Living with Covid-19: Meet Efrat

In the ninth of our Living With COVID-19 series, where we learn how fellow health workers are adapting and coping with the ongoing pandemic, we hear from Efrat Kean, based in Philadelphia, USA. Efrat is an emergency medicine physician at Jefferson University Hospital and part of our collaborative network. The United States has been heavily impacted by the COVID-19 pandemic. Her words here describe how she has felt and what she is experiencing during this time.

I am lucky.

I wake up in the morning, next to my husband and my dog, both healthy and safe. I drink coffee on my patio, watching the birds fly to the feeders I’ve attached to the windows. My beautiful fortress, safe and secure. I think about how lucky I am.

I go to work, at a job that I love, at a hospital that values me, with people I enjoy. As soon as I arrive, I slide my feet into my work shoes, careful not to touch them with my hands. Afterwards, I put on my scrub cap and my mask before I enter the emergency department. It’s 95°F (35°C), but I zip my jacket up all the way, so it covers my neck too. Daily routines dictate that I wipe my workstation and chair with bleach, carefully scrubbing each number on the phone at my desk. The bleach damages the phone, but it’s ok. Someone will replace it when it breaks. I wear my N95 mask and face shield and I thankfully, never worry about running out. The N95 pinches my nose and marks my face, but it fits. I go outside every now and then for a sip of water or to eat but I never remove my mask indoors. There is enough PPE. More than enough. I am so lucky.

Some of my patients have COVID-19, and some are very sick from it, but it’s nothing like it was at the peak. Philadelphia has had around 100 new cases per day for weeks now, scattered thinly through the droves of patients who are coming in now with all the problems they were too afraid to be seen for in March and April. At its peak, the virus was infecting over 600 people per day, with hundreds of patients admitted to every hospital. I remember the tension, waiting for things to surge, waiting for them to get as bad as New York. But they never did. We got lucky.

When I go home, I strip off every piece of clothing at the door and put them directly in the washer. My dog doesn’t run to me anymore – she has learned not to. My husband leans over and gently kisses my lips, very careful not to touch any other part of me. My lips have been under a mask all day. My lips are safe. We are so lucky.

The shower washes away the day, and though I cut my hair short when this pandemic started to make this process easier, I am still careful to wash every strand, and scrub every inch of skin. You can never be too careful. I imagine I can see the little viruses, spiralling down the drain with the soap. Lucky me.

Once I get out of the shower, I can finally pet the dog. I tell my husband about the grocery store worker I saw whose manager wouldn’t let him go home even though he has a cough and a fever, who can’t afford to lose his job. I wrote him a note, but I’m not sure it will help him. Or about the elderly woman who was lonely and invited a friend over to play cards, not knowing her friend had been exposed. I spent a long time with her, teaching her to use the symptom tracker on her iPhone, and going over and over and over when to come back to the ER if things get worse at home. He worries with me. The logistics of meeting with anyone safely are so complicated, so we mostly just spend time alone together. We talk about how lucky we are.

I call my parents, who I rarely see, and when I do, it’s only outdoors. I tell them it doesn’t look like I can see them this week. The weather isn’t going to be good enough, and there are more COVID-19 patients this week, and it doesn’t feel safe. My parents are young and healthy, but you can’t be too careful. Not if you want to stay lucky.

We go to bed. It was a normal day, like yesterday was, like tomorrow will be, but I feel so tired. My mind is spent from making a million tiny decisions, each one carefully calculated to buy just one more inch of safety for myself, for my patients, for my family. This is the house of cards we all live in.

It’s exhausting, being this lucky.

Efrat Rosenzweig Kean, M.D

Emergency Physician, Philadelphia, PA