April 10, 2020 COVID-19

Reflections from a Cardiovascular Physician Assistant During COVID-19 Pandemic

By Elizabeth Hoffman

As a cardiovascular physician assistant, I have been vaguely aware of coronavirus (COVID-19) since the beginning of its global spread. I watched with mild concern as it swept across Asia, knowing that my stepson, Jon was about to visit the region for work. I didn’t feel any real concern about Europe and the United States; this changed in late February with the first report of community spread in Washington state. I thought about other epidemics that I have observed in my career, such as SARS, H1N1, Ebola and Zika, and wondered how this virus would compare. Somehow this felt much different.

Unlike SARS, which impacted just over 8,000 people worldwide, COVID-19 was spreading rapidly. Unlike H1N1, where some members of the adult population had antibodies, no one seemed to have immunity to COVID-19, and it continued to appear highly transmissible. The coronavirus wasn’t in a far-away place like Ebola had felt. Also, it wasn’t concentrated in certain outbreak areas with the greatest risk concern being mainly for pregnant women and their babies, like Zika.

Mixed messages about crisis severity also made it challenging to determine how to appropriately respond. On one hand, my hospital system and public health leaders were using a very serious tone about the potential health impacts on our community; meanwhile, Washington D.C. initially projected an optimistic forecast. I went to work, where we had set up a Command Center, and we were discussing canceling or postponing non-emergent procedures to free-up personal protective equipment and hospital beds. I would come home, and the national news I was listening to conveyed a message that there was “nothing to see here.”

I work as part of a large cardiology practice, in cardiac arrhythmia management (Electrophysiology) with responsibilities in hospital and clinic settings. The normal daily routine of a clinician includes precautions such as hand washing, and wearing gowns, gloves and masks when appropriate. These measures help ensure that we are not putting our patients, or the rest of the population, at risk by inadvertently spreading germs throughout the hospital and community. Typically, we “foam-in/foam-out” with antibacterial sanitizer dispensers available in every clinic space, as we enter and leave a patient’s room, and wash our hands with soap and water many times throughout the day. But within days we started to hear more about the judicious use of materials such as masks and about being good stewards of our material resources. This was new.

While our focus continues to be on patient-centered care and providing the best care possible to our entire patient community, our day-to-day work has changed. We are minimizing person-to-person contact by switching our clinics to virtual/telecardiology visits. The normally busy campus is very quiet with visitors discouraged and elective procedures put on hold.

Besides my clinical work, I have been especially lucky over these past few months to spend time as an intern on the State Affairs team at United States of Care (USofCare). I was attracted to their work because of their mission to ensure that every single American has access to quality, affordable health care and how it resonates with my values and work. My current employer supported my enduring interest in health policy which allowed me to get a glimpse into the world of this mission-driven, passionate group of smart and talented people. As the COVID-19 pandemic moved into more and more communities, in March the team at USofCare transitioned its focus to provide support for states and the federal government, identify public needs, and support effective responses to the pandemic.

Being on the front line at my job and participating as an intern at USofCare gives me a unique vantage point to experience, first-hand, the impact of COVID-19 on our health systems. Having access to the policy side of the preparations and tactical response to this crisis has been a valuable learning experience. I’m proud to participate in conversations with national leaders and subject matter experts who are grappling with best practices to limit virus spread and mitigate economic harm. Despite the ever-spreading grip that COVID-19 has on our collective psyche, my experience and new gained knowledge has provided me with a deep sense of gratitude and optimism.

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#VoicesOfRealLife

During these difficult times we are connecting with folks across the country as a part of our #VoicesOfRealLife series to share how COVID-19 is impacting their lives, their work, and their community.

Take a look at Elizabeth’s vlog on how her hospital is handling the early stages of COVID-19. Health care professionals like her are on the front lines of this pandemic and we owe them our deepest gratitude!