Millennial Medicine: Our Voices from the Frontlines of the Pandemic
An Interview with Jessica Wise
As our nation begins to look at the possibility of reopening this May, Audacity thought it was important to hear from our very own peers who fight the global pandemic everyday. While the CDC, health insurance companies, and medical doctors have been valuable voices during this time, those who work for them do not have the same platform. In this special panel, conducted all-virtually, we sit down with millennial healthcare workers who are grappling with starting their careers in the midst of the worst health crisis of our generation. These residents, students, and nurses, are prepared to give us a much need reality and, even better, remind us what it truly means to “look out for the other guy.”
Today, we hear from:
Nehemiah Lawson, DDS, Pediatric Dental Surgery Resident
Julia Simon, RN
Obi Bassey, 3rd Year Medical Student
Ehizele Osehobo, M.D., Neurology Resident
How has the pandemic changed the way hospitals and clinics operate?
NL: As a resident who works in both the children’s hospital and outpatient dental clinics, quite a few changes have taken place. Both the children’s hospital and outpatient clinics are reluctant to admit patients without a true emergent issue or probable cause. In pediatric populations, we try our very best to educate parents on what truly constitutes an emergency, whether it be medical or dental specific. Parents are encouraged to monitor symptoms of their child from home unless symptoms become unmanageable or life-threatening (cardiovascular/respiratory). For dental, we have stopped seeing patients unless the emergency includes swelling up to the eye or near the airway, uncontrolled bleeding, dental trauma from accidents, and prolonged unprovoked sensitivity that is severe and throbbing. All healthcare workers (and patients) who come into the children’s hospital have to be screened every single day for symptoms. Additionally, all workers were fitted for N95 masks. I anticipate that the COVID-19 pandemic will change the way PPE (personal protective equipment) for the field of Dentistry is, likely forever.
EO: Pretty much everything has changed. Some newer policies include screening for fever at the entrance, and requiring everyone to wear masks inside the hospital whether you’re in a patient’s room or not. From a logistical standpoint, our work schedule has changed too. For example, my residency program has taken many residents on elective rotations and placed them on COVID backup, which is to say that if one of our fellow residents needs to quarantine themselves, we will come in to take their place. Attending physicians have also been re-deployed to different departments or hospitals to help with the expected surge in patient volume.
What is a nurse’s role in managing the pandemic? How does that vary on the different types of nurses? CNA, LPNs, RNs, etc.
JS: Nurses serve as the backbone of the healthcare industry with or without the presence of the COVID-19 pandemic. During this pandemic, some roles of the RN include assessing for high risk patients, monitoring for signs and symptoms of the coronavirus in all patients we encounter, initiating and maintaining effective isolation of the positive patient, taking precaution when providing care to positive or presumptively positive patients including the correct donning and doffing of PPE, administering medications and assessing for its effectiveness, collecting specimens in various ways to perform lab testing, and effectively communicating with medical doctors to obtain appropriate orders to reach the goals of the patient’s plan of care.
How serious is this for citizens who are considered at-risk (pre-existing conditions, pregnancy, geriatrics, mentally ill, cancer patients, etc.)?
JS: COVID-19 is very serious for the high risk population. I work first hand with the geriatric population, all who have other pre-existing conditions. This combination makes for the most vulnerable, immunosuppressed, or immunocompromised population. Due to their weak immune systems, if these individuals get infected with COVID-19, they will be facing a very poor prognosis
NL: This pandemic is serious for everyone, regardless if you have a pre-existing condition or not. As a pediatric dental resident, we often see so many medically complex patients in the hospital for dental clearance for different surgical transplants like cardiac, pulmonary, hepatic, and renal. These patients are still being seen during the pandemic for the simple fact that infection is a risk and these surgical procedures are deemed “critical.” These patients, although very young, tend to fall into the immunocompromised population. With an impaired functioning of the immune system, they are subject to become easily infected with COVID-19. We exercise extreme caution even for something as “simple” as dental clearance.
OB: The coronavirus family that COVID-19 originates from normally presents as a respiratory infection, so for generally healthy people it usually comes off as a pretty bad flu. But people in immunocompromised states such as cancer treatments, transplant patients, older populations, or diabetics can have serious complications such as severe pneumonia that can be life-threatening. A common misconception is that only older people will get really sick from this, but there have been many hospitalizations of young adults because it does not take much to become immunocompromised enough to have serious problems from COVID-19.
What are your thoughts on the pandemic? Do you believe people are taking it seriously?
