On the Front Line, COVID-19 Has Them Scared to Go Home

Karen Weintraub

April 15, 2020

Editor's note: Find the latest COVID-19 news and guidance in Medscape's Coronavirus Resource Center.

A Boston-area firefighter moved into a Harvard University dorm to protect his wife and two children.

An emergency room doctor sent his wife and four kids to live with her parents, so he won't risk bringing COVID-19 home.

Another strips in the garage, throws his clothes right into the washing machine and jumps into the guest bathroom shower before greeting his family.

Healthcare workers and first responders are going to great lengths during this epidemic to keep their families safe from COVID-19, even as they worry that they are carrying the virus home on their shoes, in their hair, or on a layer of clothes.

There's been a lot of attention on how the lack of personal protective equipment (PPE), such as masks, gloves, and gowns, puts healthcare workers' lives at risk. But those workers are also quite conscious of the others it puts at risk: their closest family members.

Virus Taking its Toll on Workers, Families

There are no statistics on how many healthcare workers and first responders have passed the virus to their children, spouses, or parents. But, thousands of American healthcare professionals have fallen ill so far — over 400 in Alabama alone — and 27 had died as of last week. A CDC report issued Tuesday estimates that more than 9,200 healthcare workers have been infected, a number the agency says in reality is probably much higher.

And not everyone has free housing, willing in-laws, or a place to change safely before coming in the front door.

Ganelle Salmon, a patient information specialist at Beth Israel Deaconess Medical Center in Boston, can do little more than stuff her clothes into a plastic bag on the seasonal porch and hope that she doesn't track the virus into her apartment. Managing to get only about 3-4 hours of sleep every night, she hasn't yet figured out how to make time to go to a laundromat, now that she doesn't feel safe running over to her mother's to use the washer.

Salmon says she worries endlessly about bringing the virus home — so much so that she struggles to fall asleep even when she doesn't have to rush to work, help her 13-year-old with his schoolwork, or keep her 3-year-old son entertained. Both boys have asthma, and she doesn't quite believe the studies showing that the virus, while infecting children, makes very few extremely sick.

A small number of hospitals and nursing homes are offering free housing to workers who can afford to be away from home. But most do not, and many, like Salmon, don't have anyone to take care of their children even if they wanted to move out.

For those who can, such alternative housing is essential at a time when hospitals and other care facilities don't have enough protective equipment, says Eric Schneider, senior vice president for policy and research at The Commonwealth Fund, a national philanthropy that conducts research on health and social policy issues.

"As long as adequate safeguards related to PPE and testing are not in place, hospitals and public health officials should be isolating healthcare workers from their families and communities," he says. "It is the only way to be sure that further community transmission is slowed."

Hotels and Harvard

One Boston-area nonprofit that provides nursing home care for older adults, Hebrew SeniorLife, has begun to offer free hotel accommodations for its direct care staff. The company recently reserved a block of hotel rooms for its 820 physicians, nurses, nurse practitioners, physician assistants, nursing assistants and therapists at its Boston and Dedham facilities. "Staff members who want to remain close to work, have back-to-back shifts, or want to stay in a hotel apart from their families can do so," according to a release from Hebrew SeniorLife.

Harvard University has opened some of its dorm space to first responders in surrounding communities. One area firefighter who asked not to be named because he doesn't want to publicly criticize his department, says the housing provided him an essential refuge — because his city isn't providing him the protective equipment he needs.

After a colleague got tested for the virus, he started changing his clothes in the basement before seeing his family. When the colleague's test came back positive, he decided to change clothes at the station, disinfecting with hand sanitizer before getting in his car and changing again when he got home, leaving his clothes untouched in the basement for 3 days before washing them in time for his next shift every fourth day.

Then, he got a call to treat a man in his 20s with COVID-19-like symptoms, who needed CPR. There was only one gown among the three first responders at the scene, he says. "I'm only wearing a mask, goggles and gloves — but all my clothes are exposed, including my hair. You wipe yourself down, but did you really do a good job?"

