Thursday, January 7, 2021

More Than Just Protective Equipment: A Physician’s Take on PPE and Practicing Medicine During COVID-19

 “It’s smarter to be cautious”

The COVID-19 pandemic put many physicians in a bind, as obtaining personal protective equipment (PPE) has been a roller-coaster challenge for medical practices. To get a deeper insight on the lengths doctors have gone to protect themselves and their patients, Me&My Doctor spoke with Manvinder Kainth, MD, a direct primary care physician and Texas Medical Association (TMA) member based in Plano. 

Like many physicians, Dr. Kainth struggled early on to obtain PPE or faced high prices to buy what she needed. Recently, TMA shipped doctors’ boxes of masks for just the cost of shipping and handling, which she says greatly helped her practice. TMA obtained the PPE from the State of Texas to distribute to physicians. TMA and county medical societies across Texas continue the process of distributing the more than 23 million N95, KN95, and surgical masks to Texas doctors. 

In this brief interview with Dr. Kainth after she received her TMA shipment, she describes her efforts to protect herself and her patients.

Me&My Doctor: Before now, what was your experience of trying to obtain PPE during the pandemic?

Dr. Kainth: “What I have been doing, being a very small practice, is any chance I could get I would buy a box of N95s [face masks], but they’re quite expensive. Like, one box of 25 masks was $120. And so, when you have staff and yourself…obviously I want to keep them protected and I want to keep patients protected as well, so if we have the supplies, I want to use them. But when masks cost $5 a pop at least, it gets to be hard as a small office to be able to afford PPE. Nonetheless, every time I’d get a chance to buy a box, I would buy one. There would often be a limit of how many boxes you could buy, so it’s not like we could buy more than one box at a time. 

“Honestly, it’s always in the back of my mind:  ’Am I going to run out?’ and ’When am I going to run out?’ and ’What am I going to be able to do from there?’”

Manvinder Kainth, MD, (left) and clinical 
assistant Larissa Hendricks (right) receive
new N95 masks from TMA.
 Photo courtesy of Manvinder Kainth, MD 

Me&My Doctor: Your need for PPE is still crucial for some in-person patient visits, though you use telemedicine to care for many patients virtually. Tell us about this. 

Dr. Kainth: “When COVID-19 hit, I was fortunate that all of my patients were already used to phone call [doctor] visits, so they were not fazed as much when we couldn’t meet face-to-face. [However] sometimes I must examine the patient [in person] to really know what is going on. 

“My office is very small; it’s me and one assistant, and we are it for our patient population. If one of us gets sick, we’re out of luck – and so are our patients. It’s important for us to be protected and to protect our patients as well when they must come in.

“If I didn’t have the N95s, I really wouldn’t be seeing patients in the office because medically I know it’s not safe to do so, and I can’t [adequately] examine a patient if they’re six feet from me. There’s just no way to do it feasibly, and I do a lot of women’s health and just taking care of everybody. A lot of times it does involve a physical exam. [In those cases] I put all the PPE on, and I train my staff to do the same. It’s not only to keep me and my staff protected, but also for my patients, their families, and whoever they are in contact with. It’s such a chain reaction that one small mask makes a huge difference.”

Me&My Doctor: As a primary care physician practicing medicine during this pandemic, can you explain why having this proper equipment matters to you and your patients? 

Dr. Kainth: “I’ll tell you, in medicine, there are very few things that we, especially as physicians, get scared about because we are trained to deal with serious things and devastating things, and we can push our feelings aside and do what’s right for our patients. But when a pandemic hits – and we all knew something was going to happen in our lifetime, we’ve been due for one – we are human, and we start to think about our safety and our loved ones’ safety. And without proper equipment, I don’t know how much I’d be able to help others – because honestly, I would be too scared to do so. It’s not so much being scared of the virus, it’s fear of the spread. I know how fast this can spread and how devastating it can be. 

“We can do so much more if we just have the right equipment. For the first few months of the pandemic, none of us felt like we had enough until the county medical societies [and then TMA] gave us option to buy some.”

Me&MyDoctor: What is something you, as a physician, want the public to know when it comes to protecting yourself from catching and spreading the virus?

Dr. Kainth: “I need people to know that as physicians (and I think most of us are thinking this way) when we see a person we haven’t seen before and we have no PPE on, all I’m literally thinking is, ‘You [might] have COVID-19 and we need to protect each other, so let’s stay 6 feet apart, wear our masks, I don’t touch anything you touch, and I am constantly washing my hands.’ Some people think that it’s overboard, and they can think that. But the science doesn’t lie. We know how this is transmitted, we know a lot of it is spread when you have no signs or symptoms and it’s smarter to be cautious than to not, because it’s not that hard to be cautious.”

Me&MyDoctor: What would you say to people who are experiencing pandemic fatigue, especially about social distancing?

Dr. Kainth: “I know the hard part is the social distancing, but I try to remind people you don’t have to completely socially distance, I just need you to physically distance, and there’s a difference. I try to remind my patients, ‘I don’t want you to stop having relationships with other people; I just want – when you do get together – for you to be smart and stay 6 feet apart and pretend like you all have COVID-19.’ Play a game of ‘we all have COVID-19’ and wear a mask and wash your hands and wipe down surfaces and don’t share food or drinks. 

“I just had a patient who went to a wedding recently and so far about two thirds of [the attendees] have turned out positive. Not only have they turned out positive, their elderly family members who were not at the wedding are now positive as well. Again, it’s a chain reaction. People don’t realize that even if it doesn’t affect them long-term, it can definitely affect their loved ones or somebody else.”

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