NL: I think that is a layered question. There are certain educated pockets of society that have at least a basic understanding of public health, immunity, etc. I do think that there might exist a little confusion on why we have a quarantine. At the same time, there are a lot of sociological and policy implications with this pandemic. Concerning healthcare as a whole, this pandemic has truly emphasized the disparities that exist within our current system and how those of a lower socioeconomic status are disadvantaged from the beginning with not being able to adequately social distance and “quarantine” to prevent the chances of contracting COVID-19. I also see way too much “fear mongering” and “panic buying.” If people would take this time to educate themselves, take proper precautions, and show compassion during this time, I think that the overall outlook as a community will improve. We are in this together.
OB: I have a mixed opinion on this. For the most part, I think people see the number of cases and number of deaths and immediately believe they are at risk. Many people have bought masks, gloves, hand sanitizer, and other things to protect themselves. On social media, you see people posting about staying at home and not putting people at risk. Almost every state government has put up a shelter-in-place order at the very least. So in that regard, I see people taking it seriously.
On the other hand, you have politicians who are willing to put thousands of people at risk for the sake of the economy, people who are upset that they cannot have gatherings, and people just downplaying the seriousness of the situation. A huge part of it is the lack of health literacy, and that is not the fault of the individuals. But if more government officials took the time to explain the seriousness of this to the public in a concise manner, I think it would help convince more people to take it seriously. For example, Governor Cuomo of New York has done a good job explaining the public health measures needed to control this crisis in a way that anybody can understand, without talking down or scolding people.
How crucial is it for people to take this seriously and stay home if they can?
JS: Until public health officials find and approve a vaccine for this virus, social distancing and hand hygiene is the most effective way to take precautions. I do not think people are taking this advice seriously and I do not think they will until they or their family members and/or friends are impacted by the devastating effects of COVID-19 firsthand. Despite the testimonies of affected patients and statistics on the news, I feel as though the majority of the public has that “It will never happen to me,” mentality and attitude. It is truly frustrating as a healthcare professional because we are risking our lives to save others and the only way we can put an end to this crisis and protect ourselves is if people take social distancing seriously.
NL: It’s incredibly important. The virus can be spread through respiratory droplets and there are still clinical trials out for treatments and vaccines. While those who are not susceptible have a high chance of recovering, that is not something that you want to take the chance on. Unfortunately, it looks like many won’t take it seriously until it affects them personally or someone that they know.
OB: Everyday, I feel like they find out new complications caused by COVID-19 and they are constantly reevaluating what is known about the virus. Until all the facts are established, the most we can do is prevent the spread by maintaining policies that mitigate large exposure and promote good hygiene.
I am not a big fan of the term “social distancing” because it is a new term that is not always clearly defined. When communicating to the general public, it is important to use concrete phrases such as “stay at home” and “keep 6 feet away from people in public.” Both ways illustrate the same idea but one is more clear to interpretation. Contracting the virus and not having symptoms is a huge risk factor because you may be spreading it to everyone around you unknowingly, making the problem worse. The only way to prevent this is to keep your outings to a minimum and keep physical distance from other people as much as you can.
In your opinion, is the government truly doing all they can to slow and prevent the spread of this disease?
NL: I think that to an extent, the magnitude of this pandemic took quite a few by surprise. This pandemic has exposed a lot of things that we have to work on as a nation. From science, to research, to healthcare policy and healthcare administration, we have to check our priorities. This is not the first time that an administration (including this administration) has been warned about the detrimental potential of a pandemic, but legislation put into action is what prepares and bolsters a nation to handle a crisis to this extent. Healthcare workers everywhere are so selfless and a lot of time get caught in the quarrels of policy. Stay informed. Stay involved.
OB: Absolutely not. I think the government had a couple of crucial moments that could have mitigated the crisis and they completely dropped the ball on that. Instead of an organized response at the federal level, the current administration dismissed initial warnings and downplayed the seriousness of the virus. Despite South Korea having their first positive case the same day that we did, their rate of infection and death have been completely controlled as compared to ours. People will say that South Korea has a smaller population but statistically, rates are proportional and can be used to compare different populations. They handled it better by having accessible testing, and enacting Stay-at-Home policies sooner than the United States did. They were preventative. We were reactionary, and thousands of Americans paid the price. Even now, we need to do more to get widespread and accessible testing for everyone, but that process has not been as fast as it needs to be.
