texas they’re doing that, or maybe in Oregon, but not in California.

That question about microbrews ... is that kind of a sore subject?

Yeah, it actually is and I wish you wouldn’t bring it up. Right now, in the days before the surgery, I can’t have Advil (as it thins the blood) so I have to take Tylenol, and I can’t have any alcohol with that because I care about my liver. So even though a lot of people are advising me to treat my symptoms with beer, I can’t, and I had to I had to give up a 32-ounce growler of Fieldwork IPA because it was going to go bad in my fridge. So that hurt, I think that hurt even more than my injury.


Don’t worry, the beer found a good home. The pal I gave it to later Beck’sted it from his patio.


Do they allow you to bring a pet in your car for the drive-thru Covid-19 test?

This is actually on my paperwork for the test: they specifically forbid you to bring a pet. If you have a pet in your car, they will turn you away, which kind of makes sense, right? Because if Rover is in the in the car with you and someone takes like this q-tip that’s like a foot long and sticks it so far up your nose you’re reminded of a sword swallower, Rover’s probably going to take action. Rover’s like, “Okay, that person’s killing my master—this is my finest hour, I’m going to save the day!”

Did you want to bring your pet to the Covid-19 test?

I have a cat. Needless to say a cat has never protected its owner so there’s no risk there. I probably could have filed the paperwork to have the cat registered as an emotional support animal, but only if they never met this cat. She’s useless. I’ve been laid up since Saturday and this cat will not get on my lap, will not even come around. It’s like I’m damaged goods, the cat is avoiding me like the plague. So no, I was not even tempted to bring her, not even to punish her, because she can’t change her stripes.

What was it like getting the Covid-19 test?

I was in the backseat of the car (I can’t drive right now) and somehow I’d been led to believe the person was going to get into the car but I think I must have been a little bit of a little bit confused. Instead the tester had me roll down the window and then she leaned in and first swabbed all over my mouth so needless to say I was not wearing a mask for this but obviously the tester was wearing a face mask, shield, the whole thing. Then she said, “I’m going to go up your nose.” And she sticks this thing up in there, gets it like an inch up my left nostril, and she’s like, “That one’s a little tight, I’m going to go through the other nostril.” I’m thinking great, what if this other one’s tight too … then what?

But the other nostril was apparently okay so she said, “This is going to last for 10 seconds,” and I’m really glad she gave me the countdown because it was weird, I mean it was like way in there, and I don’t know if you’ve ever had this happen where you’re eating pasta or rice so fast that you get a piece that goes way up in there so it’s stuck like halfway between your nose and your mouth and it just sits in there and kind of hurts, like when you hit a raw nerve with a drill when having a cavity filled without Novocain (which is how you should do it because it doesn’t hurt that bad) so it’s annoying and you’re thinking like “Oh god, I got pasta up my nose!” and then you get a Kleenex and you just blow your nose like super hard and then you feel the noodle bit flying out of your nose, when you look down you’re like, “There it is!” and it is just such a relief. So if you’ve ever had that happen, that’s kind of like what it’s like getting this Covid-19 test. They put the swab so far in there and kind of wiggle around and I’m kind of going “Uuuugh! uuuugh!” (but silently) and she’s counting, “All right, I got 5 more seconds” so I’m thinking “I can handle this!” and then it’s over. So, all told, we got there and sat around for a couple minutes while they did whatever and then from the time like the swab came out till I was done was like two minutes and then we hit the road.

How quickly did you get back the test results?

It was about 15 hours—pretty quick! They called me the next morning and let me know.

Do you have Covid-19?

No, I don’t. At least, I’ve tested negative.

Did they give you the antibody test so you can see if you’ve ever had Covid-19?

I asked about this and they said the antibody test gives so many false negatives (or was it false positives?), its accuracy rate is about 50%, so it’s just completely useless and they wouldn’t bother getting me that one.

If you test positive for Covid-19 do they still go ahead with the surgery?

I thought the answer to this would be no, they’d have to reschedule, but actually, given the severity of my injury, and since it’s not considered elective, they would move forward with the surgery even if I have Covid-19. They just would send me to a different facility where they have a “negative pressure” operating room where they can basically make it safer. I was kind of surprised about this and asked my doctor friend, who said, “Yeah, they should just operate, like why should they be so worried? They’ve got their PPE and this is the environment they work in; what’s the big deal?” I was kind of surprised … I was thinking it would be the patient at risk in that case. But I guess if you’re not showing any symptoms, it’s full steam ahead.

Would now be a good time to finally get a surgery for that chronic dandruff?

You know, as disgusting as my dandruff is—and it’s really bad, I’ll admit, it’s just a disgrace—I think I’ll wait until the pandemic is over before I go in for that scalp transplant.

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