'There is no downtime': What it's like for ER doctor dealing with COVID-19 during a 10-hour shift

Dr. Daryl Wilson's daily routine involves having his temperature taken before entering Edward Hospital in Naperville for a 10-hour emergency room shift.

Once cleared for duty, Wilson gears up. He dons scrubs, goggles, gloves and an N95 or surgical mask, wipes down his workstation and then is ready to see patients.

Per shift, he averages 10 to 15 patients, of whom about 70% are suspected of having or confirmed to have the COVID-19 virus.

At Edward, patient volumes are down nearly a third of what they were pre-pandemic, likely because most people with non-coronavirus symptoms are avoiding the emergency room to prevent exposure.

Yet, the 10 emergency room beds allocated for COVID-19 patients fill up quickly.

The stream of patients ebbs and flows throughout the day, triaged by Wilson and other ER doctors to be admitted or sent home.

Emergency department influx varies, with days when “multitudes of patients” come through. Most days, peak times are in the afternoons and evenings. Wilson said he usually is running a mile a minute to assess, treat and discharge patients.

“There is no downtime as a physician,” he said.

Patients are fitted with surgical masks for their protection, but also to protect front-line workers from them.

“Our risk of exposure is very low,” said Wilson, 49, of Naperville.

Edward Hospital is treating 60 inpatients with confirmed cases of COVID-19. It has had seven COVID-19 deaths. Since March 24, 93 patients have been discharged after being treated for the virus, according to hospital officials.

Part of Wilson's job as emergency medical services director is overseeing paramedics in the field and ensuring they take great precautions when assessing people at high risk for contracting COVID-19.

“We try to limit the number of individuals that go into a scene,” he said. “It puts all of those front-line individuals on edge.”

Though masks are in short supply at hospitals nationwide, Edward has enough on hand for now. That could change with a surge of patients limiting resources.

“There is no moratorium on transporting patients to the hospital,” Wilson said. “We are not at that point.”

He urges anyone not severely ill or exhibiting mild symptoms — fever and body aches — to stay home to reduce exposure of front-line workers and use telehealth and online triage services before calling 911.

For more severe symptoms, such as shortness of breath, chest pains, altered mental status or low blood pressure, paramedics assess whether the patient should be taken to the hospital. In any case, the only emergency room treatment is managing the symptoms by supplying oxygen, elevating blood pressure through medication, and providing ventilatory support, Wilson said.

Testing is available for patients who are hospitalized and even some who are sent home because they are at higher risk, such as the elderly and immunocompromised people. Wilson said even those who test negative for the virus and are asymptomatic should practice self-isolation, wash their hands and wear masks in public.

“It really doesn't change what you do when it comes to the treatment of any viral illness,” Wilson said. “It's still a matter of rest, fluids, antidiuretics, fever medications and monitoring for any worsening signs and symptoms.”

Wilson hasn't been tested for COVID-19 because he trusts wearing protective gear prevents exposure.

Like most essential workers, he also can't afford exposure outside work, which is why he leaves outdoor tasks, such as doing the groceries, to his wife Joanne, who does COVID-19 testing for Edward.

Though emergency room workers are accustomed to operating in a high-stress environment, they need outlets, said Wilson, who plays in a rock 'n' roll band.

In these times of social distancing, Wilson settles for Zoom meetings with his peers to talk about the stresses of the job.

“We have support from the community. That helps rejuvenate the spirit of all of us because we are all doing this together,” he said.