Should I Stay or Should I Go?

By Donna Baver Rovito, Editor, Physician Family Media

“How are you protecting your family from COVID-19?”

Families throughout the world are asking that very question – but none more urgently than the families of physicians on the front lines of the pandemic. Those taking care of the sickest patients put not only themselves, as dozens of physician deaths around the world tragically attest, but their families at risk for exposure. As a result, many physician families are resorting to extreme measures to keep themselves and their children safe, ranging from deep disinfecting and cleaning routines to complete separation. Physician Family Magazine author Warren Holleman, PhD started a conversation about this topic in our own Physician Family Community Facebook group, one of many Facebook groups dedicated to the family of medicine. (Warren also suggested the title of this article, so we thank him for his creativity.) Warren wrote:

“My wife is a family physician on the ‘front lines’ of this epidemic. Here is a photo she texted me with her nurse at the end of a day of testing at their makeshift corona virus clinic – under a tent in the parking lot. We are trying to figure out whether and how much to separate over the next few weeks. I would be interested in knowing what other couples are doing.

In our case, our children are grown up, and we are in our mid-60s. We have instituted a few rituals, all as experiments so far:

            (1) a laundry basket on the porch that she puts all her clothes into when she gets home and then takes a shower;

            (2) we sleep in separate bedrooms;

            (3) we eat at the big dinner table – far apart like rich people in those British TV shows;

            (4) We fix our own breakfast, and I fix dinner for both of us;

            (5) I’m totally isolating from others to reduce likelihood that I will make her sick.

Most family medicine couples/families I know are struggling with this issue of separation, cohabitation, etc, like that song by The Clash: ‘Should I Stay or Should I Go?’ Not sure if we are distancing from each other too much or too little. Any tips from what others are doing?” ~Warren Holleman, PhD

The response from other physician families was immediate and sparked this blog post. In order to gain additional perspective, we posted a question about this topic in several other physician family groups. (Thanks to all the admins who said yes!) We’ve changed contributor’s names to ensure privacy. For those unfamiliar with physician family social media abbreviations, DrH stands for “Doctor Husband” and DrW is “Doctor Wife.”

First, we’ll include those who’ve developed special cleansing routines, but haven’t elected to separate entirely…YET.

“My husband works ER. He changes his clothes to hospital scrubs when he gets to work. He has his own room at the hospital to store his bag of the clothes he wore to work. He wears what protective equipment they have, which is on short supply. When he’s done with his shift he leaves his hospital scrubs for them to sanitize with their other laundry, showers, changes back to his clothes for the drive home. Leaves his work shoes by his vehicle in the garage. He showers before seeing any of us. Washes the clothes he wore to/from work on sanitize cycle. Wipes down bathroom/sink area he used. A hug when he leaves for work but no kiss. We have a bed and shower downstairs he could use if he has contact with COVID patients. We leave the house for walks and necessities only. Grocery pickup when we need groceries.”    ~Kathy

“It’s recommended to frequently disinfect common touch areas in the home. Teach yourself to not touch your face; it took me about three days to teach myself to not touch my face or bite my fingernails. It’s taking longer to teach my kids but we are working on it. Always wash your hands before eating, or really touching anything in the kitchen if you can do that (SARS-CoV-2 has really cut down on my snacking). Make your own masks for when you must go out (two paper towels lined with a sheet of tissue paper was shown to be 80-90% as effective as a surgical mask) and use hand sanitizer to clean hands while out and about. Sadly, soon my wife may start using the back door to directly enter our master bedroom and fully section away from the kids and me. We have also explored her possibly staying at another physician’s house because we have to keep the kids safe from this.”    ~Joseph 

“He leaves his shoes in the garage, puts scrubs in a basket in garage, dons fresh clothes and goes immediately to the shower. I Lysol his shoes, his car interior, the door knobs, put scrubs in the wash (only his scrubs) and then I Lysol the washer and wash my hands to my elbows. He is also going to the guest room at first known exposure. He will begin to shower in there as well. We don’t want to be separated and are doing the best we can to keep every surface clean and to wipe everything down. We knew EM would be “signing up” for any and everything. We are doing the best we can, but my anxiety is high. It’s a stressful time.”    ~Melanie

“My husband currently strips immediately and has a separate hamper. His pager, pens, and ID get Clorox wiped before they touch anything. But soon he will be moving to a friend’s empty apartment to protect us.”   ~Marla

“He strips in the garage and goes right to the shower for now. We’ve purchased masks from the local medical association. We have a donated trailer lined up to isolate DrH in when he says it’s time and he’s being to exposed, to keep us safe. I’m helping on the RVs 4 MDs page on getting other families connected with donated RVs.”    ~Debbie  

(More on the amazing effort called RVs 4 MDs later.)

