Pete Gemmell figures his chances of dying as an emergency room doctor during the coronavirus pandemic are 1 in 200.

“I’m willing to take that chance,” said Gemmell, the father of sixth grader Claire Gemmell who works at Sacramento Medical Center (2025 Morse Ave.). “I feel like I went into the right job. I’m glad I’m an ER doctor right now because at least I get to do something.”

Gemmell explained that some patients are not strong enough to survive being taken off a ventilator due to their age or underlying condition. For this reason, his two COVID-19 patients — who were “on the sicker side in the first place,” Gemell said — were DNR/DNI (do not resuscitate/do not intubate).

These two men developed pneumonia and were in poor condition, receiving supportive care such as fluids and medications to support blood pressure as well as experimental COVID-19 medications. 

After seven to 10 days in the hospital, one of Gemmell’s patients was discharged. The other, however, died. Gemmell said he could not state their ages due to the Health Insurance Portability and Accountability Act (HIPAA).

“They were both nice guys,” Gemmell said.

Because he works in the ER, Gemmell had not lived or spent time with his daughter during the quarantine until he received a negative COVID-19 test result on April 5. 

“That has been hard,” he said. “Most people have been isolated, but it’s been just me in the house. I’m usually a bit of an introvert anyway, so it hasn’t been too bad, but (it) gets a little lonely sometimes.”

Gemmell said he also has interacted with fewer people in the ER. Normally, many people visit for minor problems, but those cases have decreased dramatically, according to Gemmell. 

The same is true for Benjamin Leavy, a physician in the UC Davis Medical Group (500 University Ave.), the father of junior Nate Leavy and Isabelle Leavy, ’17, and the husband of AP Art History teacher Liz Leavy.

“There’s less work to do because everybody is so afraid to go to the doctor, which makes sense,” Leavy said. “But everything is tense and anxiety-producing.”

Thanks to medical school, Leavy has learned effective stress management techniques. 

“Coping with anxiety and stress is just part of the job,” he said. “Medical education is an anxiety-producing process, so pretty much anybody who’s gotten through it has learned stress management techniques. If you don’t, you don’t get through it.”

At his workplace, he said social distancing is practiced as much as space allows, and common areas and items are cleaned frequently. When he returns home, he immediately puts his shirt in the laundry and showers to prevent bringing in any pathogens. 

While COVID-19 has only occasionally added hours to Leavy’s workload, the rise has been much more significant for others working in health care.

Jane Tsai, a physician with internal medicine at Mercy Medical Group (3000 Q St.) and the mother of Allison Zhang, ’19, worked 14 hours per day before the pandemic.

“Before COVID-19, I was (already) running a very busy medical practice on top of my administrative role as department chair,” she said. 

“With COVID-19, every waking moment is occupied by work, revamping the practice to virtual care, engaging the community during this public health crisis and developing processes that can safely care for our patients.”

Tsai’s office now conducts video visits through Zoom, FaceTime, Doxy.me and other platforms, which are now government-approved because of the pandemic, according to Tsai. 

“It is quite an experience to be ‘invited’ to my patients’ living room and meet their dogs and cats,” she said.

The workload of Sacramento County Health Director Peter Beilenson, the father of eighth grader Hank Beilenson, has increased from 40 hours a week to 60 or 70, including weekends. Similarly, Kimberly Sommerhaug, a nurse manager for the Heart and Vascular Center at UC Davis Hospital (2315 Stockton Blvd.) and the mother of junior Elise Sommerhaug and Eivind Sommerhaug, ’19, usually works about 45 hours per week and is on call 24/7. But due to COVID-19, she now works at least 60. 

“It is pretty exhausting,” Sommerhaug said. “It gets stressful. And unfortunately, when we go home, we can’t sleep at night because our brains just will not shut off.

“When you go to medical school and nursing school, you learn to be without a lot of sleep, and you just acclimate.”

“It gets stressful. And unfortunately, when we go home, we can’t sleep at night because our brains just will not shut off.”

—Kimberly Sommerhaug

While her hospital is not overwhelmed, she said on average 20 patients test positive per day, and most admitted patients are in poor condition, requiring ventilators. 

“The patient will typically take a sudden turn for the worse, have respiratory issues and need to go on a ventilator right away,” Sommerhaug said. “(On the national level), a high percentage do not make it off ventilators, but we are having a high success rate as we are not overwhelmed.”

Although some of Tsai’s patients require hospitalization and/or ICU (intensive care unit) admission, she said most COVID-19 patients have mild symptoms and can be cared for at home with frequent check-ins. Symptoms are classified as mild if the patient does not need supplemental oxygen, according to Sommerhaug.  

As of April 29, Sacramento County has had 1,068 confirmed cases of COVID-19 and 42 deaths, according to the county’s website. 

Sommerhaug said health care workers worry about contracting COVID-19 in the hospital.

“Even as health care workers, there is an amount of fear among us taking it home to our families,” Sommerhaug said. “Everybody has that fear. I have staff who fear taking it home because they have babies or elderly parents that they take care of, or they have spouses who are on oxygen. We’re all trying to isolate from our families, especially because we don’t have the (protective equipment) we always need.”

