Medical workers are living in fear of catching COVID-19 and exposing their families to the virus.
People treating coronavirus patients are undressing in their garages, entering their homes via back doors, sanitizing every surface they touch, and hiding from children seeking hugs until after they shower.
The families of healthcare professionals are pleading with people to follow social-distancing guidelines.
When Rezwana Hoque's husband walks through the door, it usually prompts a joyous cacophony.
Laughing and yelling, "Yes! Daddy's home!" their sons, 9-year-old Aidan and 2-year-old Zain, rush to hug their father, who is doing his residency at a Louisiana hospital.
But the coronavirus has ground that excitement to a halt — affection comes at too high a price.
"Since the first coronavirus case in our city broke out, we decided that it would be best to refrain the kids from hugging my husband," Hoque said. "The first day he walked through our back door, I had to restrain Zain from jumping on him. Zain, of course, had a full meltdown, and from that day forward, we decided it would be best for my husband to sneak in through the garage."
Business Insider confirmed the identity of Hoque's husband but she asked that his name be withheld due to the nature of his work.
The couple said they now follow a step-by-step decontamination process: He takes off his shoes, and she disinfects them; he removes his scrubs and puts them directly in the wash; she collects all his personal belongings in a container and sanitizes each one of them, and then he jumps in the shower.
"After all that, he comes out to hug the boys," Hoque said.
Medical officials are monitoring Louisiana as the next potential coronavirus hotspot since 26% of all administered COVID-19 tests are coming back positive, according to Dr. Deborah Birx, who is on the White House coronavirus task force. As of Friday, at least 266,600 people across the United States had tested positive for the coronavirus, and almost 7,000 have died. Louisiana alone has reported more than 10,200 cases and some 370 deaths.
This is becoming an increasingly common story around the United States, as people potentially exposed to the coronavirus take extreme precautions to protect their families. In the absence of adequate personal protective equipment (PPE) — medical gowns, masks, goggles, and gloves — some have temporarily moved out of their homes or self-isolated by sleeping separately and using different bathrooms.
The emotional strain of this and the daily work will take a toll on medical workers' mental health, experts warn. A study published in the Journal of the American Medical Association surveyed 1,257 health care workers treating COVID-19 patients in 34 Chinese hospitals, and found that 50% reported symptoms of depression, 45% experienced anxiety, 34% struggled with insomnia, and 71.5% dealt with psychological distress.
The coronavirus is interrupting family celebrations
The coronavirus itself is worrisome in that it is "indiscriminate of race, age, and gender, and the symptoms and severity [vary] from person to person," Hoque said. She is 34 weeks pregnant with the pair's third child — a daughter — and concerned by the "unpredictable nature of the coronavirus" and how quickly it spreads.
After reading in February that Italian women were being forced to give birth alone, Hoque has been preparing mentally for what's to come.
"Right now, there is a possibility that my husband might be COVID-19 positive around the time of my birth," she said. "If he is, he has to be quarantined and might not be able to be there with me. I'm a go-with-the-flow kind of person, and we are facing a time where no one has control over anything that's happening, so I don't think there's [any] point in stressing myself out over this."
Hoque plans to give birth at the same hospital where her husband works; administrators there have already moved labor and delivery into a separate building. If all goes well, she plans to check out of the hospital within 24 hours of the birth to protect her baby from the virus.
For now, though, Hoque has turned to online shopping — not for retail therapy, but because the pandemic has prevented her from getting ready for the arrival of her daughter.
"My sister just had a baby, and she was going to pass on certain things to me, but she lives in Texas, and since there are travel restrictions to Louisiana, I am not sure I can retrieve those items before the baby arrives," Hoque said.
Stay-at-home orders don't constitute a holiday or a punishment
The coronavirus outbreak in Ohio — where Amanda and Ryan Alek live with their three children — is smaller: Just over 3,300 people have tested positive and 91 have died.
Ryan Alek is the safety coordinator at a Toledo hospital, where he is on the COVID-19 operations team.
Emily Martin Photography
"Too many people are looking at this as a vacation or are complaining about having to stay home," Amand Alek told Business Insider. "I wish my husband could stay home. They need to change their mindset and be thankful they can stay home and stay safe."
It's been upsetting, Alek said, to see people visiting friends and family and going to the store "to grab one thing here and there," rather than following social-distancing guidelines to reduce the virus' spread and avoid overwhelming local healthcare systems. Amanda shared a tearful message on Instagram after witnessing people not taking the illness seriously.
"People are not staying home, and that's just going to prolong this and prolong the 'new normal' for my family," she said. "I wish they would walk in someone else's shoes for the day and see how this is affecting other people's lives."
Alek added that her mother has COPD, and her father is diabetic, raising their risk for more severe complications of the virus.
