Tales from the Wilton Healthcare COVID-19 Frontlines: Dr. Brian McGovern, Norwalk Hospital ER Doctor

This is the first in a series of interviews GOOD Morning Wilton will be doing with healthcare providers working during the COVID-19 pandemic.

GOOD Morning Wilton editor Heather Borden Herve interviewed Dr. Brian McGovern, a Wilton resident who is a board-certified attending physician at Norwalk Hospital‘s emergency department, as well as the medical director for the Wilton Volunteer Ambulance Corps.

We spoke with him on Tuesday, March 31, the largest, one-day jump in positive cases in Fairfield County. With Fairfield County the epicenter of the COVID-19 crisis in CT, Norwalk Hospital is the ‘epicenter of the epicenter.’

Key quotes from our interview:

“On the one hand we’re seeing less flow through the emergency department. On the other hand, the patients that we are seeing tend to be more difficult for us to manage and diagnose and take care of.”

On the stress he and his colleagues face:  “It’s part of what we signed up for. The good news is that there are many likeminded people in that hospital–physicians, nurses, techs, secretaries, social workers, all on the same page. All working towards one common goal. And in that we find solace, that we’re all doing this together for a better good.”

What it’s like in the ER:  “There are no visitors, no matter what. There have been patients who have died with no visitors at their bedside. We now split up our emergency department, in ways where we try and put all patients who we think might have the virus or could potentially have it in one certain area, so we’re not co-infecting everyone. Patients will sit in their room isolated, we might take the history by phone. We want to limit our time and exposure to them and try to keep them well informed as to what’s going on. But again, we have to limit our own personal exposure to them. You would walk through there and see doctors, nurses, techs wearing uniforms that might scare people–personal protective equipment that is comprised of an N95 respirator, a shield over that, a very tight-fitting gown and two sets of gloves. It’s very uncomfortable even to breathe, to examine, to take histories. It’s not that easy.”

Changes made at Norwalk Hospital due to COVID-19:  “There are no non-emergent procedures, no non-emergent surgeries, now till the end of April. We’ve taken our GI suite and converted it to a 15 bed ICU. Presently there are 15 patients in that ICU. All intubated, all COVID-positive. As of [April 1], we are no longer admitting pediatric patients to our hospital. We are not closing that department. We are now going to open it up for overflow of adult patients. If we now have a pediatric patient who needs to be admitted, we need to look elsewhere to get them admitted. We started a tent outside the emergency department now, to screen ambulatory people who walk up to the emergency department to get an idea–do we think that you do possibly have this or don’t, and then shuttle them accordingly. We can even take care of some patients out there and discharge them right from there. If we have a psychiatric consultation in the emergency department, the psychiatry team no longer comes down. We put a television in front of the patient and they communicate that way. So lots of changes. Listen, they’re not all terrible, but again, it’s just adapting and it’s it on a daily basis. The changes are pretty incredible.”

On the surge of patients at the hospital:  “The numbers aren’t crazy. The problem is, that those who get admitted are sicker and staying longer. We hear everywhere about these respirators, we need these ventilators. Well, the problem is that when someone gets on a respirator, they are on for two or three weeks, if they’re going to come off of that at all. The amount of time they’re in the hospital is much longer and that’s where you get the backflow on the backend. We’re not getting people out of the hospital. So yes, we are looking at what is plan C, D and E. Transferring patients to other hospitals further upstate. There are eight counties in this state; Fairfield County has 60% of the COVID-positive patients, So we are seeing a great majority of the patients in the state.”

On advice to people to prevent spreading or catching the virus:  “Social isolation would be the best thing. The best thing is not to come into contact with someone who has the disease. You as an individual, you can control that. You can control what you do. You cannot control what the person in the supermarket, the person in the pharmacy, the person at the gas station is doing. And that’s the problem. The more interaction you have with other people, the greater your chance is of getting it.

“Another thing that people need to understand, this disease knows no age boundary. Most of the people who are not fairing well, who are dying, are older, 75, probably greater than 80 years old. If you are greater than 70 years old, you really take that up to almost 90%. I’m going to tell you at Norwalk hospital, we have intubated a 21-year-old, a 30-year-old, a 39-year-old. And these are young, healthy people with no co-morbidities. So that is very scary.”

On facing the stress and protecting himself:  “We know too much, which is not always the best thing. Of the 18 physicians in my group, two of my more senior members, they retired suddenly because of this, they do not want to get sick. They cannot afford to get sick. They are of the age where that put them at a high risk. That’s the ultimate statement there. These are career physicians who said, ‘This was it, I’m done.’ On the other hand, there’s just support–we are a team. People are showing up. If people are being asked to furlough, other people take up extra shifts to step in for them. And we are seeing a tremendous response in that regard.

“It’s a little difficult because at times, you have a little sniffles, this is hay fever season and you’re like, “Am I starting to get sick or what is this?’ And you’ve got to talk yourself off the ledge a little bit here. But again, we need to do as we’re asking the public to do–self- isolate, self-distance. We need to be very vigilant about what we do at the hospital to protect ourselves. [And our families.] Because when I come home, I’m probably high risk. So, therefore, there’s no hugging, there’s no kissing, there’s listening to those self-distancing rules and staying apart.”

What he wants people to know:  “This is a very dynamic situation. What we think is the right thing to do today might change tomorrow. Having people informed is very important. But understanding that things will change. Things will change in many ways. When you show up at a hospital, you know how things are changing. Constant motion in how we’re learning, how we’re treating and how we’re dealing with all of this. It’s very important to keep in mind that this is not going to stop. This is going to keep moving on and we’re going to get better at this every day and you know, we will get through it. We don’t know the timeline. That’s a bit of a problem as well. But we will get through this.”