Undercurrent

On the busiest days, it seemed the workers were just one room ahead of the next patient coming upstairs from the ER.


It never occurred to me that we could run out of negative pressure rooms. Whoever calculated how many our hospital needed calculated correctly, before COVID. The handful in our hospital always seemed adequate to handle the occasional suspected, or confirmed, case of TB. In 2014, during the Ebola outbreak in West Africa, we chatted nervously about the number of these rooms, and one of them was augmented with an elaborate decontamination chamber, but thankfully, Ebola passed us by.

This past March, we began a hospitalist daily huddle, in our attempt to grasp the countless new words, phrases, policies, and procedures: conservation of PPE, masks and PAPRs, persons under investigation, isolation versus quarantine, visitor restrictions, every type of shutdown, testing sites. But we hardly commented on the truly remarkable construction and engineering project taking place around us.

For weeks, each day, I witnessed crews of workers transforming our medical wards into COVID units. Portable ventilation and filtration systems were installed in each window to prevent airborne COVID from escaping into the hallways. New doors appeared on the rooms, each with a large window, for easier and safer lines of sight to the patients. On the busiest days, it seemed the workers were just one room ahead of the next patient coming upstairs from the ER. They crawled around on the floor in wards filled with COVID patients: doggedly installing, securing, and testing the equipment. Inches away, nervous teams of doctors argued about whose turn it was to see the COVID patients, and waved awkwardly at the patients through those new windows. We knew so little about how the virus was transmitted, and the nonclinical staff knew even less, most likely. Yet their level of risk was often similar to, if not greater than, ours.

I'm relieved to report that our COVID numbers have tapered, and the hastily designed COVID rooms are mostly just regular rooms again, with the doors left open and the ventilation machines on standby. Outside the hospital, some charming and thoughtful signs about health care heroes are looking a bit tattered. It's time to dispose of these signs, because the front lines are simply drawn from the imagination, and only fictional characters wear capes.