"I am concerned with their underlying health issues that this could be bad for them," Alek said. "I am also concerned as my son has a reactive airway and often has breathing problems when he gets even a common cold. I am surprised by the fact that we weren't more prepared as we saw this coming."
The pandemic is causing physical and emotional weariness
Alek said her husband's work takes a daily mental toll on him.
"My husband is a strong man, he hardly ever shows weakness," she said. "This has been the first time I have ever seen him scared, except for once, when our first-born was sick as an infant."
Ryan Alek has already lost weight, and the skin on his hands is dry and cracking from the constant washing and sanitizing.
But Amanda said he has "promised me to not sugar coat anything that he hears."
"He knows I need to talk through things, too, and he consoles me when I get emotional about all of it," she added.
The Aleks are also taking precautions to prevent the coronavirus from breaching their house.
"[Ryan] comes home and undresses from his work uniform in the garage, opens the door, and then sanitizes the handle behind him," Amanda said. "When I see him pull in the driveway, I run to the bathroom to start the hot water in the shower and then start to distract our 2-year-old."
Before the outbreak, the couple's youngest daughter used to drop whatever she was doing when she spotted her father at the back door and scream, "Daddy!"
Ryan loved being "tackled with hugs every day," Amanda said. "Obviously, this has had to stop with fear that his clothing or skin could be contaminated. So he sneaks past us and showers and then greets the kids, all in hopes that that was enough to stop this from entering our home."
Soon, he will be limited to using one bathroom, while the rest of the family uses another.
'I miss seeing my kids'
T. Carter Musgrave, a Utah pharmacist, also sheds his clothes at the door and uses the downstairs shower before heading further into his house.
"I do this because I am afraid of spreading this to my family," he told Business Insider.
T. Carter Musgrave
But Musgrave doesn't get to see his family that much anymore at all because of the long hours he's working. Even after a magnitude-5.7 earthquake rattled Utah on the morning of March 18, he went in to work.
"My days have been difficult," he said. "I have been staying several hours late after a 10-hour shift, trying to keep up. Many of the days I'm gone before my kids wake up and [I come] home after they've gone to sleep, so I miss seeing my kids."
Musgrave works for a pharmacy located inside a grocery store. The store shuts at 4 p.m. every day because it's not receiving shipments of goods, but Musgrave got creative and now turns to to curbside delivery after the shop closes.
"Both of my kids are very young, so they don't fully understand why everyone is home except Dad," he said. "I hope one day they will understand what I was doing, that I was fighting for the health of our community, and keeping good on my oath as a pharmacist."
'Please stay home' for the sake of healthcare workers
Musgrave said he sometimes struggles to believe what he's hearing and experiencing.
"Pharmacies have been bombarded," he said. "We were already maxed out before this virus decided to rear its ugly head. Today we see people making the problem worse by hoarding supplies like toilet paper, masks, and hand sanitizer."
Musgrave added that he has seen a shortage in inhalers and hydroxychloroquine, a malaria medication touted as helpful to coronavirus patients. His regular work volume has spiked amid fears that people won't be able to get their hands on necessary medicines. Customers at the pharmacy have to deal with longer-than-usual wait times because Musgrave can't work at his usual pace due to the "extra precautions" in place.
The store where he works focuses on surface cleaning and keeping people at safe distances from one another, using tape on the floor and roped poles, because they too are plagued by a severe lack of PPE.
"We don't have enough PPE. I don't know anyone who does," Musgrave said. "I have had patients come and donate their PPE to the pharmacy. This has been a lifesaver for us."
Musgrave said that he has heard people dismiss the need to stay home "in the name of supporting the local economy."
"I promise you," he said, "this is the time to support your local healthcare providers by staying home. We are sacrificing our health by going out so that you can stay home. Please stay home. ... Keep your distance and wash your hands."
Staring down the 'possibility of death' for the sake of patients
Hoque said her husband "knows that there is a high risk of exposure to COVID-19 and that there is a possibility of death, but that does not phase him — he continues to go to work every day eager to serve."
Some healthcare workers on the frontlines of the coronavirus crisis have been forced to self-isolate in basements, garages, and hotels. The Hoques aren't taking that step: They've chosen to face this crisis together.
"As the number of cases rises, we are constantly questioning whether or not we have made the right decision for our family," she said, noting that Zain is asthmatic. "As someone told me, 'In sickness and in health takes [on] a whole new meaning during this pandemic,'" Hoque added.
The family hopes that frequent sanitizing and social distancing — on their part and that of others in their community — will help protect them.
"I don't want him to go through the mental and emotional toll of dealing with a pandemic alone," Hoque said of her spouse. "The thought of him being sick and facing this on his own frightens me ... If these are the final days I have with my husband, I don't want to live apart from him."
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