Coping with coronavirus in a two-physician household: Prepare for worst-case scenarios

The novel COVID-19 virus is tearing its way through America. Households are seeking to adjust to the new normal and hospitals are scrambling to restructure their services to meet rising needs. We are one household that is struggling to adapt.

As a couple, we are both young medical doctors, currently training in subspecialty fellowships at Boston-based hospitals. As far back as both of us could remember, we always wanted to be physicians. We were drawn to the field because we like helping people. It was as simple as that. We met during our training in New York City as we worked our way through an eight-year program to obtain our M.D. and Ph.D. degrees. As physician scientists, we have made it our professional mission to advance the frontier of medicine through scientific research.

We are hardly in the minority, as somewhere in the range of 20-40% of doctors marry other doctors or health care professionals. Many young adults find love during graduate medical school training, whether in the classroom, the anatomy lab, or in our case — at an on-campus party crammed into a tiny, hot studio apartment talking about basal metabolic rate over a couple of beers.

Would we risk exposing friends and family?

Our lives became exponentially more complicated last year when we welcomed a baby into the world. Our daughter is now 9 months old and continues to be a constant source of joy. Having always prioritized our careers, we often look at her and can’t believe it took us this long to start a family.

If we thought coordination of childcare was complicated for a two-physician household during peacetime, we have a new appreciation for the complexities during a national crisis. Many young doctors, nurses, and health care providers are struggling to come up with creative solutions now that schools and daycares are shuttered. Our ever-resourceful community has even started recruiting furloughed college and medical students to babysit for families of health care workers called to serve on the frontlines.

Prior to the COVID-19 pandemic, our professional efforts were mainly centered around pursuing biomedical research that we hoped would translate to clinical benefit for patients with cardiovascular diseases or cancer. However, our laboratory lives have promptly been put on hold as we prepare to rejoin the inpatient workforce where help is urgently needed. To ensure adequate staffing in the hospital, help is needed day or night, further complicating our ability to make dependable childcare arrangements. We are scrambling to prepare for worst-case scenarios in which we would both be called in last-minute. Unfortunately for us, we do not have immediate family in the area but even if we did, would we risk exposing them?

We also worry for our friends and colleagues on the most perilous frontlines who are stationed in emergency departments, COVID-specialized wards, and intensive care units. Furthermore, physicians, like the rest of the population, are not immune to being classified as high-risk should they become infected, including those who are immunocompromised or pregnant.

Infection seems inevitable

As we shift our focus to caring for those in the hospital, we are also grappling with what this means for our patients who we see in weekly subspecialty clinics. Nonurgent outpatient visits are being rapidly converted to the virtual care model to avoid unnecessary exposures for both parties. We have been fielding difficult questions via telemedicine encounters, secure messaging systems, and phone, as people are asking when their cardiac catheterization will be rescheduled or if supply-chain pressures could interrupt their chemotherapy cycles.

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As we struggle to keep up with the deluge of new information and guidelines that change day-to-day, we are trying to come to terms what this all means for our household. These last few nights, we lay awake discussing worst-case scenarios. What if one of us has an exposure or contracts COVID-19? Should we self-quarantine in the garage or knowingly expose the other since our risk as health care workers is relatively high anyway? What about our baby? Do we risk exposing her? If we are both quarantined, or worse - hospitalized, who will take care of her? Should we be drafting a will even though we’re otherwise healthy 30-something-year-olds?

In fact, most of our colleagues are in similar quandaries that are already playing out daily. Data on rates of infected healthcare providers vary across the globe. In Spain, about 14% of those affected are medical professionals and in the hardest hit areas of Italy, reports cite rates between 10-20%. However, numbers are likely even higher for households comprised of two health care workers and if proper personal protective equipment is unavailable, then infection seems inevitable. Current recommendations dictate that if a health care provider does indeed fall ill, he/she is expected to self-quarantine at home. As of now, the U.S. does not have a centralized quarantine mechanism in place like the one implemented in China, even though the highest risk of transmission is within family clusters.

In the few moments in which we dare to think about the future, we wonder what we will tell our daughter about this frightful time. We hope to tell her that both of her parents fought bravely on the frontlines against this microscopic enemy. We hope to tell her we provided compassionate care for our patients even when circumstances were dire. We hope to tell her that scientific reasoning prevailed and that we have no regrets about our chosen line of work. We hope to tell her the country came together and championed unity and courage over partisan ideology and bitter divisiveness. We hope that we will both be telling her this story together.

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Most of all, we hope that her generation — the future of America — will learn from the mistakes made in 2020. Perhaps those in Generation Alpha will be inspired to pursue careers as virologists, epidemiologists, or infectious disease specialists to ensure preparedness for future pandemics yet to come.

We are bracing for the surge that will inevitably arrive in the coming weeks. As we do, we implore you to stay at home, flatten the curve, and minimize the transmission rate by doing your part. We will be doing ours.

Dr. Jaime Schneider is a hematology/oncology fellow and Dr. David Gross is a cardiology fellow, both based at Boston hospitals.

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This article originally appeared on USA TODAY: Coronavirus: Coping in a 2-physician household: Prepare for worst-case