Quarantined

Abstract

As an emergency medicine physician, I am used to being at work when most people are at home. At the end of February, the first patient in the United States to be diagnosed with COVID-19 without a travel history occurred in Sacramento, CA. Eighty-nine healthcare professionals who had contact with the patient were quarantined. At the beginning of March, I worked in the emergency department and treated a patient with viral symptoms without a travel history who was admitted to the hospital. It was also the first day the hospital implemented an internal laboratory test that was FDA approved to detect novel coronavirus. The next morning, I checked the chart and saw that the patient tested positive for novel coronavirus with the new lab test. It confirmed the growing suspicion that the virus was being transmitted within the community. I immediately started thinking of what I had planned for the day, which included signing closing paperwork on our first house. I spoke with the county health department who said that CDC used a different test and they were not familiar with the hospital test. They said to wait for the official county result for the patient and that I did not need to be quarantined. I let the title company know I had a potential exposure and postponed the signing for the next day. Over the next few hours, occupational health told me to be in a 14-day quarantine and to stay 6 feet away from my family; my family did not need to be quarantined. Then occupational health said my family needed to be quarantined. The CDC physician working with the county health department said I was under quarantine, but my family was not. Hospital infection control said I probably did not need quarantine since I was wearing a procedure mask when I saw the patient. When my kids came home, I asked them to keep 6 feet away from me. My 5-year old daughter thought I was playing a joke and came to me for a hug and I put out my hand and said, “Sorry, no hugs for now.” My family ate dinner at the dining room table, while I ate standing in the kitchen. The second morning after exposure, my 5-year old daughter asked me to play checkers with her. We found a way to play while staying 6 feet away from each other. She would move a piece and step away from the board, then I would move my piece and step away. After breakfast, I spoke with the county health department to clarify my quarantine status who said a physician would call me back. By noon, a CDC physician who specializes in healthcare professionals exposed to COVID-19 told me that the recommendations would be changing again. Given the high rate of community transmission in the area, I no longer needed to be quarantined. The title company also called the county health department and was told I was still under quarantine. After multiple phone calls, we designated power of attorney to my sister to sign the closing paperwork. The title company insisted on mailing the paperwork to my sister rather than have her come into the office to sign. By late afternoon, I received a call from occupational health who confirmed I no longer needed to be quarantined. I did a risk assessment and decided it was probably safe to eat dinner with my family at the same dining table. I am off quarantine and my next shift in the emergency department will be in a few days. As I approach the 14-day mark, I realize that I may have not gotten COVID-19 from this exposure but eventually I probably will.