Featuring Dr. Philip Verhoef, Clinical Professor of Medicine at the University of Hawaii and ICU physician: How does it feel to risk your life just going to work, like during the coronavirus pandemic? What’s the best way to tackle the PPE shortage? In this final episode in a four-part series, Dr. Philip Verhoef joins host Brenda Gazzar to discuss these issues, plus how South Korea’s government-run healthcare system bolstered its ability to control the spread of the deadly virus.
COVID: Keeping Doctors and Nurses Safe + South Korea’s Success
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Welcome to Code WACK!, your podcast on America’s broken healthcare system and how Medicare for All could help. I’m your host Brenda Gazzar. Today, we’ll talk about the challenges an ICU doctor in Hawaii is facing amid the coronavirus pandemic.
Dr. Philip Verhoef is a clinical assistant professor of medicine at the University of Hawaii and an intensive care unit physician and immunology researcher in Honolulu.
This is the fourth episode in a series about the coronavirus with Dr. Verhoef.
Welcome to Code WACK!, Dr. Verhoef.
Verhoef: Thanks, it’s a pleasure to be here.
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I’m sure you know doctors around the country and if not the world. I’m wondering how you feel that doctors like yourself are now on the front lines of the pandemic, risking their lives and in some cases unfortunately, losing their lives?
Verhoef: Yeah, it’s not like anything we’ve ever seen before. You know, I think we all go into medicine for different reasons but at the core, I think for everybody that chooses to get through it, it’s because we want to help people. And I think the majority of us didn’t assume that that job would come with any demonstrable risk to our own health. You know in some respects, it is a little bit like in the 80s, when people didn’t know what HIV was, right? You know I talked to my mom about this. She was a nurse in those days. Nobody knew how it was spread and there were a bunch of different ideas about it and she looked at her family with three kids at home and she, being one of the primary breadwinners, and said this is a big risk for me. I’m going to move out of the acute care hospital and move towards nursing home and geriatric care — things that seem a little bit safer. And so for her, that was looking at this and making the decision that was right for her family. I know people are doing the same thing right now, looking at their families and having to say ‘Gosh is it worth it to me to be isolated from my family for a month to take care of these patients? My family needs me but patients need me, and I have a unique skill set to help’ and I think that’s scary. I think this is why the emphasis on Personal Protective Equipment and keeping our healthcare workers safe is really so important because we need a healthcare system. We need people to continue to want to take care of patients but we cannot make that something that you have to risk your life for.
Right. What do you think can be done to ensure doctors have enough Personal Protective Equipment amid this pandemic?
Verhoef: I think manufacturing more is critical but I think that keeping there from being huge spikes in disease is the most important thing, right? So if public health efforts can continue to keep this thing at a slow sort of it’s always there but it’s not spiking with thousands and thousands of people being sick at the same time, we’ll be able to stay on top of it. Obviously, we are going to need to be cognizant of the amount of PPE that we have but the most important thing we can do is to keep there from being huge spikes in disease, where all the PPE needs to be used all at once. That is one of the biggest benefits of what we call the nonpharmacologic interventions, the behavioral interventions, the public health steps, is to keep there from being spikes. The other reason that’s a great thing is that it gives time for a vaccine to be developed or a novel treatment to be developed. So the more that we can buy time, the more likely we are to be able to get a handle on this.
Got it. Why do you think South Korea was so successful in containing COVID?
Verhoef: You know, they tested aggressively. They isolated aggressively as well. And so, it’s a combination of being able to devote the resources to testing but then what do you do with the test results? If you have positives, you need to do the basic public health epidemiologic work to figure out who all those positives came in touch with and then say ‘ hey look you need to be quarantined. You need to be monitored for sickness’ so that you can know how extensive the spread is going to be. And it seems like South Korea has had the agility and the resources to be able to test widely but to also do the epidemiologic work – the public health work – to make sure that the patients that are positive are appropriately cared for and that their contacts are appropriately managed. That’s the work that all of our state and local health departments are doing in this country. It’s not been an impossible feat here in Hawaii because we have you know under 600 cases but you can bet it’s an impossible feat in New York City. South Korea was able to manage this thing when the number of cases was relatively low and kind of nip this in the bud.
So do you think that having a government-run system helped them to do the early testing and the isolation?
Verhoef: Oh, I think without question. I mean I think you can mobilize your workforce much more effectively that way. It’s all about resources and you know an individual hospital doesn’t have resources, an individual state has some but never as many as they need. You need that capacity in order to be able to handle a pandemic like this effectively.
Thank you so much, Dr. Verhoef. Find more Code WACK! episodes on ProgressiveVoices.com and on the PV app. You can also listen at HEAL dash C-A dot org. This podcast is powered by HEAL California, which uplifts the voices of those fighting for healthcare reform around the country. I’m Brenda Gazzar.
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