Eric Stulberg: Young doctors call on Utah for a stay-at-home order

(Trent Nelson | The Salt Lake Tribune) Negative pressure tents have been set up outside University of Utah Hospital in preparation for COVID-19 cases, in Salt Lake City on Monday, March 9, 2020.

Dear Governor Herbert and Lieutenant Governor Cox,

We are residents, physicians-in-training, battling the COVID-19 pandemic here in Utah. We are writing to strongly urge that you implement and enforce a state-wide stay-at-home order and resist any temptation to take away control from local authorities, such as those in Salt Lake City, who are implementing stay-at-home orders.

While this is not “World War II,” and we appreciate your sentiment to avoid scaring people, we feel adamantly as healthcare professionals that, in fact, this is the time for the public to be scared. People are dying, and your decision could cost lives.

Unlike 42 other states, you still haven’t implemented a stay-at-home order and there is talk of the state government superseding local authorities’ stay-at-home orders. These local officials’ decisions — county commissioners and mayors — are the reason why Utah has been spared the brunt of COVID-19 in spite of your lack of a statewide order.

In this letter, we won’t point out to you how many people could die because of no statewide mandate or the governor’s office removing local stay-at-home orders. We won’t quote physicians, scientists and public health officials, like Dr. Anthony Fauci, who are desperately urging the remaining small minority of states, like ours, to issue a stay-at-home order.

Rather, we’ll tell you how bad things could get. Because by the time our communities are hit, it will be too late to act. We have physician colleagues in New York, Detroit, New Orleans, Los Angeles, Milwaukee and Baltimore who have shared with us the following stories. We all must keep this reality in mind:

“I’m angry and terrified and so exhausted from watching people die”

“I wake up every day in fear. I have palpitations all the time. I wear a garbage bag to work because we are out of PPE gowns. I wear one N-95 mask for my 14 to 24-hour shift – it’s suffocating, not to mention probably spreading the infection.”

“People are hooked up to ventilators for weeks. In three weeks, I have seen one person successfully weaned off a ventilator. I have had to tell more family members in the past two weeks that their loved one is dead — and died alone at that — then I have had to do in the previous nine months.”

“We have an all hands on deck policy because we are on such short staff. Already a handful of nurses and physicians — including a resident — in the area have died. I am so scared.”

“If people only knew … I had to cover a catheter with my finger for 10 minutes while we looked for a cap. It’s chaos.”

“We have implemented a policy where everyone with COVID is ’Do not resuscitate’ by default. The risk of spreading the infection in a code situation is too high, so people unfortunately don’t really have a choice anymore.”

“We have run out of almost every paralytic or sedative we use when we intubate people. What will we do when we run out of Ketamine?”

“I have seen a 34-year-old otherwise healthy individual go from breathing OK without a ventilator, to shortly thereafter needing a ventilator and then dying a few days after.”

“I am positive I have contracted the virus, but we don’t have enough tests to test me. I have taken one day off in 2.5 weeks. I haven’t seen my family in weeks for fear of infecting them. I am so tired physically, emotionally and mentally. The suffering I’ve witnessed and the hours I’ve put in are adding up.”

Governor and Lieutenant Governor, we have been fortunate to have not yet become a hotspot for COVID-19 in spite of your not issuing a statewide stay-at-home order. This isn’t because of your policy or even because of luck; it’s because of bold action taken by leaders like Salt Lake City’s mayor and the county commissioners who have implemented local stay-at-home orders. We need to keep it that way.

Please don’t call us physicians heroes. We don’t have superpowers. We can only do so much. We need our community and our state to support us, not just with their words but also with action. Our lack of a statewide stay-at-home or shelter-in-place order is already an insult and grave risk to us providers. If you or the Legislature rescind the stay-at-home orders of local counties, we fear — and readers of this paper ought to as well —what will happen next.

Respectfully, on the behalf of 59 other resident-physician cosignatories.

Eric Stulberg

Eric Stulberg, M.D., MPH, is an internal medicine/neurology resident at the University of Utah. The opinions expressed above do not represent the institutions at which he or any of the other co-signatories work. All views are their own.

Adam Sitzmann, M.D; W. Shea Wright, M.D.; Evangelia Lazaris, M.D., MS; Asha McClurg, M.D.; Susan Nourse, M.D.; Katherine Gentry, M.D.; Dana Canfield, M.D.; Julie Nguyen, M.D.; Jessica Kaplan, M.D., MPH; Lauren Gimbel, M.D.; Hannah McLaughlin, M.D.; Alex Zheutlin, M.D., MS; Lauren Nicola, M.D., MS; Leah Cooper, M.D., MS; Meredith Humphreys, M.D.; Jared Hilton, M.D.; Elena Gibson, M.D., MSPH; Elizabeth York, D.O.; Pete Hendrickson, M.D., Ph.D.; Evan Daugherty, M.D., MS; Evan Daugherty, M.D., MS; Cecelia Robinson, M.D.; Bridget Ollesch, M.D.; Izzy Dodard-Friedman, M.D.; Emily Niehaus, M.D., MPH; Kasey Stoutin, M.D.; Michael Hagan, M.D.; Kendra Pham, M.D., MPH; Guinn Ellen Dunn, M.D.; Sydney Hartsell, M.D., MPH; Josh Epstein, M.D.; Adam F. Sitzmann, M.D.; Nick Gavern, M.D.; Kumiko Chino, M.D.; Justin Foley, M.D.; Alastair Moody, M.D.; Calvin Stone, D.O.; Natashia Bottoms, M.D.; Joshua Gibney, M.D.; Carlie Benson, M.D.; Thomas Gethin-Jones, M.D.; Nicholas Anzalone, M.D.; Taryn Young, M.D.; Eric Stulberg, M.D., MPH; Gabrielle Anthony, M.D.; Taylor Frost, M.D.; Olesya Ilkun, M.D., Ph.D.; Walaa Hamadi, M.D.; Lauren Facer, M.D.; Keegan Colletier, M.D.; Matthew A. Christensen, M.D.; Faris Alhomida, M.D.; Shannon Myers, M.D.; Jason DuBroff, M.D., MPH; Michael Hagan, M.D.; Logan Horne, M.D.; Kaitlyn Bryant, M.D.; Trenton Fuller, M.D.