A Doctor Describes The Front Lines Of The COVID-19 Pandemic

Dr. Tipton's coworkers.

This is the front line crew working with Dr. Matt Tipton to care for COVID-19 patients. According to Dr. Tipton, “they do the heavy lifting.” Photo by MATT TIPTON

I typically do not digress into topics outside the energy sector. But I have spent a lot of time covering the COVID-19 (coronavirus) pandemic because of the extraordinary impact it is having on the sector. 

In January I began to recognize the potential for a big impact on the energy sector as a result of the emerging COVID-19 (coronavirus) outbreak in China. I first warned about the potential impact in January with Oil Prices Are Feeling The Coronavirus Threat. I have since written multiple articles around the impact of COVID-19 on the energy sector.

Today, I veer out of my normal area for additional coverage of the COVID-19 pandemic.

Dr. Matt Tipton is a former Army Ranger, a friend of mine, and a doctor handling incoming COVID-19 patients in a Mississippi hospital. During the first week of April, it was reported that Mississippi now has the highest rate of COVID-19 hospitalizations of any state. So, Dr. Tipton and his colleagues are on the front lines of this battle in the south.

On Sunday, March 22nd, Dr. Tipton gave me a virtual tour of his hospital floor via FaceTime. He described the rapid growth in the number of patients, and explained some of the unique challenges in treating these patients while ensuring the safety of the physicians, nurse practitioners, nurses, and allied health personnel like paramedics and respiratory therapists.

He explained that the hospital normally has about 30 intensive care unit (ICU) beds, but due to the rapid growth of COVID-19 patients (~50 when I last spoke to him) they have expanded that capacity to 88 beds. There are further plans to add another 44 beds as needed.

Patients are kept in negative pressure rooms to keep air from escaping the rooms. They often communicate with patients via phone from outside the rooms to minimize exposure. Intravenous (IV) medications can also often be administered from outside the room.

A few days after our first conversation on March 22, Dr. Tipton developed symptoms consistent with COVID-19. On Wednesday, March 25 he was tested for COVID-19 and sent home to recover.

On April 2, he was sufficiently recovered to return to work, where I caught up with him at the end of a 12-hour shift. I asked Dr. Tipton a series of questions about his experience with the pandemic so far, and where he sees things developing from here.

Robert: We last talked on March 22, and a few days later you went home sick. What happened?

Dr. Tipton: I got sicker than I have ever felt as an adult. It hurt to breathe, and I had body aches. There was no motivation to move. My sense of taste was off. I ate an orange and it tasted like an apple. I treated myself with the medications we are using to treat COVID-19 patients, and I set an alarm every two hours so I would wake up and drink water. I started to feel better after about 24 hours.

I was tested on a Wednesday, and finally got a call on Sunday night that my test result was negative. But I was also told that about 30% of the people getting tested have been false negatives that are later confirmed as positive. They also tested me for flu and streptococcus, and both were negative. Later I will get an antibody test that will confirm whether I had COVID-19. At this point, I hope I did so I no longer have to worry about it. If I have the antibodies, then I can donate plasma to help treat patients.

Robert: It took them four days to get those results back to you. Is that typical?

Dr. Tipton: It has been taking three to seven days to get results back for patients. The turnaround seems to be random. Someone can be tested one day, but then another person can take a test the next day and get their results back quicker.

Robert: When did you get your first patient?

Dr. Tipton: On March 15 I got the first two patients and the number has approximately doubled every 4 days. This week (the first week of April) we have gotten up to 45-50.

Robert: What is your work load like right now?

Dr. Tipton: I will work the next six days. I work 12-hour shifts, with a 1.5 hour commute each way. I also work during the commute, usually phone conferencing.

Robert: Can you describe how COVID-19 differs from seasonal flu? What kind of symptoms are you seeing?

Dr. Tipton: This is not a typical March/April hospital season. We have an unusually large number of patients requiring a ventilator, and people are dying. This is not a statistical blip. Patients don’t normally need to be intubated in these numbers. We are having to take extraordinary measures to treat these patients.

What we are seeing is the lungs start leaking plasma. Eventually the lungs fill up with fluid and they don’t work. We are seeing acute respiratory distress syndrome (ARDS) with the fluid leaking into the lungs. With ARDS, breathing becomes difficult, oxygen cannot get into the body, and it can lead to death.

Robert: Why is this outbreak putting such a strain on our healthcare systems?

Dr. Tipton: It’s not the same reason everywhere. For example, we have enough ventilators right now at our hospital, but we are short of the respiratory therapists and critical care nurses who do the bulk of the work. You can have plenty of ventilators, but if you don’t have enough trained people to operate them, it won’t do any good. We are also in good shape on personal protective equipment, but we are sterilizing and reusing masks to conserve them.

Robert: And you have lost some patients from COVID-19?

Dr. Tipton: Yes, we have lost some from COVID-19 and we have others who died that are presumed COVID-19 but not yet confirmed. But without getting into details, I would just refer you to the official state numbers.

Robert: What do you think of the current measures we are taking as a society to combat the pandemic?

Dr. Tipton: I am a Libertarian. I don’t like government overreach. But sometimes you get dealt a bad hand, and there are no good choices. We have made a number of bad decisions related to social distancing. I want normal people to make good decisions. I don’t want heavy-handed tactics. If we could get our act together for 14-21 days, this would go away. But that won’t happen as long as small groups keep passing it around. It will resurge.

Robert: How else is this pandemic impacting hospitals?

Dr. Tipton: Hospitals are hurting financially during this crisis, because people aren’t doing elective procedures like knee replacements. That leaves some medical professionals underutilized, while others are overwhelmed. So this pandemic has created some real imbalances in the workload.

Not all nurses are critical care nurses, and they can’t be retrained to do that overnight. You are a chemical engineer, but if you had to work as a mechanical engineer, that would probably require more training. Further, you may have no desire to be a mechanical engineer, just as many nurses have no desire to be critical care nurses.

Robert: What do you believe will be the lasting impact of this pandemic?

Dr. Tipton: I believe this is our generation’s Great War. Americans came together during World War II. Women worked the factories. People planted victory gardens to stretch the food supply. But we also made mistakes. For example, we locked up Japanese Americans in internment camps. So, I think we will look back on this challenging period and say “This response was good, and this one wasn’t.” But we may not know which is which for years.

This is having a big medical impact, but the economic impact and unforeseen impacts are going to be even bigger. Keeping people out of work for 60 days will have huge consequences. People are going to fall behind on bills, and it will be a while before they have much disposable income. I fear we are going to be somewhere between an economic collapse and Great Depression the way this is playing out.

Robert: Thanks for taking the time to speak with me Matt. And thanks for what you and all of your colleagues in the medical profession are doing to combat this pandemic.

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