EO: No. From a federal standpoint, it took way too long for 45 to recognize that this is a serious problem, especially given the information he had at hand. In Georgia, COVID spread like a wildfire and the governor was twiddling his fingers despite having the CDC just down the road giving him all the information he needed to shut down the state. Notably, the federal COVID bill gave more money to big business than it did to the healthcare systems fighting the epidemic. I shouldn’t be using the same mask for two weeks while seeing all my patients...that’s not what we did before this pandemic but because of poor preparation and funding, that’s what we’re doing now.
“It is now often forgotten that we too are normal human beings who have families, children, friends, and hobbies that we would like to get back to safely.”
Are hospital-grade masks appropriate and/or necessary for the public? If so, how should you go about cleaning them?
NL: Again, this comes down to education. The general public should not have access to hospital-grade masks for the simple fact the healthcare workers and hospitals all over the country need them with the current shortage. Nurses, physicians, and dentists need them as they are at risk every single day. The CDC has recommended something as simple as a scarf or bandanna to cover the face. This is to prevent the individual from spreading aerosols and/or respiratory droplets, particularly if they are asymptomatic and not aware. I think this is a misunderstanding that needs to be addressed.
OB: So to understand what masks are appropriate, there needs to be a clear definition of the types of masks and the purpose of them. The N95 masks such as the ones that M3 make are the most protective against the virus but are only useful if properly fitted, which all healthcare workers have to do in their training. These N95 masks should be preserved for healthcare workers because they are the most at risk of infection. The surgical masks are the ones that are a bit thinner and more frequently used because they protect against respiratory droplets that may carry viruses. These will not protect you from everything, but they are beneficial in terms of day-to-day protection in a grocery store. Cloth masks and scarves can help, similar to the surgical masks because they do protect against respiratory droplets, but they probably would not be as effective against a sneeze because those droplets are aerosolized, which is why social distancing is just as important as having face masks.
How can we as a community support healthcare workers during this time?
JS: STAY AT HOME! Healthcare professionals are seen as superheroes, and it is now often forgotten that we too are normal human beings who have families, children, friends, and hobbies that we would like to get back to safely. The best way to support and say thank you is to help stop the potential spread of the virus, which is best done by practicing social distancing.
NL: It’s really easy. Stay at home. Again, this pandemic has opened the eyes of society to those workers that truly make our economy run. Hopefully, this time provides a newfound appreciation of these individuals. We are human beings who have families, friends, hobbies, get tired and anxious just like everyone else. Check in on your healthcare workers. A simple thank you goes a long way.
OB: Staying at home. Preventative measures are the best way to help a healthcare system in any setting. I know many people in New York are finding creative ways to support healthcare workers such as babysitting for them or coordinating free lunches for hospital staff remotely. Many of these things can be set up at a distance and I think that taking the weight off of nurses, doctors, and other hospital staff by helping them handle these other tasks can genuinely make a difference to them.
We know going to urgent care and ERs during a pandemic is risky. At what point is it TRULY necessary to go to the hospital?
NL: Only go if you are experiencing severe symptoms. Always call in first to speak with a nurse or physician. And dental emergencies should go to a DENTAL OFFICE. What constitutes a dental emergency? Swelling up to the eye or approaching the airway, a pimple on the gums with a fever not alleviated with NSAIDS, tooth/teeth trauma (broken teeth), uncontrolled bleeding, unprovoked pain that lingers, or exudate/drainage in the mouth.
OB: I highly recommend everyone have a thermometer in their home, and if you are feeling sick at all then use it and check for a fever of over 102 degrees. The CDC also has a screening tool on their website for COVID-19 that people can use if they are concerned they have the virus. It asks you to report symptoms and evaluates your risk of having the infection based on that. Otherwise, I would recommend trying to set up some sort of telehealth meeting with a primary care physician for things short of a broken bone or heavy bleeding.
EO: The simple answer is to come to the ER if your symptoms become too difficult to manage. If you’re feeling like you’ve got the flu (fever, chills, body aches, nausea/vomiting/diarrhea) but you’re able to quarantine at home and take care of yourself with fluids and time, then do so.
If you have the aforementioned symptoms and you haven’t been able to eat anything for 2 days, or if you have the most concerning symptom of shortness of breath while at rest, that may be an indication to have a medical professional evaluate you. If this is the case, during this time you should avoid using Aleve, Advil, ibuprofen, or other NSAIDs to treat fever if you’re at home...while useful for most fevers, they can worsen symptoms in COVID. Try Tylenol.
How has your work life changed since the pandemic? Are you more stressed? Do you feel unsafe?
