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CORONAVIRUS Q&A with ER doctor

CORONAVIRUS Q&A WITH REP. JON SANTIAGO — With coronavirus cases on the rise in Massachusetts, I spoke with state Rep. Jon Santiago, who works as a doctor in the Boston Medical Center emergency room when he’s not on Beacon Hill. Santiago trained at Boston Medical Center for four years, and is in his first year as an attending physician. Our conversation was edited for length and clarity.


What's it like in the emergency room you work in right now? It's been intense. What we've seen over the past week, given the state of emergency, the national emergency and the fact that community spread is going on in seven counties in the state of Massachusetts, efforts to address it have picked up significantly. Now people are coming in, some of them sick, some of them not so sick, but many of them having concerns about whether they've been infected by coronavirus. That puts us in a difficult position given the fact that we need personal protective equipment, and we need to make sure those people are triaged appropriately. The worst thing in the world is to bring these people to the emergency department, expose them to nurses, doctors, medical personnel and other patients who haven't been exposed. Things are in flux. The testing situation has made it all the more difficult, but I'm optimistic. Things will get worse, no doubt, before they get better, but the medical community is up for the challenge.


This time next week, what do you expect it to look like inside Massachusetts emergency rooms? There's no doubt there will be more cases and more people concerned with symptoms. With each day that passes, the number of people infected increases. That's two-fold because we're detecting more cases and we're scaling up testing. I'm going to work Friday, Saturday, Sunday again, and it'll be interesting to compare both experiences. We're still trying to put things together, put teams together. We've dedicated floors in the hospital to specific COVID-19 floors to cohort these patients that we suspect have the virus. And we've gone so far as to put tents outside … to triage people outside the emergency room, to really decrease the amount of exposure that they will have and cause to other medical personnel.


Should the state take more drastic measures to enforce social distancing? Gov. Charlie Baker has said the state will not issue a shelter-in-place order, contrary to rumors. Has the state gone far enough to keep people away from each other? All options should be on the table, there’s no doubt. Given what we're seeing in Italy right now, a day or so ago there were 350 deaths in one day. And quite frankly, the medical community, the hospitals — it's the number of hospital beds and ICUs. They can't handle what's at stake right here. If we don't really do our best to limit contact, to increase efforts to social distance, we're in for what Italy experienced. So yeah, I think that should be on the table. I'm sure Gov. Baker is conversing with a number of stakeholders, government partners, people in the private sector as well. That should be something on the table for sure.


What's something you wish people better understood about coronavirus? The thing that has me most concerned, particularly after watching what happened on St. Patrick's Day weekend, was that so many young people were out there given the way that the virus has been playing out. It's so asymptomatic in young people, particularly children, and we know that these folks can still pass on the virus, they're still infectious and contagious. Folks in my generation, people who are healthy, younger, should pay special attention to how they're interacting with other folks -- are they washing their hands? It's really all hands on deck. Everyone can play a role in this. Just because you're not a doctor or nurse or in the medical community, you play just as important of a role in your efforts to socially distance yourselves from other people.


As a state lawmaker and a doctor, what happens to business on Beacon Hill, like the state budget? Will the Legislature be thrown off kilter? Things will have to change with respect to how government is going to operate. From the Speaker on down, we're all committed to making sure that government is still operating and being held accountable and working with its constituents and with its partners. I'm part of a small workforce that Speaker Robert DeLeo has designated to look at the internal workings in the House. The conversation is ‘How can we still function?’ It's not a good idea to have 160 members of the House of Representatives show up and, you know, shake hands and cast a vote. But the Speaker is committed, as I think many members of the House and leadership and myself are, to handle the business of the day. No doubt, that starts with addressing the coronavirus epidemic. As you saw last week, we passed the $15 million bill to infuse some funds, and over the course of this week my hope is that we can begin to address the issues that people will face as the coronavirus begins to affect other parts of the economy and families.


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