THE DAILY MOTH:
Hello! Can you introduce yourself and tell us where you work currently?

IV MIRUS:
Yes, hi. My name is IV Mirus. I’m a resident in the Emergency Department at University of Rochester in the middle of Rochester, New York.

THE DAILY MOTH:
Now, we’re in the coronavirus pandemic and you’re a doctor. You’re in the front lines. Have you seen people with coronavirus come in? How do you make sure you’re not infected? How do you treat these people?

IV MIRUS:
Yes. In my area, we have two confirmed cases of coronavirus right now. We expect that number to increase because we’ve been starting tests to see and identify who has it and who doesn’t. Right now it isn’t busy, but we are preparing for a big wave of infections.

THE DAILY MOTH:
How do you protect yourself? You’re in the ER and many people come in. How do you make sure you don’t get infected and stay healthy so that you can continue to work instead of isolating yourself? What measures do you take?

IV MIRUS:
Right now, most hospitals in the US are trying to implement policies to limit the spread of the virus in hospitals. For example, a limited number of visitors in the hospital are allowed. They’re trying to encourage using telemedicine through video chat. If you feel concerned or have symptoms you can use telehealth services or call your doctor to see what you should do next. For us in the Emergency Department, we have PPE, which is Personal Protective Equipment. That includes goggles, masks, and gowns. If we suspect that a person might have coronavirus, we put that gear on. It doesn’t only protect ourselves, but to protect other patients we visit. You have to remember, we expect many people to get coronavirus, but there are still other patients who have other problems that don't go away. People still show up to the Emergency Department sick, with a heart attack, stroke, and other problems. They don't go away. We still have to take care of them and also protect them, too.

THE DAILY MOTH:
I wonder - for that virus, do you use that gear to treat someone, then do you have to take it off and throw it away? Will you run out of masks and gowns?

IV MIRUS:
Right. It’s really important that we advise the public that you don’t need to buy masks. Save it for hospitals and for health care providers. We’re trying to collect those and save it so that we’re ready for someone coming soon.

THE DAILY MOTH:
Wow. In hospitals, what changes have you seen in preparing for a pandemic and the possibility of a higher number of people coming in? What kind of changes have you seen in the hospital system? In your system, and maybe the same system has been implemented in other hospitals too?

IV MIRUS:
When the system gets overwhelmed, we have to turn to what is called a triage. That means for who is the most sick, we need to take care of them first. How do we know? We know coronavirus causes viral pneumonia. We know that means people who are really affected or are already older and have a disease, or have lung problems or so on, will have low oxygen and they will have a hard time breathing. We can measure that by monitoring their blood pressure and seeing their oxygen levels. How do we support them through it? We give them oxygen or possibly a machine to breathe for them. Like I just said, the problem is if there are too many people who show up at the same time, we’ll run out of equipment. We’ll run out of personnel, and we’ll run out of doctors who can see them. We have to figure out a way to find who is the most sick and help them heal, and then move onto the next patient. That’s what we plan, and what we’re trained to do.

THE DAILY MOTH:
I read some news in Italy and France that they are overwhelmed and because there isn’t enough equipment, some doctors have to decide who dies, like those who are 80 or older. Are you concerned that the same thing could happen here in America?

IV MIRUS:
That’s a good question. What I’ve seen and noticed is that I know many people are scared. They’re really worried. I also know about another group who think it’s nothing, it might be the media that’s overblown, and they think that it isn’t a big deal. We can see what’s happening in Italy and Iran. I think the virus is like a storm. In Italy and Iran, they’ve been really hit hard. But… Other countries like Japan and Singapore are doing well. They aren’t affected that badly. We can measure how many people are sick. We can see the charts. In Italy, there was a big curve, and in China too. Right now, our numbers are starting to rise. We can see that it’s matching Italy and Iran’s numbers. That’s why we need to start being careful now. What is the difference between us and Italy? We have time. We have time to act now. So what does that mean? Isolation and staying home. If you’re sick, don’t spread it. Wash your hands and practice other techniques to prevent the spread. Give us, in the hospital department, more time to take care of our patients. But, with that said, I don’t want you to worry. Because from what we can see in France, we notice now that they have more young people in the ICU, but 95% of them survive. Yesterday in France, I think, 91 people - not yesterday, but lately - 91 people have died but 71 of them were older than 75 years old. To the common person, this disease will be like a cold. I’ve had a cold before. You’ve had a cold before. I’ve had pneumonia before, and I did fine. Most of us will just experience a cold, cough, fever. We will be alright. I don’t want you to worry, no, but we need to act now.

THE DAILY MOTH:
For those who are vulnerable. I wonder… What about newborns, one to two year olds, toddlers, and children under five? Small children might not be as healthy as older people. Are they at risk? Are we worried about them or will they recover? What have you seen?

IV MIRUS:
Yesterday in England, a newborn was found positive for coronavirus. But luckily, we also noticed that children seem to not get serious pneumonia or colds. It can spread in children and they can get it, but children are very different to adults. We’ve seen some viruses really impact children more than adults, like for example, RSV. That causes children to get sick and the virus spreads to children but adults don’t get hit badly from RSV. Coronavirus seems to have the opposite effect. Right. It’s the other way. It really impacts adults and older people, but children seem to do all right. We’re really lucky for that.

THE DAILY MOTH:
I wonder, you as as doctor, what’s your mindset? You know, in the past in January and December, last year, you were getting by as usual in the ER. Now, there’s a pandemic. How are you transitioning? Plus for other nurses and health care workers… you all have to be there and face it while we can stay home and you are in war right now. How do you stay positive and keep going?

IV MIRUS:
I'm really proud of the University of Rochester’s Emergency Department. I know their nurses… really, it’s a team support. The nurse, doctor, head doctor, staff, and janitor and cleaning teams are all really important. We need everyone. We make sacrifices by going to work and possibly bringing disease to their family at home too. It's a really serious sacrifice, but I’m really proud of the group. I know our emergency department and other emergency departments will be doing an amazing act of heroism. I know, and we all know what we signed up for. This is a really exciting time in Emergency Medicine because we have an opportunity to help so many people. We are ready. The storm is coming. I don’t know how severe that storm is now, but we are preparing and getting ready to fight back.

THE DAILY MOTH:
Wow. Our thoughts are with you. Thank you for your important work.

IV MIRUS:
Thank you.

THE DAILY MOTH:
We need you more than ever. Keep going. Stay strong. Stay healthy, too. Thank you so much for your time.

-Thank you.

I appreciate it.

IV MIRUS:
Keep healthy.

-----
Supported by:

Convo [https://convo.click/2mVhM8h]

Gallaudet University: [gallaudet.edu]