Infectious disease doctors in South LA brace for surge

The fit is important. Every N95 respirator mask must be properly fitted to Dr. Erin Dizon and Dr. Maita Kuvhenguhwa’s heads to ensure an airtight seal that might save their lives.

Then there are the face shields. Patients with COVID-19—which is about all the two infectious disease doctors see these days in the busy Emergency Department of Martin Luther King, Jr. Community Hospital (MLKCH)—often present with a hacking cough that can spew invisible virus particles as far as three feet. The virus can enter the body through the eyes, so face shields of all sorts, including goggles and safety masks, are part of the armor both doctors don each day.

With the masks and the shields come isolation gowns to keep the virus from clinging to their clothes, nitro gloves thick enough to protect their hands from punctures, and polypropylene shoe booties that cover their feet. The gear is hot, cumbersome—and critical to keeping healthcare workers safe.

Both Dizon and Kuvhenguhwa are infectious disease doctors, so they know the risks perhaps better than anyone. They’ve studied medical responses to Ebola, SARS and other dangerous outbreaks overseas. They knew it was likely that a pandemic could someday come home.

Now it’s here. COVID-19 has quickly created a new set of risks and responsibilities. Each day, more patients are testing positive for the disease. Each day, the doctors suit up to treat them, knowing that this is just the beginning of a wave of cases to come.

During the best of times, the patient population they care for is already particularly vulnerable. A history of health inequity coupled with a shortage of primary care means that many patients are already battling conditions like diabetes and heart disease. Diabetic amputation is common here, as are bloodstream infections caused by untreated illnesses. 

This is the context in which COVID-19 is spreading in South LA—conditions which have already made MLKCH’s Emergency Department one of the busiest in Los Angeles County.

Dr. Dizon worries about the special challenges South LA residents face. As national, state, and city guidelines call for isolation and social distancing, she worries about homeless patients—how will this pandemic overwhelm people who cannot “shelter in place” because they have no place to shelter? 

Both doctors have watched the disease cut across China, Italy, and states like Washington and New York. Both know what is coming.  

But while both share feelings of fear, apprehension and sadness, the response from the hospital and their community has given them hope. Donations large and small are pouring in.  Emergency preparedness plans made months ago have been deployed. A strong infection prevention team and pharmacy with good access to antibiotics are sources of strength for the hospital. The donation of two medical tents from the International Medical Corps has taken some pressure off the need for treatment space. And a robust public health information campaign has gotten the word out to the riskiest and most vulnerable populations. 

Inside the hospital, a nurse reached out to Target, resulting in a donation of more than 3,000 N95 masks. Outside the hospital, a teacher from the nearby Charles Drew Magnet High School of Science and Medicine wheeled a cart full of gloves and other medical supplies across the street to the hospital’s door. Hollywood seamstresses accustomed to dressing celebrities are sewing isolation gowns. Local restaurants are feeding front line staff. 

“Everyone is stepping up and figuring out all the ways we can be prepared. People are thinking about how this will affect everything from social work to bioethics to case management. We’re collaborating and thinking creatively,” said Dr. Kuvhenguhwa. 

The weeks and months ahead will be hard. But one thing both Drs. Kuvhenguhwa and Dizon know: there are plenty of people who care about the community, and many of them work at MLKCH. 

“As long as we’re healthy,” says Dr. Dizon, “We’ll be showing up to work.”