It's the greatest job on earth. Boston-area firefighter who has had to move into a dorm to protect his family at home from coronavirus.

When that shift ended, the firefighter decided he couldn't go home.

He drove to his house, waved to his wife, 10-year-old daughter and 5-year-old son from outside, and checked himself into a hotel. He later found free housing through Harvard, living in a room intended for actors at the Harvard-affiliated American Reparatory Theater, now shuttered because of the virus.

He says he doesn't have any particular risk factors for developing a serious case of COVID-19, nor do his wife or children. But "I don't want to play a numbers game," says the man, who decided to become a firefighter when he was in high school, after seeing first responders' heroism on 9/11.

"I knew that this job involved sacrifice. It's part of the profession," he says. But he's the one who signed up for that risk, not his kids. "That's not their profession. I'm not sacrificing them."

He says there's simply not enough protective gear for all the first responders who need to show up at the everyday crises and tragedies that continue to happen, regardless of the virus. Every emergency requires a fleet of responders, he says.

When asked whether he ever considered quitting the department because of the lack of protective gear, he scoffs.

"No. Come on. It's the greatest job on earth," he says. He knew there would be tough parts of the job. "I didn't think my enemy was going to be some invisible bug that was going to torment my life. But I'm not going to say this isn't what I signed up for."

I Love You, Stay Away

Alden Landry, an emergency room doctor at Beth Israel in Boston, realized it was time to do something when he struggled to keep his 3-year-old twins from running to hug him when he came in from a shift. "It was really hard on them" to stay away long enough for him to shower and change, he says. "We convinced them that doing elbow bumps was cool, and that daddy was taking care of really sick people."

But once school was canceled for his older two children, 6, and 9, and his wife's research lab was closed down, the family decided it made more sense for her to take the children to her parents' in Maryland.

"My kids are thriving. They get to see their grandparents. They get to be in a place they've always considered fun," says Landry, adding that he reads them stories over the phone or via video, and recently shared a virtual church service with them.

https://twitter.com/AMLandryMD/status/1244431955271311360

But the separation still involves a lot of sacrifice all around. "It's really lonely to be here alone in a house that's usually filled with a lot of noise," he says. "It's tough, but honestly, in hindsight, it was the right decision."

Ali Raja, executive vice chairman for the department of emergency medicine at Massachusetts General Hospital, says his daily ritual includes pulling sweats on over his scrubs before getting into his truck to head home. He takes them off in the garage, throwing everything directly into the laundry and using the guest shower before heading into the rest of the house to greet his family.

"I'm fortunate," he says. "I have the ability to have a guest shower and laundry. If I had to go through the house, there'd be no way for me to avoid tracking this inside."

Dedication and Longing

Raja says one friend recently shaved his head — not because his barbershop is closed, but so he can rub sanitizer on his scalp and avoid bringing virus particles home in his hair.

"We've got folks, especially older faculty who are very concerned about themselves, but still showing up at work," he says.

"That's the most heart-warming and also sad part of this thing, is that we haven't had an increase in absenteeism," Raja says, despite the lack of personal protective equipment and the real danger this virus poses to workers and their families. "Everybody [is] coming to their jobs and doing their jobs, knowing there's a risk they never signed up for."

https://twitter.com/AliRaja_MD/status/1250447907175772160

Salmon, who lives in Quincy, south of Boston, says she'd love to stay home, to spend more time doing science projects with her older son and just goofing around with the younger one. Simply to sleep for a whole night, instead of working three 12-hour shifts a week. But she feels lucky to have a job right now when so many others don't, so she drags herself awake after just a few hours. She makes sure her older son takes his medicine and isn't spending all his time playing video games. She waits for their father to come over to spend the night, hoping that he's stayed careful enough and isn't putting the boys at risk.

Then, she gingerly pulls out the clothes she stuffed into that plastic bag and heads back to the hospital.

This article first appeared on WebMD.

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