For Sommerhaug, this fear possibly became a reality.

Although her test results were inconclusive, Sommerhaug said she experienced “all the classic signs and symptoms of COVID-19.” In response, she stayed home from work, isolated herself in her bedroom and ensured the house was wiped down with Lysol.

“I had what were considered mild symptoms, which means you could be really sick like the flu but are not requiring oxygen,” she said. “I was pretty sick. I had a dry cough, a low-grade fever, a horrible headache, aches and pains, malaise and fatigue. I had these weird shooting pains in my muscles, and I was just really tired.”

As of April 21, 3,877 health care workers had tested positive in California, according to the California Department of Public Health. While over 25 nurses and doctors have tested positive at her workplace, Sommerhaug said since only those showing symptoms are tested, the number of those with COVID-19 could differ. The same is true for patients. Since testing has always been a problem, the number of COVID-19 patients displayed on the hospital’s daily dashboard could be inaccurate, according to Sommerhaug. 

At first, anyone exposed to the virus went into self-isolation for two weeks.

“But we were losing so many health care workers that we had to change that and make sure that they just wore masks 24/7 and washed their hands thoroughly, which we always do in health care anyway,” Sommerhaug said. 

Before returning to work, Sommerhaug needed to be fever-free for 72 hours without the aid of a suppressant. Sommerhaug then wore a mask for a week to protect those around her.

While her hospital originally had a shortage of masks, Sommerhaug said the situation has improved.

“Before COVID-19, we typically had isolation carts (that held masks) and an abundance of boxes of masks at the nurse’s station and in the supply rooms,” she said. “But a lot of visitors started hoarding our masks at the hospital when they saw them on carts. 

“We ended up having to pull them all off the carts to ration them.”

On April 1, her hospital announced that surgical masks could be worn throughout the hospital, but they are still being rationed, according to Sommerhaug. The higher-quality N95 masks are only used when dealing with a known COVID-19 patient or when going to a code blue (cardiopulmonary arrest).

“During a code, there’s a lot of chance for exposure to blood and such,” Sommerhaug said. 

Although she said personal protective equipment (PPE) — “specialized clothing or equipment worn by an employee for protection against infectious materials,” according to the Occupational Safety and Health Administration — is in “pretty good” supply, medical professionals are reusing surgical and N95 masks, which normally is never done.

Gemmell agreed, adding that he and his coworkers always use N95 masks or better PPE, which are often uncomfortable. 

“The more protective gear is, the less comfortable it is, so wearing the gear all the time is not really feasible,” Gemmell said. “For example, I’ve got a very good (P100) mask that I only bring into the rooms of the people who likely have COVID-19.” 

Leavy said he has enough PPE for now.

“The trouble is that you never really know what’s enough because you don’t know how much you’re going to need next week, next month,” he said. “The supply chains are not very well intact. 

“It’s sort of like saying, ‘Do you have enough toilet paper?’ You have enough to last until the next time you go to the market, but maybe they’re not going to have it at the market.”

“It’s sort of like saying, ‘Do you have enough toilet paper?’ You have enough to last until the next time you go to the market, but maybe they’re not going to have it at the market.”

—Benjamin Leavy

Beilenson said the federal government’s Strategic National Stockpile is meant to amass PPE to prepare for public health emergencies, but it was unprepared for the pandemic.

“For the federal government to say, ‘We’re the backstop’ — that’s not the function of the federal government,” Beilenson said. “The federal government’s function is to be the front stop and the front line. That’s why we have a centralized federal government to centralize protective equipment.” 

When the Strategic National Stockpile runs out, states and localities bid against one another on the open market, according to Beilenson. 

“So we’re competing with hospitals, health departments, their providers, as well as other companies for PPE, which leads to price gouging and the ridiculous lack of PPE,” he said. “If you lose a bid, you don’t have the PPE that’s necessary to protect your providers. So it’s not a good situation, to say the least.”

Tsai agreed, saying COVID-19 has exposed many weaknesses in the health care system and revealed the effects of a globalized society.

“(The World Health Organization) is not as strong as I wish it would be,” she said. “In this pandemic, we need a command center to strategize and coordinate efforts and supplies to fight this public health crisis. There is a void.

“COVID-19 illustrates how people around the world are all connected, whether we like it or not. There are consequences of the choices we make on our neighboring countries.”

The federal government’s most significant “failings,” lack of PPE and testing, continue to this day, according to Beilenson.

Sacramento County has increased its number of tests from 50 per day to 500, but it’s still “woefully inadequate,” Beilenson said. Only those with symptoms are tested — but people can be contagious while lacking symptoms. 

“One of the most important things to do is to get people tested so we know what we’re facing in terms of the scale of the epidemic,” he said. “We need to (test) a statistically significant sampling so we have an idea of what percentage of people have been infected and which areas are most highly affected, in terms of socioeconomics and neighborhoods, as well as workplaces. 

