Inspired Series: Health Professionals' take on COVID-19: It's not all that bad

“Mask Distribution Policies” the projector reads as the City of Hope Hospital’s chief medical officer, several of the institution's finest viral researchers, members of the internal communications staff, and her other Health Administration fellows gather around the table for their daily COVID-19 meeting. 

Although it’s obvious that everyone’s crisis mode is on - phones keep flashing with notifications, sleepiness has increased beyond coffee’s repair, hands are cramping from the incessant typing - she feels an unprecedented sense of calm blanketing the room.

What many Americans fail to understand while assuming all healthcare professionals are currently consumed by anxiety and stress is that there are two sides: the clinicians who are praying for the return to pre-COVID practices and the healthcare administrators, like 25-year- old Los Angeles-based Nandita Kotwani, who argue that from the administrative healthcare perspective, this outbreak has and is going to change the world for the better. 

A silver lining of a pandemic? Is that plain cold or a problem-solving reflex for administrators? 

Kotwani insists it’s the latter. 

While equating the pandemic to the “type of push needed to get us to where we need to be in healthcare”, Kotwani explains that, for one, this pandemic has demonstrated how this country’s healthcare system can be significantly improved when its workers embrace their human side and unite. 

“In the Command Center, people are a lot more human and in tune with how they’re feeling and how others are feeling,” Kotwani said. “But at the same time there's a sense of this common crisis and everyone's willing to do anything they can. That's a really beautiful thing.”

Pre-pandemic healthcare, according to Kotwani, was so focused on dealing with current crises that there was little time to reflect on the details of or remodel the methods used.

COVID-19, however, issuing a pause on all non-critical medical issues, has been a unique crisis for many hospitals including the City of Hope. Consequently, healthcare workers such as Kotwani and her fellow employees have gained the ability to dedicate all attention, efforts, and thought to a very narrowed range of pandemic-related issues that they can approach with the interest of effectiveness rather than rushing for the sake of time. 

What are these “pandemic-related issues”? 

As of lately, problems largely revolved around matters of Personal Protective Equipment and healthcare policy including the largely controversial concern over mask availability and efficacy, Kotwani shared. 

“No matter what the president says, the atmosphere in the hospital is that protective personal protective equipment is finite, is limited and everyone will not get it,” Kotwani said. 

While some doctors are fearing the lack of surgical masks, others are complaining of the misuse of N95 masks by groups of people that don’t need as much protection. 

Although she sympathizes with this fear many are experiencing right now, Kotwani reiterates that the healthcare administrators have a plan to keep everyone safe.

By communicating with the local Los Angeles government and understanding the latest information in the context of science and policy, Kotwani wants to assure the general public “that we’re doing anything and everything we can to protect everyone.”

Aside from noting the benefits of the walls-down side of healthcare workers and developing  pressured plans to deal with urgent equipment shortages, Kotwani claims that the system is also and finally being forced to learn how to implement the widespread use of technology. 

“People are gonna have to wake up and realize that telehealth is here and now and cannot be delayed, should not be delayed,” Kotwani said, reflecting on how the system “is finally getting a push into the 21st century.” 

Though the necessity of remote communication between doctors and patients at a time like this is rather obvious, Kotwani revealed that telehealth will provide patients from targeted populations access to health, decrease energy wasted on transportation to and from the hospital, and offer an often more efficient alternative to in-person visits even the pandemic comes to an end.

Simply put, “it’s an option that needs to be there.”

After noting the 40-60% volume reduction in hospital visits due to cancellation of all non-essential visits, Kotwani further gathered that the healthcare system is now working to reconsider the definition of “necessary appointment.” 

Though this may take away from the personal attention many hope hospitals provide, “making the system more lean” does cut down the unnecessary healthcare costs of in-person, frequent appointments significantly. 

Harsh? Arguably. 

But from the administrative standpoint, the improvement in clinical productivity trumps the lack of patient provider intimacy.  

On a more wide scale level, Kotwani also believes this pandemic is pushing the US healthcare team to become considerably more self-sufficient. With our reliance on China coming to a recent and abrupt end, companies around the country are being forced to supply medical necessities for the increasing domestic demand.

Even if stressful financially, this development would open up jobs and provide the overall “self reliance and independence that this country needs.”

Kotwani’s capacity to foresee such helpful, advantageous transformations from the COVID-19 chaos was not something she had from the very start.

It was something she grew to learn. 

“Initially it was a lot of “oh my god” could we get to that point?” Kotwani said referring to the exponentially growing number of cases in Italy and New York within just the first few weeks of COVID-19’s spread.

Soon, after week three or four, the curve started to stabilize within the state of California and Kotwani and her employees were finally allowed the opportunity to “look back and take a deep breath” relaxed enough to start looking at this pandemic with a problem-solving lense. 

While Kotwani continues to explore the numerous ways this pandemic catalyzes needed medical management modifications as an administrator, clinical healthcare workers, like Dr.Sindhu Dadlani, are preoccupied with starkly contrasting attitudes. 

Struggling to ensure that her patients abide by social distancing rules, Dadlani shares the “can’t get her older ones not to go to the grocery store.”

Are the patients to blame?

No, Dadlani expresses, the government is.

Dadlani links much of the general public and healthcare professionals’ anxiety to this country’s lack of experience with handling infectious diseases in the past few years.

Ultimately, this has led to the inability to understand how to establish the correct policies like social distancing and, more importantly, when. 

“If we had listened. If the politicians had listened to the experts, we may have averted some of this. Not completely. But minimized made it so that our system didn’t get so overwhelmed,” Dadlani said. 

As a primary care physician of over 20 years, Dadlani knows that the job description of a doctor will always stay constant, pandemic or not: “you have to do the right thing by the patient.” 

And the pandemic has not made this job any easier. 

Doing the right thing means coming into work everyday and checking up on patients, ordering the right prescriptions to maximize quality and quantity of life, and healing the patients with comfort and kindness.

While the former two tasks have sufficed through telemedicine, the latter has been a challenge to accomplish, Dadlani said. 

Dadlani recalls a moment a few weeks ago when a frantic patient started banging on the door of her clinic, in defiance of the well-known stay at home policy in the Zephyrhills area, screaming that his wife is in the ICU with pneumonia and the doctors are telling him she has very little time to live.

He started tearing up, emphasizing the fact that he couldn’t even visit her right now and that she took care of everything for him, including his medications. In that moment, as she stood six feet away from him with a mask, Dadlani shared, she so badly wanted to give him a hug or even just pat his back.

Adjusting to these restrictions and relying solely on telehealth is “tough,” Dadlani said. “People are feeling the loneliness. The lack of human connectedness.” 

While doctors like Dadlani continue to struggle to provide the same level of care to their patients and administrators to use this pandemic to highlight and fix the problem areas of the healthcare system, both admit that this pandemic has shown how important healthcare professionals are. 

Kotwani reflects that at a time when her field is at the frontlines of a global issue,  she feels even more proud to have joined a career full of “selfless, passionate individuals.”

Endorsing her faith in the field once again, Kotwani asserted that as long as people are doing their part in staying educated about social distancing practices, healthcare professionals will handle the rest. 

Until then, Kotwani stresses that it’s ok to be scared, but one thing to remember is that we are all in this together. 

“I mean the entire world being involved in, or being subjected to the same situation that none of us have control over is really causing us to look to each other for comfort,” Kotwani said. “When that happens on an entire global scale, it just brings a whole world together.”