“Lysol the shoes. It used to just be don’t bring them into the house. Now, he takes his shoes off in the garage and I go out and cover them in Lysol spray.”  ~Mindy

“One of my concerns right now is that our residency program sends its residents to different hospitals. We all move around every six weeks. It only takes one resident to pass this virus from one hospital to the next before each of these locations becomes overwhelmed with COVID cases. We will be moving home soon, and DrH will have his own section of the house. It’s hard in the smaller apartments to really remain too distant.”   ~Kate

My husband is a graduating cardiac surgery fellow, so while not ER we imagine he’ll soon be putting a fair number of COVID-19 patients on ECMO, as he has done the past several years with critical flu cases. We are still sleeping in the same bed and interacting normally, but we have a plan to move him to our guest room (with separate bathroom, on a different floor) and let him keep his own dishes in the mini-kitchen there so he’ll have his own fridge, dishwasher, etc. and won’t have to touch the common areas in our kitchen. I realize what a luxury it is to have this, but living in the middle of the city, we don’t have a garage or porch on which he can leave hospital gear/shoes, so we try to just “quarantine” them in the same spot by the door each day. Hard to know when we should have him isolate from us (now? after he’s seen a presumed positive patient? If/when he shows symptoms?) but I guess for my own sanity and that of our two kiddos (5 and 2) we’re trying to keep things are normal as possible for now, and just have him be extra careful when it comes to coming home, getting right in the shower, and wiping down his ID, glasses, pocket pen, etc. etc. Good luck to everyone — stay safe and healthy! ~Allie

“We’re not panicked. He does shower the minute he gets home before he hugs/kisses anyone and clothes go right into the laundry. He is not on the front line of this either.”  ~Tara

“Everyone is doing the best they can. For us my husband is taking off shoes, changing out of scrubs before leaving work and showering before he interacts with us. He is still interacting with us as normal, but we also have a plan of what part of the house can be “his” when he gets more frequent contacts. I should add my husband is a general surgeon and critical care fellowship – so he will be called in if they get the numbers.”  ~Lisa

“My husband is a surgical resident, so not exactly on the front lines, yet. They have cancelled all elective surgeries and instructed surgical residents to come in for morning rounds and leave hospital as quickly as they can to minimize exposure. He has been keeping scrubs and shoes out of the house, and showering when he gets home before interacting with us. We’ve been interacting as normal, but no kissing! We sleep in a king size bed together still, so not especially close (dog sleeps between us). Once his hospital has more than a few cases, I will move into the guest bedroom so he can have master with attached bath to himself. He will likely have to start doing shifts in the ER and assisting with managing patients in the ICU. He will try to stay away from our kids (ages 2 and 5) and from me. We are 35 years old and I’m 14 weeks pregnant, so we are worried about the uncertainties involved with that. Hopeful our state’s relatively early actions to shelter in place will keep our hospitals from getting hit too hard, everyone will stay the heck home, and praying for more PPE to become available soon!!”   ~Cassie

“My husband is in primary care. We are interacting as normal although he is changing out of his clothes and showering before he interacts with us. Since I am no longer going to my office, I figured I would quarantine along with him if he has a patient test positive. But we are keeping as much distance as possible.”   ~Amy

“My husband is an ER doc and we’re still sleeping in the same bed. I have Sjogren’s syndrome and two kids (6) and (10). We decided from the very beginning that we are staying in the same house and the same bed. If one of us gets it, we all get it. Also, on a different note, I take Plaquenil (hydroxychloroquine) for my Sjogren’s. Somebody from the Sjogren’s foundation had mentioned it way back in early February. At that point I knew it was going to be of some value to the US. I jokingly said to my husband, ‘Maybe I’ll have some protection.’”    ~Brenda 

