A Day in the City
Fighting COVID
Fundraising for the Greater Good
BB: You are an ER physician at Riverview Hospital in New Jersey. How many years have you worked there? *
Dr. Roma: I have been practicing Emergency Medicine for over 25 years. I have worked at Riverview Medical Center in Red Bank, NJ for the last 17 years.
BB: Historically speaking, what are the most typical cases that come into your ER?
Dr. Roma: On a typical day in the ER, we see a variety of illnesses such as chest pain, abdominal pain, shortness of breath, fevers, accidents, and much more.
BB: Tell us about the protocols put into place once the WHO announced COVID-19 a pandemic?
Dr. Roma: Due to the novel coronavirus, we have developed screening and isolation of patients who are potentially COVID positive. We are now required to wear personal protective equipment during patient evaluations that could potentially have COVID.
BB: Who implements and oversees these protocols?
Dr. Roma: Each department has immediate managers that are in direct contact with their team to oversee that the new protocols are being used.
BB: How has a typical er day changed since the pandemic?
Dr. Roma: The Emergency department volume and acuity has drastically changed since the pandemic hit. The screening of patients for COVID-19 has changed the normal workflow in the hospital. We would usually rush into any room with a patient in distress. However, we now have to consider every patient as potentially COVID positive. This requires us to have to wear PPE prior to evaluating patients.
In addition, due to limiting exposure from COVID, no families and/or friends are allowed in patient’s rooms. The care team has to now act even more as a surrogate for patients and their families during this difficult time.
Community support has been tremendous. We truly appreciate the meals, PPE, and other donations that have been provided for me and the hospital staff. I can not thank the community enough.
BB: Does the hospital have sufficient ppe supplies?
Dr. Roma: I can thankfully say that in the emergency department at Riverview Medical Center we have had a constant supply of ppe throughout the pandemic.
BB: Does the staff (i.e., nurses, doctors, techs) require additional training?
Dr. Roma: Throughout this pandemic, there has been constant training. As a physician who is a lifelong learner, I have been following multiple sources of learning and training. The hospital staff and I have continually been adapting as more information has become available in treating COVID patients.
BB: Can you tell us about the first COVID-19 case that you saw?
Dr. Roma: I think that myself, as well as most physicians and healthcare providers, had seen our first COVID-19 case and were unaware. However, my first confirmed case that I know of took place on March 13th, and the results later came back as positive.
BB: To date, approximately how many cases have you seen?
Dr. Roma: I have seen approximately 40-50 confirmed cases give or take.
BB: What are the typical symptoms? What symptoms have you seen that are rare?
Dr. Roma: Typical symptoms of COVID -19 vary from each patient. The sickest patients usually come into the ER with shortness of breath and with a high fever. Other symptoms I have seen are cough, diarrhea, weakness, anosmia (loss of smell), altered mental status, and overall fatigue. Meanwhile, some patients have no symptoms at all.
BB: Many people have coronavirus, but never enter the hospital. When does a patient need to be hospitalized?
Dr. Roma: Those that require hospitalization really depend on a clinician’s overall gestalt. Most significant is their oxygenation level, vital signs, presence of additional symptoms, and comorbidities.
BB: In this pandemic, what has surprised you the most? What has frightened you the most?
Dr. Roma: I have been most surprised about how rapidly patients can deteriorate from one day to the next. I am also surprised how this disease can affect anyone no matter their age or previous health status. This is what frightens healthcare providers, questioning if we will develop the disease and experience the most severe form of the virus.
BB: How does the medical staff let off steam?
Dr. Roma: The medical staff lets off steam by keeping a positive mind and a good sense of humor.
BB: How many people come to the ER convinced they have coronavirus, but do not?
Dr. Roma: Many people think that they have the virus and come to the ER expecting to be tested. However, in the early stages of the outbreak, only patients presenting with symptoms of the virus that needed to be admitted were then tested. Otherwise, patients were given instructions to self-isolate at home.
BB: We’ve heard that the ER’s are not as busy from general emergencies. What do you attribute this to?
Dr. Roma: ER volumes have significantly dropped. I believe that this is due to the fear of contracting the virus at a hospital visit. In addition, the virus has caused hospitals to cancel all elective surgeries and other services, which also affect ER volume. Lastly, the stay at home order has caused a decrease in injuries and accidents which would normally require an ER visit.
