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Fatigue, Eerie Calm Inside OHSU Emergency Room

May 20, 2020

Dr. Esther Choo knows how to deal with disasters.  As an emergency medicine physician and an associate professor at Oregon Health & Science University, her training and that of her colleagues is organized around doing just that.

But COVID-19 has put a strain on even veteran emergency room doctors across the country.

“It’s been such a sustained level of stress and effort,” she said. “Something that affects the entire world and is a sustained effort for months with no short-term wins, that’s very tough.”

Choo said some people have just hit a wall over the last few weeks. The ongoing grind, coupled with the challenge of trying to learn so much about a brand-new disease, has been simply exhausting.

“There are some people who are simply angry and frustrated,” she said. “There’s a lot of sadness as family members and colleagues are getting ill.”

Choo works the overnight shift at OHSU in Portland. She said that as the pandemic looms large, there’s been a surprising decrease in trauma patients coming through the emergency room doors on her watch.

“You have people staying at home and you’ve closed recreational facilities, and people aren’t able to go out and socialize and drink as much as possible.” That’s led to a decrease in what she calls “drug and alcohol-related misadventures,” like impaired driving and interpersonal violence.

Fewer people are also being treated for other common ailments like heart attacks and strokes—illnesses that shouldn’t be decreasing.

“There is concern that people are waiting things out at home,” she said.

She worries that initial messages urging people to avoid going to the hospital for testing were misinterpreted, and too many people think they need to avoid emergency rooms at all costs.

“Obviously, that’s not the case,” she said. “If people are sick or having symptoms they don’t understand, they should seek emergency care, the way they always have.”

Dr. Choo said this moment of relative calm has had some positive benefits for her practice. “I have time to sit down and talk to my patients and make sure I’ve answered all their questions,” she said. “I can’t remember the last time an overnight shift was like that consistently.”

She’s realistic about the long road ahead. The pandemic is far from over, and as counties across Oregon begin to reopen, she anticipates an uptick in COVID-19 cases. But at this moment, she’s cautiously optimistic about Oregon’s response to the virus so far.

“Oregon really is a model state in many ways.” Choo said. “We actually may have benefited from our proximity to Washington state. Being so close to the center of the first public outbreak made Oregon’s leaders take it very seriously.”

“We started shutdowns just nine days after the first death from COVID-19,” she said. “In other states it took many weeks. We were able to get on top of it and show the rest of the country what flattening the curve looks like.”