“It is just us, seems like that is important to note. She talked about taking some steps like sleeping in a different room. But she’s going through enough at work, I’m not allowing any stress here at home. My aim is to keep everything as normal as possible and try to give her a chance to not think about the virus as often as possible.”  ~Thor 

In some families, physician and partner aren’t on the same page about distancing, as this comment indicates:

“I am the one thinking he needs to isolate from us, but he doesn’t think we’re there yet. He’s tested a patient in his office that was positive and he’s working the hospital next weekend. And I’m pregnant. I’m kind of freaking out about him sharing our house with us even though he strips in the garage and heads straight to the shower. I don’t even know what to do. I said we should rent him an RV; we have friends who would loan him one.”   ~Karen 

But numerous families have already begun to isolate the physician from the rest of the family, and are doing this, reluctantly, in a variety of ways:

“I want people to understand what this looks like from the doctor’s family’s side. At least in my area, people don’t seem to be taking this as seriously as they should be. My husband is self-isolating in our basement. It honestly feels a little unnecessary right now because so few cases have been reported where we are, but then I also know that exposure can happen before any symptoms appear. Even close friends who know what we are doing didn’t understand the scope of it until I showed them pictures of my husband playing tic tac toe with my kids on the window with dry erase markers and doing bedtime songs with a wireless speaker so they can still do some of our bedtime routine. We are making it work. The people who have to move to RVs or stay at the hospital have it worse.”  ~Becky

“Hubby is currently living separately and comes over for walks around the block outside.”   ~Chrissy

“My husband left today for a month. It was the only way to keep our son safe. We were lucky that the hospital has a house across the street. They are allowing him to stay there for free. Our son is immuno suppressed which is why he was staying away. Our son has already been gone for two weeks with a friend to keep him safe. At least this way our son can come home.”  ~Annie

“I moved to the basement bedroom. My grown daughter lives upstairs and my husband is quarantined to the master suite and gets meals prepared and delivered there. Originally, I was not going to move out of the master suite so he wouldn’t feel like an island and I’d be there to comfort him because I made vows until death do we part. However, I got sick. I scrubbed that master suite spotless for him and he gets to eat all of the stinky garlicky foods he doesn’t normally eat because it is wife repellent. I cook for him and make smoothies to keep in his yeti cooler on my bathroom counter and check on him regularly to see if he has what he needs. I put fresh sheets on his bed every time he goes to work. He also goes for a few miles walk every day in our forested neighborhood. I make sure that he feels like he is on vacation the best I can. We socialize out in the yard in chairs at least 10 feet apart. The virus is up in our neck of the woods in neighboring towns so probably here. He finally got a new n95 mask yesterday. He has been using the last one for three weeks. We miss each other. But this is only a period of weeks or a couple of months; we should ride this out and stay as healthy individually as we can.”   ~Kathleen

“We temporarily relocated. I’m 30 weeks pregnant with a 2-year old. OB recommendation.”  ~Allie

“I know a family where the physician spouse is staying in a camper in the driveway. His wife and children are keeping their distance from inside the house.”   ~Jimmy

And speaking of campers….someone created a Facebook group specifically for the purpose of connecting camper and RV owners with physicians who need a temporary place to stay while they battle COVID-19 on the front lines. This amazing partnership, between generous folks willing to donate the use of their vehicles to doctors, nurses and other front line health care professionals who are providing selfless care to their patients is called RVs 4 MDs To Fight the Corona Virus.

It isn’t only physicians and physician families who are trying to keep our courageous medical work force healthy and safe. A Canadian magazine has published this handy Front Line Worker Safety Guide, created by Talia Zenlea, MD, to help keep physicians – AND THEIR FAMILIES – healthy. Here’s the graphic, which you can print and keep in your office, home, vehicle – or even in the camper temporarily parked in the driveway, where the physician in the family is isolating himself or herself in order to keep the family safe.

Dr. Holleman shared more wisdom as we discussed the publication of this #PhysicianFamilyBlog:

“I’m afraid this is going to be a very difficult period over the next couple of months. But I’ve also noticed that doctors and nurses feel called to help in these situations, and perhaps ‘thrive’ is too strong a word, but they do perform very well in a crisis!”

Indeed they do. And for ALL they do, we can’t thank our physicians – and their families – enough!

Stay #PhysicianFamilyStrong.