BB: What are the most common symptoms of the COVID patients you treat? What is the average age?
Dr. Roma: The most common symptoms of my COVID patients that have required admission include fever and shortness of breath. The ages I have seen with my COVID patients have varied from 20-year-olds to 90-year-olds. I personally have seen a majority of patients who are 50 years or older, however this could be coincidental.
BB: What is the most difficult part of the job? The best part?
Dr. Roma: The most difficult part of the job is realizing that all that I can potentially do may still not be enough. The best part of my job is seeing those who have fully recovered due to our care.
BB: We understand there are protocols in place when a patient passes. We imagine the process is harrowing. Can you tell us how you are trained to manage the grief associated with that experience?
Dr. Roma: Sadly, in emergency medicine, we are familiar with tragedies on a regular basis. I believe that my coworkers are the best source of comfort during these times because we have experienced the joys and horrors together.
BB: As far as we’re concerned, you and your colleagues are all heroes. Is there a person you work with that is especially inspiring?
Dr. Roma: I think that everyone is a true hero. Techs, nurses, x-ray, housekeeping, unit secretaries, physician assistants, nurse practitioners, respiratory therapists, security, EMS, medics, and transporters. Everyone is doing their job above and beyond.
BB: If there is one memory from this experience that stands above the others?
Dr. Roma: My best memory is a patient who I recognized that was sicker than they thought. Eventually requiring mechanical ventilation, dialysis, and medications to support their life. The patient miraculously was able to overcome all of these obstacles and was able to be taken off the ventilator successfully and no longer required dialysis. A true miracle.
BB: What has the media gotten right? And wrong?
Dr. Roma: I think that the media has stoked a lot of fear and created more anxiety than necessary, however, some news features have been rational, calming, and informative.
BB: If you weren’t a doctor, what type of work would you do?
Dr. Roma: If I was not a doctor, I would have most likely continued my former career as a New York City police officer, but I would have probably been retired many years ago.
BB: What is your favorite charity?
Dr. Roma: My favorite charity is the Beauty Foundation. This is a local charity that my wife Kim has been a member of for the past few years. The Beauty Foundation’s mission is to alleviate the overwhelming financial and emotional strains that cancer treatments place on families. As a physician, I know how difficult cancer can affect a patient and the strains it can put on a family. The Beauty foundation raises money to offset the expenses they incur.
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BB: We’ve sheltered in place for approximately 7 weeks now. What have you learned from this experience?
Dr. Roma: From this experience, I have learned that 7 weeks may seem like a long time. It may be difficult to alter your daily routines and lifestyle, however it is possible to be done. No one could have predicted this pandemic, but it is amazing to see how communities have come together to help one another.
BB: When do you think the world will be back to the way it was pre pandemic?
Dr. Roma: I do not foresee in our future ever fully returning, at least in healthcare, to the pre-pandemic era. This virus has changed the way we live our daily life and I believe that this may cause a new normal.
BB: What changes do you expect to see in the world after the pandemic has fully passed?
Dr. Roma: I believe that workplaces will have to establish policies and protocols that protect their workers, patrons, and businesses.
BB: Once the shelter in place order is lifted, what is the first thing you’ll do?
Dr. Roma: I would love to be sitting at a restaurant/ bar overlooking the water, having food and drinks, and listening to a band play with good company. Overall, enjoying the Jersey Shore.
BB: How will you live differently?
Dr. Roma: I will never take for granted the ability to travel, go out to eat, socialize in groups, go to sporting events, concerts, and museums.
BB: When not working, what’s your favorite part about staying home? Your least favorite?
Dr. Roma: My most favorite part about staying home is being with my family. My least favorite part about staying at home is also being with my family…a little too much HAHA
BB: Is there a question you wished we had asked?
Dr. Roma: Are we prepared?
BB: If you could send a message to the world, what would it be?
Dr. Roma: My message I would send to the world would be to never take life and those around you for granted and to truly appreciate those that are in fields that risk their lives to serve others.
* Disclaimer: These answers are the opinions of Dr. Roma and do not represent Riverview Medical Center and Hackensack Meridian Health
(Posted: June 2020)
