Fighting on the Front Lines

WEB EXCLUSIVE Before Charul Haugan, an emergency medicine physician at UNC REX, sends her teenage sons to the grocery store, she makes them put on homemade masks and a pair of disposable gloves. Haugan says they volunteered to do the grocery shopping in order to help keep her safe from contracting coronavirus.

“They’re like, ‘Mom, we’re young—if we get sick, it’s fine. You can’t get sick,’” Haugan says. “I may or may not have threatened that I wouldn’t feed them,” she adds, jokingly.

Haugan, who has worked as an emergency medicine provider at REX since 2001, says she believes everyone should be wearing masks right now, including those without symptoms, as they still may be able to spread the disease. 

But if you’ve seen the news or have been on social media at all in the past month, you know there’s been a shortage of masks across the United States, along with other essential personal protective equipment (PPE) for healthcare workers. This, Haugan says, is largely due to the fact that India and China have cut off their exports, which is where most PPE is manufactured, in addition to the inability of domestic manufacturers to keep up with unprecedented demand, counterfeited products and price gouging—a typical N95 mask costs around $1.50, whereas some masks are now for sale at $6 or $7 apiece. 

A nationwide survey from National Nurses United revealed that a majority of U.S. registered nurses believed their healthcare facilities were unprepared to handle COVID-related cases and/or had a shortage of PPE. And last week in North Carolina, a group of medical workers begged the General Assembly to get them more PPE in order to help prevent shortages as more and more people are expected to flood hospitals in the next few weeks. 

Haugan says the supply chain issues cause even more stress and concern for healthcare workers already dealing with difficult situations at work every day.

“Emergency medicine doctors are the bravest, toughest group of people,” Haugan says. “These are the leaders and they are afraid. They’re afraid for themselves, for their staff that looks up to them. They’re afraid of getting infected and bringing it home to their families.”

Many doctors are sequestering themselves at home so as to not potentially spread the disease to their loved ones, even sleeping in separate bedrooms and using separate bathrooms to further prevent contact. Haugan says missing out on that family time and support is an additional burden for healthcare workers during an already difficult period.

Haugan says she has nightmares and that she is concerned for her colleagues and her sister, also an emergency medicine doctor. But she says she and her colleagues feel an obligation to take care of their patients, no matter what. “We have a duty—many of us think we have a duty—and we have a calling to help patients who need us,” Haugan says.

For the general public to help the cause, Haugan says the most important thing to do is stay at home to help flatten the curve. It’s not just about how many people end up getting infected but also about the rate at which people get infected. Flattening the curve allows U.S. manufacturing companies to ramp up their manufacturing of the ventilators patients need and PPE that healthcare workers need. 

“The more we can delay the inevitable, the more time we have to prepare,” Haugan says.

Additionally, Haugan says she encourages patients and the public to wear homemade masks to help slow the spread of coronavirus and flatten the curve further. 

Haugan says UNC REX, and most hospitals around the country, are generally planning diligently to make sure they’re prepared to care for COVID-19 patients as they continue to arrive in increasing numbers in the coming weeks. At many local hospitals, staffers are setting up tents, offloading patients from the hospital to virtual care centers for telehealth evaluations and getting infrastructure in place to free up inpatient beds.

Area hospitals are also partnering with universities and other organizations to utilize technology in order to sterilize existing supplies and manufacture new supplies. Doctors and nurses are collaborating to understand and share best practices and drive innovation. Haugan says the community has stepped up with impressive donations of medical equipment and basic necessities such as hand sanitizer and cleaning wipes—all of which will help curb the spread of the disease.

It’s especially imperative during this time that we keep our frontline workers healthy and protected. “The skill sets for emergency medicine providers cannot be easily met by people who haven’t worked in that world,” Haugan says, adding that she promises to continue working tirelessly to be a leader for the UNC healthcare system and to do her best to get supplies to the people that need them.

“I have never really thought of myself as an activist, but I’ve never been more moved to action as I have with this issue,” says Haugan. “Each and every person has a responsibility to do what they can to stay home and stay healthy.”