Nurses, doctors and other medical professionals face hazards in coronavirus pandemic

The coronavirus pandemic confronts physicians, nurses and others with a time-honored dilemma: We have a social contract with society to provide health care in both good times and bad, but what about our own health in the face of infectious pandemics?

For most of the past 100 years, times have been good. Antibiotics and public health interventions have kept the American public generally healthy. Today, the major killers are chronic diseases such as diabetes, heart disease and cancer. Infectious diseases like tuberculosis, polio and 1918 deadly influenza pandemic have not posed serious public health threats. Chronic diseases do not pose a threat to health workers the way infectious diseases did.

Enter the new coronavirus, also known as COVID-19. Over the past 40 years, the world has been challenged by a series of new infectious disease threats – like HIV, SARS, Ebola, MERS and the coronavirus – that threaten the public’s health and can place health care workers at a higher risk of contagion.

Must health care workers assume a risk to their own health to assure that patients receive care? If we look at history, the answer is clear. Not long ago, 10 percent of each medical school class would develop tuberculosis. In the early 20th century, hundreds of doctors and nurses died from the 1918 flu epidemic while caring for sick people. The same was true for those caring for people infected with Ebola in 2014.

I recall that in the early years of caring for HIV infected patients, and in covering the HIV epidemic for National Public Radio, I met providers who refused to care for HIV-infected persons. These providers acted partially out of fear, but some acted out of hostility toward HIV’s victims: gay men and drug users. The stigmatized people received inferior care.

During an epidemic – or what has now been officially called a pandemic – if all providers get sick, it would be a disaster for current patients. It would also be a disaster if health care providers refused to come to work out of fear of getting sick.

What would it be like if a firefighter was only willing to fight small, safe fires? Or if police officers would only respond to parking violations out of fear for their own safety?

Of course, we should not ask health care providers to assume risks to their own health unless everything is being done to minimize those risks. Today, we have protective wear that we didn’t have a generation ago, such as masks, gowns and disinfectants.

We also have powerful medicines and ventilators that increase the chance of people surviving. But we rely on health care providers to accept some personal risk and demonstrate a moral commitment by adhering to their social contract that provides for a duty to treat.

Medical, nursing, social work, dentistry and other health science trainees need to be reminded that, at times, their profession is associated with personal risk. This is why society trusts and respects us. Medical students understand the inherent personal risks when they arrive at medical school and they are reminded of those risks in our opening ceremonies that welcome them to the profession.

The public depends on our commitment to put their welfare above our own. People rely on our commitment to provide unbiased and compassionate care, and on our willingness to place ourselves at some risk by simply coming to work (with all reasonable protections).

My colleagues at UC Davis – and in the medical field in general – are standing tall in this health crisis, and they are united in their commitment to providing care to those in need.