Microbiologist Kerry Pollard performs a manual extraction of the coronavirus inside the extraction lab at the Pennsylvania Department of Health Bureau of Laboratories. Photo courtesy Pa. Governor Tom Wolf.
If the fight against COVID-19 is a war, hospital personnel are the front-line troops. But where are the reserves?
Tens of thousands are working today in practices that specialize in fields far removed from pulmonary care and emergency medicine. Across the country, and even in hot spots like metropolitan New York and the Puget Sound region of Washington, many medical offices continue to provide routine services in pediatrics, orthopedics, gastroenterology, dermatology and dentistry. Some offices in these fields have closed, to protect both staff and patients from spread of the disease. Others have limited themselves to emergency or urgent care. But apart from being urged to avoid or reschedule elective surgeries to conserve precious supplies, most are free to continue providing service for the time being if they choose. Life goes on; children still get ear infections and workers’ compensation claims still get processed.
All these medical professionals – doctors, nurses, physician assistants, nurse practitioners and yes, even dentists – are eligible to volunteer for emergency duty to augment or replace hospital staff who fall ill or simply become exhausted under the pandemic’s rapidly rising caseload. Already, tens of thousands have. In some cases, these professionals work in practices owned by large hospital systems, which may ask or order staff to redeploy where they are most needed, or which may close their offices to prevent further spread of the disease-causing coronavirus.
The reserve also includes former practitioners who have retired, or who have moved into hospital administration and fields outside medicine. New York is one state that has offered to permit former practitioners to return to service during the emergency despite their expired credentials. It is reasonable to expect that other states are taking similar steps, or soon will be. The Department of Health and Human Services also maintains an emergency system for recruiting health care workers, though NPR recently reported that the online portal needs attention to work as designed. For now, the states are taking the lead.
New York Gov. Andrew Cuomo this week lauded the 40,000 health care professionals he said had signed up for the state’s volunteer program. He also acknowledged the service of more than 6,000 psychiatrists, psychologists and mental health counselors who are donating time to serve on a free telephone hotline. These volunteers will assist doctors, patients, families and members of the general public who are trying to cope with the anxiety-inducing situation.
Having enough fresh troops in the field can be as much a matter of life and death as having enough ventilator-equipped intensive care beds and personal protective equipment. Shortages of all these resources have contributed to the pandemic’s exorbitant mortality toll in Italy, Spain and, increasingly, France. In the United Kingdom, Prime Minister Boris Johnson regularly speaks from behind a placard bearing the legend “Protect the NHS,” the U.K.’s beloved but chronically undercapitalized National Health Service. That country, too, has called for volunteers – as many as 250,000 – to backstop its health care system. Johnson reported that 405,000 people answered the call in the first 24 hours.
It is worth remembering that while wars are fought on the battlefield, they are usually won or lost far behind the front lines with service provided by the “noncombatant” labor force. And so it is right now. Many American states and communities are fighting the virus by asking residents to stay away from work and leisure gathering spots. Those of us who do not need to leave home can do our part by social distancing and obeying government instructions to shelter in place.
Most everyone appreciates the warehouse workers, mail carriers and delivery drivers who bring goods to our doorsteps, making this practice sustainable for the rest of us. Less visible, but equally important, are the truckers, bus drivers, and airline and train crews who are still moving goods and people across the country; the police, firefighters, ambulance drivers and other emergency workers providing their customary first responses; the restaurant staffers still on the job who are providing takeout and delivery meals; the grocery clerks and cashiers providing provisions for our homes, and the doormen, security guards and janitors who still interact with strangers and their belongings every day to keep the rest of us safe and comfortable. Almost all of them do their jobs with concern but without complaint. Many are already paying a price in their own personal health, and more will likely do so.
We have several of these important “noncombatants” on our own staff at Palisades Hudson. Like most accounting and financial services firms, we are considered an essential business that can stay open while maintaining social distancing under emergency closure orders. Most of our staff members have been working safely from home since March 4, when I limited our in-office presence. But a skeleton crew has kept open our larger offices in Atlanta and Stamford, Connecticut, as well as our Fort Lauderdale, Florida headquarters. I have made sure that our people can drive directly between home and office, avoiding mass transit and other public spaces. Their service allows us to continue helping clients navigate the financial market gyrations the pandemic has caused, and to handle tax filing and other business management services for those who can benefit from prompt turnaround despite the extension of federal deadlines to July 15.
Most Americans realize by now that we are all involved in the battle against COVID-19, even if we are not on the front lines. Those who are may be the most visible heroes. But the ones who are volunteering to fill in for them or join the fight when called upon to do so are equally heroic, as are all those taking risks to keep the rest of us safe.