JS: Since the pandemic, my work life has been very stressful. Every email stating that a COVID-19 positive patient has been admitted onto our service sends my heart racing. Every time I leave my home, I close my eyes and pray to be kept safe and that I do not bring anything home that will affect my family, especially my parents who suffer from other pre-existing medical conditions. I feel unsafe and worried that we do not have adequate PPE to protect ourselves. Everyday I wait and pray for the day that going to work does not feel like going to a battlefield.
NL: As a resident, the training in our pediatric dental specialty program is holistic. I was always on call before and seeing emergencies in the ED and Diagnosis and Treatment Planning, healthy and medically complex patients all the like. I am still learning and teaching as well. This aspect has become a little more tedious. Education around the world has been forced to go on a more virtual format, so for seminars, exams, and teaching alike, Zoom has become my new best friend. I think all healthcare workers at first (and even currently) were concerned for their overall health. I’m thankful for knowledgeable faculty and the best co-residents in the world who are truly my family.
OB: Being only a medical student who was going to start on clinical rotations soon, that was all put to a halt since the pandemic really hit the United States. Currently, I am at home supporting my family because medical schools across the nation did not want to put medical students at unnecessary risk. I do appreciate the fact that my school took effort to do this and I recognize the privileged position that I am in to be able to take this time off. The most I can do now is stay safe and educate those about proper health measures to prevent being sick.
How has your job as a healthcare worker during this time affected the way you can interact with your friends and family?
NL: I’m a Georgia transplant located in Dallas, Texas specifically for my training in pediatric dentistry. As a very extroverted person in quarantine, it can be somewhat lonesome outside of the residency responsibilities. There have been endless Zooms and FaceTimes with my best friends and family. It’s given me a little more time to reflect on what matters and cherish those that mean the most. I try to take walks, get fresh air, and exercise as much as I can. I am a lot more cautious with my day to day in how I disinfect where I live, my clothing once coming from outside and from work, and my groceries. Physical interactions with my co-residents are still the same since we work and are exposed to one another every day.
EO: I see my friends via IG story and extended family contact is limited to phone calls. I take off my scrubs and shoes at the door soon as I get home, and shower quickly to limit the chances of spreading it in the house and having my wife catch it. I’ve been tempted to visit friends but inevitably decide against it, in most cases because the nature of my job puts me at high risk of carrying and spreading the virus, and I don’t want to put my friends in danger.
If you could speak to the Surgeon General right now, what measures would you ask him to take?
NL: I would ask him to form a plan on addressing the disparities between these different populations, and what we are doing to bolster hospitals.
OB: Find ways to provide wide-spread testing for people to more accurately track the spread of the infection. When vaccines are ready, ensure that everyone will have access to it. Address health disparities and lack of access to care among minority populations. Advocate for improvements to health literacy among the general population.
Nehemiah lawson, DDS
Dr. Lawson completed his Bachelor of Science and Bachelor of Arts in Biology (Neuroscience Emphasis), and Theatre, at the University of Georgia with honors. He received his Doctor of Dental Surgery at the University of North Carolina Chapel Hill School of Dentistry where he was heavily involved with leadership and advocacy. Dr. Lawson found his love for treating infants, children, adolescents, and special needs when uniquely combining his love for dentistry and the performing arts. Dr. Lawson currently is a pediatric dental resident completing specialty training at Texas A&M (Baylor) College of Dentistry, Children’s Medical Center, and Texas Scottish Rite Hospital. He has plans to enter private practice after completing residency in June 2021.
Julia simon, RN
Juila Simon is a registered nurse currently working for a Hospice company in Atlanta. Juila graduated from Georgia State University with a Bachelor in Nursing. Her work includes caring for the elderly community and has helped transition her patients through this pandemic.
Obi bassey, 3rd year medical student
Obi Bassey is a 3rd year medical student at Albert Einstein College of Medicine who first received his Master's in Public Health from Georgia State University. He is also a research assistant at the Psychiatric Research Institute of Montefiore and Einstein (PRIME) Center for Health Equity where he is involved in studies on disparities in mental health and access to healthcare.
Ehizele Osehobo, M.D.
Dr. Ehizele Osehobo obtained his B.S. in Neuroscience from Duke University, and his M.D. from the Medical College of Georgia. As a neurology resident he covers Emory University Health and Grady Memorial Hospital in Atlanta. He has been working on the medical wards taking care of COVID+ patients since the pandemic reached Georgia. Following residency he plans to complete fellowships in Vascular Neurology and Neurointerventional Radiology, leading to a career removing brain clots from stroke patients and fixing brain aneurysms. He has a passion for helping more underrepresented minorities make it into and through medical school, and particularly into the field of neurology.