“Are low-wage workers getting the illness more, or is it health care workers, or is it the general public? All those questions we can’t answer because we don’t have enough tests.”

When Sommerhaug became ill, she said she had to wait over two weeks to receive her test results. Now, the turnover rate is about two or three days, and 24-hour tests are in the works.

Beilenson added that antibody testing, which he hopes will arrive next month, is also needed to discover who had COVID-19 and is now immune.

Before the pandemic, Beilenson’s job in public health dealt with everything from mental illness to primary care, but now he is entirely focused on the novel coronavirus. 

“The singular focus on this virus has been relatively unique,” he said. “In my 30 years as a public health official, I’ve dealt with novel viruses before, like H1N1, West Nile, SARS, etc. But none of them were so involved and led to such a singular focus of the world on the infection as this one.”

Beilenson attributed this to the virus’s contagiousness and severity across demographics as well as the constant stream of media reporting on it.

Another consequence of health care’s focus on COVID-19 is the halt of elective (non-emergency) surgeries, according to Sommerhaug.

“People are not getting the care they need,” she said. “Hopefully that will not cause mortality to increase. There’s always the risk of that. 

“And when this is over, we’re going to be inundated by people (who) were going to have surgeries and what have you. So we’re going to be very, very busy trying to accommodate all those people. It’s going to decrease access to health.” 

While her hospital isn’t overwhelmed with patients, Sommerhaug said it could be in about a week or two.

“We did not get the surge like New York and Italy,” she said. “We went into quarantine at the right time, or it may have been different.

“In our ERs (normally), every day there are people in the hallways on gurneys because there are just no beds and no rooms, which is why we have to not do the elective cases now.”

“We went into quarantine at the right time, or it may have been different.”

—Kimberly Sommerhaug

However, Beilenson said that because Sacramento County residents have taken social distancing measures, the area is likely to avoid a surge in infections that could cause hospitals to be overwhelmed. 

“Sacramento ranks somewhere around an A- as a county, and that has made a real difference in terms of flattening the curve,” he said. “The spike was predicted to come (the week of April 12), but was relatively flat and spread out over a three- or four-week period.”

Per capita, California is doing better than almost every state in the number of infections due to its relatively early stay-at-home order, according to Beilenson, who added that Northern California is faring particularly well because of its lower population density. He said reducing social contact is crucial to flattening the curve, while touching mail, plastic bags and other items is an incredibly minor contributor to the virus’s spread.

Depending on whether “people stick with the pedal to the metal” with social distancing, Beilenson estimates the stay-at-home order will last until mid-June, when it will be replaced with a modified order. He said that until a vaccine is made — which will probably be in 12-14 months — the world will return to normal slowly, periodically shutting down. 

“We’ll step our way forward until we get a vaccine, which will make a huge difference,” Beilenson said.

However, Leavy cautioned against predictions. 

“I think Yogi Berra said it best: ‘It’s tough to make predictions, especially about the future,’” he said. “There’s really just too much about this virus that we just don’t know. It might settle down into being just a regular coronavirus like the three or four others that circulate every year. They don’t cause much trouble; they cause a cold.”

Leavy added that the infection curve is likely to decrease more slowly than it increased, meaning that it will take more time for life to return to normal.

“This is going to be a marathon, not a sprint,” he said.

But until normality resumes, Sommerhaug said she urges the public to continue quarantining and washing hands regularly. 

“Thank you to the community for all their support. From us in health care, we’re so happy about the … ” Sommerhaug paused to wipe a tear. “We’re here because we love people and love to heal people, but of course we’re scared too. But just the outpouring of support has been absolutely amazing.”

On the street outside her hospital, people wrote messages and drawings of gratitude in chalk. Sommerhaug said she received a list of businesses, such as Starbucks and Crocs, that are offering front-line health care workers free products. 

“There’s this huge list of people supporting us, and it makes a huge difference for us,” she said. “It’s wonderful.” 

This chalk message was written outside the UC Davis Hospital (2315 Stockton Blvd.) to support health care workers, according to Kimberly Sommerhaug, a nurse manager and the mother of junior Elise Sommerhaug and Eivind Sommerhaug, ’19. (Photo courtesy of Sommerhaug)

Tsai also stressed the importance of socializing distantly, especially reaching out to grandparents.

“Let them know you care,” Tsai said. “Check in with your friends (and) neighbors. We all can make a difference. 

“My plea for students is to use this time wisely. Read. Be curious. Love science. 

“Our future relies on you.”

Tsai noted the outpouring of support from the community, with patients making masks for health care workers and restaurants delivering food to hospitals and clinics.

“COVID-19 has brought out the humanity within us,” she said. “I have patients emailing me and calling me to let me know they care. 

“I have encountered many heroic acts in the past several weeks — way more (than) in my entire life. We have a clinician who was going to resign to spend time with her family but decided to withdraw her request to fight this virus.

“Human vs. virus — I think human will win this war in the end.”

—By Larkin Barnard-Bahn

Originally published in the April 28 edition of the Octagon.

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