Those who enter the medical field know they are putting themselves at a certain degree of risk. Even in the best of times, there are multiple germs floating around the hospital or office waiting room.
Of course, these are not the best of times. COVID-19 has seen to that.
William & Mary's gymnastics program has approximately 50 of its graduates in the medical profession, many on the front line against this global pandemic. Some are in the major cities, some are in the rural areas, and some are in between.
Four of the Tribe's medical alums were willing to take a few minutes out of their hectic days to discuss their work and how it's changed in the last several weeks.
Lance Hoffman, '94
Emergency Medicine Physician, Fremont, Neb.
Methodist Fremont Health hospital generally sees fewer than 18,000 patients a year. The complaints mostly range from chest pains to broken limbs to accidental gunshot wounds.
But Fremont, rural or not, hasn't been immune to COVID-19.
"A couple of weeks ago, we started seeing a lot more people coming in with a fever and a cough," Hoffman said by telephone on March 31. "Of course, the problem is, we couldn't test any of them because we didn't have any tests available. And there are many other viral infections that look very similar — at least early on when it's mild.
"I do probably between 10 and 12 shifts a month, all night shifts. But in the last three nights, I probably saw three or four people with it each of those nights. I'm hoping I don't get it and bring it back home to my family."
That's a very real fear for everyone on the front line against COVID-19. There is a national shortage of personal protective equipment, and experts warn the pandemic will only worsen before it improves.
"At this point, you're required to wear an N95 mask the entire time," Hoffman said. "If you're treating a patient face to face, there are more restrictive personal protective equipment that you're supposed to use, like a gown and gloves.
"I've got this big plastic hood with a clear plastic visor on it, and an air filter plugs into the back of it. If I'm seeing someone that has a very high likelihood of exposure or who's symptomatic, I wear that."
There is plenty of fear out there, and misinformation on social media isn't helping. Hoffman stresses the basics, like staying home and washing your hands. He also suggests not coming to the hospital until you experience respiratory issues.
"I absolutely think staying home and just doing your supportive care, like sleeping, drinking enough fluids, trying to isolate yourself from other people so they don't catch it, good hand hygiene … all those things are important," he said. "The time to go to the hospital is when your breathing is affected.
"At that point, we need to do some things that you're not able to monitor at home, like the oxygen level in your blood. That's stuff that only we can do at the hospital."
And don't believe everything you read on Twitter.
"My advice is to listen to what the local healthcare authorities report," he said. "And if there's a question, go to the CDC website (www.cdc.gov). That's the voice of the nation on what the evidence shows. And it's not anecdotal."
Stacia Ruse, '15
Orthopedic surgery resident, Ann Arbor, Mich.
Stacia Ruse literally didn't sign up for this. After graduating VCU School of Medicine in 2019, she began her residency in orthopedics at the University of Michigan last July. And then …
"Back in November and December, we started getting emails about the situation in China," Ruse said. "No one really thought much of it. We were kind of like, 'It's just like a flu, not a big deal.' But at the beginning of March, people started talking about it a little bit more.
"About two or three weeks ago, we got notification that we needed to cancel all elective cases, which for ortho is almost everything outside of trauma and tumors. And now, we're running so short on staff in the medicine and ICU realm that they're asking for volunteers."
Volunteers to help with COVID patients. True, orthopedic residents aren't well versed in treating illnesses. But nearly three-fourths of the orthopedic resident staff, Ruse included, volunteered in this unique redeployment situation.
"They've combined us into what they're calling COVID teams," Ruse said. "There's seven of us on each team and we rotate every four days. We're trying to keep people in the hospital for a brief amount of time. Then you have a full seven or eight days off so that if you're symptomatic, it's caught.
"It's been really difficult for most of the departments to coordinate all this and try to find enough help. But a lot of us feel that if the department needs help, we're willing to step up."
Washtenaw County, of which Ann Arbor is the county seat, had seen 539 coronavirus cases and 10 deaths as of Monday. Unfortunately, those numbers are not final.
"Michigan as a whole has the third-most COVID cases in the country," Ruse said. "So we're ramping up pretty rapidly over here. … They're predicting in the next two weeks that we're going to have about 1,000 to 2,000 beds full of COVID patients, and our hospital isn't equipped to have that many beds.
"They're opening up the University of Michigan's indoor track (facility) for patients who aren't sick enough to be in the ICU but need general medical care. That way, we can free up some more beds in the hospital to make that more of an ICU critical care unit."
Eventually, this crisis will subside. But Ruse will always remember it.
"If you had told me that I'd be spending my intern year in the middle of a global pandemic," she said, "I'd have thought you were crazy."
Stephanie Bevan, '10
Registered Nurse, New York City
With nearly 80,000 confirmed cases and more than 4,000 deaths, New York City has become a COVID hotbed. Stephanie Bevan, who works in Neonatal Intensive Care at NYU Langone Health, is now taking care of infants who have been potentially exposed to the coronavirus.
It's unclear whether a pregnant woman can transfer COVID to her baby, but care givers are taking necessary precautions.
"We are highly encouraged to wear surgical masks at all times at work, and I often do not leave my floor, taking lunch in the break room," Bevan said by email. "When entering the hospital, we have separate lines for staff as well as visitors, and RNs are screening visitors at the entrance of the hospital for temperature and any signs and symptoms of illness prior to entering.
"When taking care of COVID-exposed infants, my hospital has strict policies regarding personal protective equipment (for) the staff and our patients. We are conserving this equipment and the hospital is also accepting mask donations. The hospital has made changes in many departments to accommodate for the influx of COVID patients, and many nurses have been reassigned to work on different units."
NYU Langone Health is allowing only visitors to pediatric patients. They must be the parents.
"This is a big change for my unit as grandparents, aunts, uncles, and siblings are not able to meet the newest members of their families," Bevan said. "We have infants on our unit for up to 3-, 4-, 5-months (old) depending on how premature they are. So you can imagine how hard this is for their families during this time."
It isn't easy for Bevan and her colleagues, either. But she believes her time at William & Mary, where she worked hard as a student and athlete, helped prepare her for this.
"I continue to sacrifice my time away from my family to go to work and help in this fight against COVID-19," Bevan said. "I encourage everyone who does not need to leave their homes to stay home and do their part in social distancing. I know we will get through this challenge and come out as stronger individuals."
Christopher Lynch, '10
Hospitalist/Internal Medicine Physician, Los Angeles
On the West Coast, Christopher Lynch and his colleagues at Harbor UCLA Medical Center had some time to prepare for COVID's full-force arrival. Now, the surge has arrived.
"Our team has now comprehensively shifted our focus to COVID-19," Lynch said. "We have now created two new separate service lines dedicated specifically to COVID-19. And our hospitalist service is one of those service lines."
"There is much we still do not know about this disease. But here, every day, we discuss each patient within a multidisciplinary forum in order to utilize the collective knowledge of our infectious disease specialists, pulmonologists, and internal medicine physicians."
According to the Los Angeles Times, California had 19,063 confirmed cases and 507 deaths as of Thursday. L.A. has accounted for the majority of those with 7,573 confirmed cases and 200 deaths.
This pandemic is unlike anything the medical community has ever seen. But like Hoffman, Bevan, and Ruse, Lynch is using what he learned at W&M as a guide.
"I am certainly drawing from my experiences on the William & Mary men's gymnastics team by embracing teamwork while persevering through challenging circumstances" he said. "Amongst our staff, all hands are on deck to focus on our response to COVID-19, requiring us to be versatile enough to address specific needs while working together as a team."