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Dr. Jackie Simonis assumed she was tired from having worked three straight overnight shifts in a COVID-19 emergency room.

She took four days off. She returned to work. Still weary.

Simonis then got a headache and a stuffy nose. On May 3, her temperature shot up to 100.1 degrees. Simonis took a rapid COVID-19 test. It came back positive.

“I was honestly most afraid that I had exposed colleagues at work the days before I developed a fever,” the 36-year-old Simonis said, “including my [physician] husband.”

Across Utah, at least 1,125 medical workers, most of them employed at long-term care centers, have contracted the coronavirus, according to data supplied by local health departments, out of more than 40,000 total COVID-19 cases in the state. That health care figure includes physicians, nurses, janitors and office staffers at hospitals, clinics and nursing homes.

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Reporter Nate Carlisle will speak with Dr. Marion Bishop and Utah’s chief medical examiner, Dr. Erik Christensen, about what it’s like to be an emergency room doctor in the age of COVID-19 — and how Utah’s death toll topped 300.
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Most of those infections (772 of them) have been in Salt Lake County, the state’s most populous county and where there has been more than 19,000 infections.

The Salt Lake County Health Department was the only local health agency to report that such a worker had died from the virus.

(Photo courtesy Teresa Thompson) Paul Mokofisi, of West Jordan, died at home June 28, 2020, after contracting COVID-19, his family says. He was 41.

The department did not provide a name, but the way the county reports its data matches the description of Paul Mokofisi. His family said the West Jordan resident was a caregiver at group homes for the disabled.

His sister found him dead in his bedroom June 28. He was 41.

Some county and regional health departments did not provide specific figures for infected medical workers but acknowledged there had been cases in their areas.

Some health departments also said their data was limited because they didn’t record occupational information for every COVID-19 patient, creating the likelihood that infections among medical workers may be higher than the numbers show.

County health departments or health districts reporting health care workers infected with COVID-19, as of last week:
• Salt Lake County, 772.
• Davis County, 210.
• Weber-Morgan, 113.
• San Juan County, 30.
• Tooele County and the Southeast Utah Health Department each reported fewer than five cases.
• Southwest Utah Public Health and TriCounty Health Department both reported infected health care workers but declined to provide numbers.

Staffing worries

Aside from contributing to Utah’s wider coronavirus outbreak, infections of health workers have, in places, hampered the state’s ability to care for the sick and vulnerable.

The biggest problem has been at long-term care facilities such as nursing homes and rehabilitation centers. The Utah Department of Health said, as of Friday, 826 health care workers at long-term facilities have contracted the virus.

Finding labor was difficult for these centers even before the pandemic, and staffing troubles have only grown worse at long-term care facilities where outbreaks have occurred.

Allie Spangler, director of membership for the Utah Health Care Association, said Friday that the Utah National Guard recently had to provide staff at one facility, Medallion Manor in Provo.

(Francisco Kjolseth | The Salt Lake Tribune) The Utah Department of Health suits up as it prepares to test staff of West Jordan Care Center for the coronavirus on Thursday, May 21, 2020. The testing is part of a plan to test staff at all long-term care facilities, with centers for memory patients and the intellectually disabled receiving priority.
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Representatives of Utah’s three major hospital networks, Intermountain Healthcare, University of Utah Health and MountainStar Healthcare, all said they have not yet had staffing shortages due to workers contracting the coronavirus.

Utah’s medical sector has warned repeatedly, however, that continued outbreaks among the general populace are increasing the number of patients needing hospitalization. That could strain health care workers, placing them at further risk, and cut into staffing at hospitals.

Not surprisingly, health care professionals have been deemed essential employees. If they are exposed to the virus but do not show symptoms, they can be exempt from quarantine recommendations and report to work, according to the Centers for Disease Control and Prevention.

Trevor Warner, a spokesman for the Davis County Health Department, which has reported 210 infected medical workers, said a national conversation took place early in the pandemic about how to manage critical infrastructure employees. The consensus: It would be too devastating to close a hospital.

“While it’s not ideal” to have exposed — though still seemingly healthy — medical professionals working, Warner said Friday, “it’s one of those things that’s been deemed necessary to keep these essential businesses open for our public.”

(Zak Podmore | Tribune file photo) This March 20, 2020, file photo shows a coronavirus sign outside the Montezuma Creek Clinic on the northern Navajo Nation.

‘A tall order'

Simonis and her husband, Dean Tanner, are both emergency room doctors for Indian Health Service. They live in Salt Lake City and commute to the Navajo and Hopi nations every two weeks to work.

They left Salt Lake City on March 4, as COVID-19 arrived in the Four Corners region, and stayed on the reservations until June 8.

The COVID-19 tent in Gallup, N.M., where Simonis was working, had plenty of personal protective equipment, she said. Still, the risk of contracting COVID-19 was always in play.

“You’re relying not only on yourself,” she said, “but everybody who’s in that emergency room — the nurses, the patients, the techs — to use their PPE correctly 100% of the time. That’s a tall order.”

(Leah Hogsten | The Salt Lake Tribune) Dr. Jackie Simonis, left, and her husband, Dean Tanner, right, with their animals at home in the Avenues, Aug. 1, 2020. The couple spend two weeks of every month on the Hopi and Navajo nations as emergency room doctors. Simonis, who contracted COVID-19 in May, suffered mild symptoms and despite living in a small apartment on the reservation, did not give the virus to her husband. Tanner has tested negative multiple times for the virus and its antibodies.

Simonis doubts she contracted the virus from a patient, around whom she always wore PPE. Simonis removed the equipment to eat her meals in a break room with other hospital staff. It’s possible, she said, she picked up the virus there or when shopping for groceries.

Her case turned out to be mild. She had two days of fever and about a week of headaches, body aches and nasal congestion. She never developed a cough or grew short of breath — and has returned to work.

Simonis and Tanner have an apartment near their work on the Navajo Nation. When she developed symptoms, her husband traveled to another hospital on the Hopi reservation to work and stay to allow Simonis to isolate.

The following week, Simonis said, he went to a motel. He’s been tested five times, she said, but has never been positive for the virus.

“If I would have had to go home,” Simonis said, “like the nurses I worked with who had their kids at home — how can you isolate yourself when you’re not feeling well? It just seems so difficult to keep this from spreading when you can’t be alone.”