Inside the battle against COVID-19 with ER doctor
Dr. Cameron Klug remembers the day he got the call about the first COVID-19 patient at Legacy Meridian Park Medical Center in Tualatin.
"I kind of stopped in my tracks," said Klug, who works as an emergency room physician and medical director at Meridian Park.
He immediately called the doctors that were on shift to make sure that they had a plan. In the spring, Klug didn't know if Tualatin would look like New York City or Seattle, where doctors were overwhelmed with critically ill patients early on.
"We spent a lot of time kind of mobilizing as an ER group, as a hospital, and as a department to try to make sure we could up staff," explained Klug. "So, in other words, meet volume surges if we needed to in a disaster scenario. What I soon learned is that nobody wrote a book on how to staff an ER during a pandemic."
Klug reached out to physicians and groups in big cities on how to deal with COVID-19 patients. The hospital then began looking at emergency credentialing other physicians in specialties such as cardiology or EMT.
Fortunately, the hospital did not receive an enormous patient surge during that time.
While dealing with a possible patient surge, Klug also had to think about the wellness of his staff. He remembers feeling a lot of fear that they would all get sick with the virus.
"One of our ER physicians did get sick right at the beginning," recalled Klug. "We hadn't instituted our current safety measures because we didn't know what we were dealing with really in the beginning phases (of the virus)."
The ER physician in Klug's department saw a patient who was short of breath and predicts that's how he contracted the virus. Klug says the doctor took the patient up and down the hallway to test how much activity she could do. The patient was then admitted into the hospital.
"Three days later, he's like, 'I feel really bad. I got a fever (and) can't smell anything,'" added Klug. "We had to take him off the schedule right away. So, we kind of had to scramble because he was scheduled to work five days in a two-week timeframe. His whole family got sick, by the way, because he didn't know he had acquired the virus."
Now, the hospital has instituted an aggressive mask policy and patient visitor policy. Patients are either wearing a mask or given a mask, and only one visitor is allowed per patient.
As for personal protective equipment, Klug says doctors are wearing full contact airborne precaution — in other words, a gown that is either disposable or goes to hospital linens to be formally cleaned and specialized masks.
At the beginning of the pandemic, Klug remembers having some anxiety about what kind of PPE would be available for doctors, considering it was an issue across the country.
"I personally wasn't losing a bunch of sleep over it at nighttime, but there are several of my colleagues that were extremely worried about it," said Klug.
He remembers brainstorming about possible PPE shortages with other doctors, but then he realized there wasn't much they could do about the possible scenario.
"It would have been a really rough situation, because it gets down to ethics," explained Klug. "At what point do you completely push aside your own safety to take care of a patient? That's a variable answer. According to who you ask, we all have families. We didn't want to put our families in a spot where we're ill and we're taking it home."
Luckily, Klug remembers the community stepping up to offer N95 masks and easing their thoughts on protective gear.
Kristin Whitney, a spokesperson for Legacy Health, says there was a huge effort underway with the help of local, county, and state officials to secure PPE for the medical staff working at the facilities. They also looked at possible supply chain issues across their system for improvement.
As for protecting his own family during the pandemic, Klug decided not to isolate from his mother-in-law and father-in-law, who are both in their mid-60s, but he did make a conscious effort to not be around them for long periods of time due to their age.
"Fortunately for me, nobody at home has immune suppression or any advanced medical problem," he explained. "That's been what we learned from patients who have other medical problems that they are at higher risk the worse the disease. Fortunately, I don't have anybody who's got cancer, lung disease, heart disease or diabetes."
Health experts are also expecting flu season to line up with COVID-19 during the fall and winter months.
After prepping for the worst in the spring, doctors at Meridian Park are ready to tackle a wave of patients for the rest of 2020.
"If there's a wave that hits in the wintertime, it's all set up and we're ready to go," Klug said. "As we do head into these winter months, it's more important that we remain vigilant and that the public adhere to the protocols that Governor (Kate) Brown and our public health officials have established for our communities so we can continue to push those numbers down."
When asked how it feels being called a hero during unprecedented times, Klug says he doesn't get into his car thinking he's a warrior. He believes treating patients — no matter how sick they are — is part of the job he signed up for.
"When do you this specialty, you don't know who's going to come in the door," Klug said, "and you know that you're exposed. … I'd say that I have mixed feelings when people think that me and my colleagues are heroes, but I don't necessarily feel like a hero. I feel like I'm just doing what I'm supposed to do. I'm doing what society and our community expects me to do."
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