By Janet Adamy 

Days after caring for a handful of suspected coronavirus patients in mid-March, Dr. Gaurav Malhotra said he was struggling to breathe just from climbing one flight of stairs. Feverish night sweats soaked his clothes.

The 40-year old hospitalist at Northern Westchester Hospital in Mount Kisco, N.Y., knew he'd contracted Covid-19.

So he sat his wife down to make sure their will was in order. Then he turned to managing his case from their bedroom. With no access to intravenous fluids, he downed bottles of Gatorade. He demurred when his boss asked if he should come to the hospital, in part because he didn't want to expose his co-workers.

"Part of our job is to deal with death on a daily basis," said Dr. Malhotra, who tested positive for the virus earlier this month. "Now it was me doing it about myself."

Dr. Malhotra is among the growing number of clinicians nationwide who suspect they contracted the virus on the job. They are grappling with such issues as the lack of protective gear, how they could have avoided the virus when treating patients and how to get treated themselves. And like the rest of the public, they are frustrated by the testing process.

Northwell Health, his hospital's parent company, has 40 doctors who have tested positive for the virus at its 19 hospitals, spokesman Terry Lynam said. The company is "doing as best we can" to keep workers safe and has an adequate supply of protective equipment, he said, though workers are being asked to reuse N95 masks

Shortages of masks, surgical gowns, face shields and other crucial equipment are heightening medical workers' concerns that they can't protect themselves from it.

Some worry that the virus is difficult to avoid once waiting rooms and hallways become crowded with patients carrying it.

"I got infected even wearing all of my protective equipment," said Shelley Urquhart, a pulmonary and critical-care nurse practitioner at Norton Audubon Hospital in Louisville, Ky., who tested positive for the virus last week.

Ms. Urquhart, 36, and three doctors all noticed they had symptoms of the virus after treating one of her hospital's first Covid-19 patients for respiratory failure, she said. Holed up in her bedroom, she trades text messages with the sick clinicians about how they are managing fevers, sore throats, chest tightness and gastrointestinal distress. They have griped about how it took at least a week to get test results, which showed three of them had confirmed cases, she said.

A Norton Healthcare spokeswoman said it has robust prevention and screening initiatives to protect patients and employees from the spread of the disease, including frequent handwashing and proper use of protective equipment.

Across the U.S., some of the sickest doctors are using their own coronavirus cases to plead for access to experimental drugs from their hospital beds. Yisachar Greenberg, a cardiac electrophysiologist at Maimonides Medical Center in Brooklyn, wrote on Twitter earlier this month that he'd received hydroxychloroquine, azithromycin and zinc, but that his condition was worsening.

"I am desperate can anyone help me get the drug from Gilead Remdesivir please help," read one of his tweets. Gilead Sciences Inc. has said it would begin late-stage studies this month for remdesivir, which has been identified as a possible treatment. A Gilead spokesperson said the company doesn't discuss individual cases. Maimonides Medical Center didn't comment on the situation.

Some doctors with less serious, though still severe, cases say they are reluctant to take up a bed in their hospital since they can rely on their own skills.

One Central Massachusetts interventional cardiologist who tested positive for the virus earlier this month said he is managing his severe case from a mattress on the floor of his home office. To make sure his oxygen doesn't dip dangerously low, he attached a finger monitor that his wife bought at Walgreens. At night he gets overcome with eerie febrile hallucinations where he hears a nurse call him to see a patient. But the only patient in the room is him, said the doctor.

Dr. Malhotra said the severity of his illness scared him.

A CrossFit devotee with no underlying medical conditions, he came home from a night shift earlier this month and sensed his temperature was rising. The next night he was sweating. He sent his wife to load up on Gatorade and went to his hospital for a coronavirus test at their employee testing area, which offered a quick turnaround.

Two days later, the results came back negative.

"There's no way I don't have this thing," he said to himself. "I've never felt this bad before." So he went back for a second test, and that came back positive for Covid-19.

A friend who is an infectious-disease specialist offered to call in prescriptions for hydroxychloroquine and azithromycin, two drugs that are being tested to treat the virus. Dr. Malhotra, who trained as an internal medicine physician, said no.

He didn't want to use up drugs that could go to sicker patients, and he worried that their side effects carried their own risks.

Dr. Malhotra said he wore an N95 mask and surgical gown while giving suspected coronavirus patients intravenous antibiotics and oxygen. At least one of them tested positive for Covid-19, he said. If those patients didn't give it to him, he suspects that he picked it up elsewhere at work.

"It wasn't like I was walking around in the hospital gowned up 24-7," he said. "It's tough for health-care workers to avoid it because it's staying in the environment."

Dr. Malhotra said he hasn't seen his own primary-care doctor in four years and is instead leaning on his boss to monitor his symptoms -- which recently have grown less severe -- by text message. He took Tylenol and Motrin at least twice a day. He's also taking electrolyte tablets that his wife consumes when she runs marathons.

"Other than turning toward my own friends and colleagues, I wouldn't know who to turn to in this situation," he said.

When he first came down with the virus, Dr. Malhotra said his children disinfected the door handles. But once his wife and daughter developed mild symptoms, that stopped.

On Friday, their suspicions were confirmed when his wife's test results showed she also has the virus. When Dr. Malhotra called the urgent-care clinic for his daughter's results, they said her test order had been canceled. The clinic offered no explanation, he said, just an apology.

Write to Janet Adamy at janet.adamy@wsj.com

 

(END) Dow Jones Newswires

March 29, 2020 07:14 ET (11:14 GMT)

Copyright (c) 2020 Dow Jones & Company, Inc.
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