08042020Tue
Last updateFri, 31 Jul 2020 1pm

A Guadalajara nephrologist describes the new ‘daily ritual’ of all hospital personnel

Dr. Margarita Ibarra is a member of the Nephrology Department at Guadalajara’s Hospital Civil. Since the appearance of Covid-19, her life has changed drastically.

 

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“Now my life is shaped by rituals,” she says. “I have rituals to follow at the hospital, rituals to follow at home and yet more rituals which get me from one to the other.”

 

The atmosphere is tense at the hospital, she tells me.

 

“We are all using masks and face shields and everyone on the staff – at absolutely every level – is following the same rituals as I am, day after day because we must constantly act as if we  have been in contact with someone who was positive.”

 

One of the rituals is getting dressed before entering the hospital’s Covid-19 unit. Although Dr. Ibarra is not assigned to the unit, she, like the staff of many other departments often have to enter the unit to help patients with non-virus problems.

 

“Not only is it important to know how to put on your overall, face mask, and so on, but far more important is knowing how to take them off, so you won’t end up contaminating some part of your body or your clothes or shoes.”

 

These things are so important, she says, that someone is permanently stationed at the entrance to check that the person did everything correctly. “When you come back out, there is somebody else with a clipboard and a checklist. Did you dispose of your gloves and face mask properly? All of this is to avoid wasting precious protective gear and to prevent contamination.”

 

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Dr. Ibarra says staff are entering the Covid-19 Unit from other departments, such as Neurology, Endocrinology or Nephrology, because “those patients don’t have just the virus, they have all sorts of other diseases too. But there is a rule that no one individual can stay in there more than five to eight hours. Then he or she will be obliged to leave and, if necessary, somebody else will take his or her place and, of course, there will be a total change of protective gear.”

 

Dr. Ibarra says resources at being used are being used up very quickly!

 

“Overalls, face masks, etcetera are sanitized and can never be used again, except for the face shields. A shield can be assigned to one person and reused, but only after sterilizing it. All the other items are thrown away, so they are being consumed really fast, and if we start getting swamped with patients, we are going to run out. So we are very careful about how we are using these things.”

 

Other rituals apply when Dr. Ibarra leaves the hospital to head home.

 

“I need to remove my shoes, my pants and other clothes. I spray all the colored clothing with alcohol and my tennis shoes and white clothes with chlorine and put all of it into a bag. Then I put on a pair of transit slippers.

 

“Upon arrival at home, I go straight from the car to my laundry room. Here, my colored clothing goes into a bucket of soapy water and the whites and tennis shoes go into another one full of water dosed with chlorine. I have yet another container for face masks, plastic bags, etcetera, which go into chlorinated water and eventually into the trash. Then I take off my traveling slippers.

 

“Now, still in the laundry room, I wash my face and hands, not quite ‘until they bleed,’ but close. Next I take a shower and wash my hair, because you never know if a droplet from an infected person got onto your hair or in your ear or maybe on your neck. Finally, I put on my house clothes and shoes and start interacting with my family: cooking and doing my normal housework.”

 

“But even family interaction is affected. “At night,” says Dr. Ibarra, “I say go

odbye to my family and go out into the yard by myself. I sleep alone in a tent to limit risks to my husband who had a lung problem in the past.”

 

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These procedures, says the nephrologist, are being followed by everyone at her hospital.

 

“Every nurse, every doctor, every policy maker and every janitor, all of them are changing and disinfecting clothes before they leave. In spite of that, some are being mistreated when they’re riding the bus on their way to work, just because of their uniform, because people think they are carrying the virus.”

 

Nothing could be farther from the truth, Dr. Ibarra says.

 

“We who work at the hospital are far more careful about preventing contagion than anybody else you’ll find on a bus.

 

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“We are following all these rituals because we health workers are consciously considering ourselves asymptomatic carriers of the virus and, in fact, everybody everywhere ought to assume the same thing whenever we step out of our houses and every time we go back home to our loved ones.”

 

I asked Dr. Ibarra whether Jalisco is ready for the next phase of the pandemic, for example in terms of ventilators and hospital beds.

 

“As for ventilators,” she told me, “every other day we get an update on their number. Right now, we have over 100 of them, but more than half may be in use at any given moment. Just like in normal times, people are still having accidents and getting sick from other diseases.

 

“In respect to hospitals, we have five in greater Guadalajara, but whether they will be enough depends totally on whether all of us behave correctly and do the right thing. We think we can succeed if people stay in their homes. But if things get out of hand, if all five hospitals get filled to the bursting point, then I just don’t know what we’re going to do. This is the truth and this is why we want the general public to stay home.”

 

When asked about people who are ignoring the stay-at-home instructions and trying to slip off to the beach, Dr. Ibarra suggests they pick up a telephone and talk to someone they know in another country.

 

“I did that and found out a good friend from Spain just lost his father to Covid-19. What especially hurt our friend was that his father died not surrounded by his loved ones, but all alone in an empty hospital room … and now his mother is in quarantine. Right now the lives of all the health care providers in Mexico are in jeopardy. Please, just stay home!”

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