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Illinois has become another national hot spot for coronavirus, with a surging number of confirmed cases. Most are in Cook County, the region that is home to Chicago. William Brangham talks to Dr. Claudia Fegan, chief medical officer for Cook County Health, about how her employees are holding up amid the stress and why they continue to worry about a shortage of critical medical supplies.
The spread of coronavirus is continuing to build in regions around the country, including the Midwest, where it is putting a big strain on doctors, nurses, first responders and hospitals.
William Brangham gets a view from the front lines of health care there.
Illinois is now another one of those states dealing with a skyrocketing rise in the number of coronavirus cases.
This chart shows the sudden surge of diagnoses in the state, and, with it, the rising number of people dying from the virus.
Most of those cases right now are in Cook County, the area in and around the city of Chicago.
Dr. Claudia Fegan is the chief medical officer for Cook County Health.
Dr. Fegan, thank you very much for being here.
I wonder if you could just — we have been seeing this dramatic spike in the number of cases in your region. How are things there right now?
Well, I think, right now, we're holding our own.
We're looking at — and we have been following the models, projecting that we were going in this direction, and have been trying to prepare on a regular basis.
We're talking about the number of beds we have, how many staff we have, and trying to get our arms around what we see happening in New York and try to prepare and hope of avoiding some of the difficulties that they're encountering.
I take it you're talking about just the lack of ICU beds, the shortage of equipment, shortage of ventilators? You mean things like that?
So what we see is that, across — around the world, that this virus is overwhelming health care systems. And to the extent that we have time to prepare, we see the surge coming, it's allowed us to rally our forces.
Hospitals are talking to each other. We're not competing. We're collaborating. And we all try to benefit from each other in terms of what's going on and taking care of these patients.
And do you have a good sense? Like, you do feel that you're adequately supplied with medical supplies, masks, face shields, ventilators, those kinds of things?
It's a daily challenge.
We keep a running log of our personal protective equipment. And when see where things that are — we look at our burn rate, and we're ordering. Although there's a worldwide shortage, currently, we have been able to maintain enough equipment for all of our staff, but we are being frugal with it.
We are instructing staff on ways in which they can reuse the equipment and when they need to discard it and when it's OK to continue to use it. So, currently, we are adequately supplied, but we know that that's dependent upon receiving regular shipments.
And when we're not able to continue to get those shipments, it will be very problematic.
We have certainly been seeing, in New York and elsewhere, in other nations as well, an enormous anxiety on behalf of the medical staff who have to go into these cases where they're concerned not only with providing the best possible care for people who are very, very sick in many cases, but also protecting themselves.
What is the sense you're getting from staff? Are they — how are they handling this anxiety?
No, rightfully so.
Everyone is afraid. No one wants to have the virus. And so we see a lot of anxiety, and it manifests itself in all kinds of behavior, maybe excessive use of PPE, putting on multiple gowns or multiple masks.
We try to provide staff with reassurance, with the information. A staff member becomes positive, is diagnosed as being positive, then everyone in that workspace becomes concerned about whether they are also going to get it.
We have reached a point in terms of community prevalence and spread that we're telling the staff that, if you walk into the hospital, you should assume that you have been exposed, and so being very mindful of putting on equipment as soon as you leave your car to walk into the hospital.
We're asking everyone to mask and everyone to use gloves in all contacts, and that, when you go home, you need to remove the items that you were wearing at work, so that you would try to avoid contamination in the home space as well.
So, you can't not be afraid. I think fear is a natural response, but it's trying to cope with it and trying to reassure people that there are ways, there are things they can do to protect themselves and that, if we're mindful of that, we can all be safe.
Just assume that everyone that you're taking care of is positive. And that way, you can stay safe and use the appropriate equipment.
That's got to be incredibly anxiety-inducing.
I mean, on some level, you want people to be conscious of it. And maybe that fear helps drive better precautions. But that fear has also got to be incredibly taxing for people day in and day out.
It is very stressful.
And we have an aging work force at the county. And so folks are very concerned about their own personal well-being. And, sometimes, that can be a tremendous distraction from doing what they normally would do in terms of taking care of patients.
We also have an extremely large correctional health facility. And you can't practice social distancing in a correctional health facility. And so it is a tremendous stress for the staff who work there, as well as the detainees who we're trying to provide the best of care.
And I think that the advantage is that the staff is working as a team and they're very supportive of each other. And we are trying to make sure our detainees are kept safe.
All right, Dr. Claudia Fegan, Cook County Health, thank you very much, and good luck out there.
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