Michael Isaacs always knew he鈥檇 work in emergency medicine. He just couldn鈥檛 have guessed how 鈥� or that the emergency would grip the entire world.
The COVID pandemic has left him with an even deeper appreciation for his field, but also with a skepticism shared by many frontline workers and strong views about how policymakers should rethink their approach to infectious disease.
The son of a paramedic, Isaacs became an emergency medical technician while still in his teens. 鈥淚 grew up around the organized chaos and battlefield treatment mentality. I loved being able to save someone dying on the street.鈥�
BEYOND CAPACITY Hospitals in California are so overcrowded with COVID patients that many are setting up tents outside for those who are less ill. (Photo: AP)
Flash forward to 2020. Isaacs 鈥� now 44, and a student in 精东影业鈥檚 online doctoral program in Nursing Education 鈥� was working as an emergency room travel nurse in California鈥檚 San Bernardino County, where, after a relatively quiet summer, COVID was resurging at a terrifying rate.
鈥淵esterday, we were at 112 percent capacity, with ICU patients in the ER,鈥� he said, reached by phone one afternoon in late November. 鈥淵ou鈥檝e got to segregate COVID patients or it will spread, and we鈥檙e doing that on the fly.鈥� One ER he鈥檚 worked in has used zippered curtains to convert a fast-track space [for patients with minor ailments] into a hazmat area, where staff now wears Tyvek suits, N95 masks and goggles. Another has set up tents with portable heaters for COVID patients with milder symptoms. [On January 14th, according to the Los Angeles Times, officials had reported 24,973 new cases over the past seven days, which amounts to 1,169 per 100,000 residents. Visit the newspaper鈥檚 for current figures.]
Yesterday, we were at 112 percent capacity, with ICU patients in the ER. You鈥檝e got to segregate COVID patients or it will spread, and we鈥檙e doing that on the fly.
鈥擬ichael Isaacs, Nursing Education doctoral student
On one level, Isaacs believes the country has made rapid progress in dealing with the pandemic.
鈥淏ack in March, New York City didn鈥檛 know what was coming, and no one knew how to treat the virus then,鈥� he says. 鈥淣ow, through trial and error, we know the progression, which patients are most vulnerable, and how to isolate them, and what drugs to give them. There鈥檚 a lot less death now.鈥�
On the other hand, his assessment of federal and state responses echoes post-mortems of France鈥檚 Maginot Line and America鈥檚 fleet in Pearl Harbor.
鈥淭here鈥檚 no scientific logic in the decisions the government is making.,鈥� says Isaacs, who self-quarantined after testing positive for COVID earlier in the fall. (He remained symptom-free.) 鈥淭his is an all-or-nothing situation 鈥� you either shut it all down or don鈥檛 鈥� so this business of closing the bars and gyms but not Walmart and McDonald鈥檚 isn鈥檛 stopping anything. It feels as though they鈥檙e doing things just to show they鈥檙e taking action.鈥�
For Isaacs, TC鈥檚 nursing education program, with its focus on evidence, is the perfect antidote to such thinking. He鈥檚 taken an epidemiology class, engaged in discussions about COVID contact tracing, read literature reviews and conducted statistical analyses. 鈥淲hen officials issue new edicts now, my first thought is, show me the data,鈥� he says.
This is an all-or-nothing situation 鈥� you either shut it all down or don鈥檛 鈥� so this business of closing the bars and gyms but not Walmart and McDonald鈥檚 isn鈥檛 stopping anything.
鈥斺�擬ichael Isaacs, Nursing Education doctoral student
Isaacs is also particularly focused on using technology to better prepare nurses and other workers for the unexpected.
鈥淲e鈥檝e created these virtual worlds for other students, so why can鈥檛 programmers create nursing and medical situations that are true to life? It鈥檚 how this generation wants to learn, and it鈥檚 obviously ideal for the situation we鈥檙e dealing with right now.鈥�
Meanwhile, he鈥檚 become only more committed to his work. 鈥淚鈥檝e always felt that the ER is the foundation of healthcare. We stabilize patients and then hand them off to the specialists and rehab units. If the ER doesn鈥檛 do its job well at the start, the rest doesn鈥檛 happen. And we couldn鈥檛 have handled COVID without it.鈥