Welcome to the latest edition of Investigative Roundup, highlighting some of the best investigative reporting on healthcare each week.
Clinicians' COVID-19 Front-Line Fears
The anxiety felt by healthcare workers on the front lines of the coronavirus pandemic is unlike anything most have experienced in their careers, the New York Times reports.
"Now that we see front-line providers that are on ventilators, it is really driving it home," Stephen Anderson, MD, who has been an emergency physician in suburban Seattle for 35 years, told the Times.
In emergency rooms across the country, doctors and nurses are suddenly wary of anyone walking in the door with a cough. It's particularly stressful for these providers who have to deal with emergencies but may not know the infective status of the patient. ICU workers, on the other hand, know they're exposed to the virus frequently.
All of that anxiety is compounded by the threat of shortages of personal protective equipment. Anderson said his hospital was down to a 2-day supply of surgical masks, which translated to one mask per shift. He has to remove it and clean it each time he takes it off and on.
"That may sound just like a nuisance, but when you're potentially touching something that has the virus that could kill you on it, and you're doing it 25 times a shift, it's kind of nerve-racking," he told the Times.
Docs, Other Workers Hospitalized with COVID-19
Their anxiety is justified as reports of healthcare workers being treated for coronavirus infection start to roll in.
The New York Times reports that two emergency physicians are in critical condition with coronavirus. One from EvergreenHealth Medical Center in Kirkland, Washington -- where many of the Seattle-area COVID-19 cases are being treated -- is in his 40s and is in critical but stable condition. The other, James Pruden, MD, of St. Joseph's Regional Medical Center in Paterson New Jersey, is in isolation in intensive care. He's in his 70s and from Teaneck, the town at the epicenter of New Jersey's outbreak. Pruden led the hospital's emergency preparedness team, and was admitted several days ago with upper respiratory problems.
Also in Teaneck, three of 11 patients at Holy Name Medical Center are hospital employees.
A 32-year-old emergency physician from the University of California San Francisco is self-quarantined at home with mild symptoms after testing positive for coronavirus. He went to a conference for ED physicians at a New York City hotel on the weekend of March 7 and 8, and felt unwell when he returned home a few days later.
Five staff members at Memorial Sloan Kettering Cancer Center in New York City have tested positive for the virus, along with three patients. Also, nine healthcare workers at Emory's health system in Atlanta have also tested positive, according to CNN.
Seattle Lab Plays Role in Boosting Tests
A lab at the University of Washington School of Medicine played a key role in opening the door to wider coronavirus testing in the U.S., even though national efforts are still lagging, Kaiser Health News reports.
Keith Jerome, MD, PhD, and Alex Greninger, MD, PhD, of the virology lab in the South Lake Union neighborhood of Seattle, started working on a coronavirus test as soon as Chinese scientists published the genetic sequence of the virus in January.
"We knew from China, we knew from South Korea, that when this virus comes into your community, you could be running hundreds of tests a day," Jerome told KHN. "No one lab has the capacity to do what was needed in Wuhan."
At first, the CDC was the only facility in the country that was authorized to test for the virus, but it became backlogged as demand grew -- and because there were flaws in the tests it sent to state and local labs.
While Greninger pressed FDA to ease requirements that prevented labs from testing sick patients, the team found a loophole that enabled them to start testing samples. On Feb. 28, their first test came back positive, confirming community spread. The next day, FDA granted a waiver to let private and academic labs start testing for coronavirus.
Soon thereafter, the lab was churning out tests, anticipating it will soon be able to do somewhere from 2,000 to 2,500 tests a day, eventually going up to 5,000 tests daily.
On a recent day, about 9% of tests came back positive: "It shows the virus is out there," Jerome told KHN. "And there's more than most people realize."