Iowans should wear masks to protect and respect others, says Iowa ER doctor

On Sunday evening, Des Moines Register editorial writer Andie Dominick caught up again with Dr. Tom Benzoni, an emergency room physician in Des Moines. This is our fourth interview with him since the novel coronavirus pandemic hit Iowa. Here are previous installments from March 31, April 28 and May 12. Below are edited excerpts from the interview: 

What are you seeing in the ER now? 

I’m starting to see more cases I suspect are COVID. I’m also seeing interesting breaks in the larger health care system. We are seeing more and more people who can’t be seen by a primary care doctor and there’s only one place they can come: the emergency room. 

People are worried they have the new virus and they want to come in and get tested. I can only tell them (that) if you’re admitted, I have to test you, but they have to understand the test may not be back while they're here or maybe in a week, and the test results may be wrong about 30 percent of the time. If you have signs and symptoms, you probably have it, and I can’t give you anything to treat it anyway. 

Did you ever get your personal coronavirus results from Test Iowa? 

No, I never got a result. I was among those tests apparently lost or damaged. 

That’s troubling. What are you thinking about Test Iowa? 

They should be open about the reasons for moving site locations. Are they going to stop testing someplace because it’s a hot spot and they know they’ll find more cases? What’s going on now seems strange. I want to believe they’re moving sites to the areas where the state has no data. But just go ahead and say that. The failure to be open and honest means people fill the void with any kind of information.

What advice do you have for Iowans as businesses open?

Wear a mask to protect other people. The mask helps to keep my spit from going onto someone else. Wear one out of respect for others. Wash your hands, don’t share cups, don’t pick your nose. 

Do you wear a mask outside work? 

Yes.

What is the safest type of mask for the general public? 

If you take a cloth and hold it up to a bright light and you can see light through it easily, add another layer. Place pantyhose over it. If you have a cheap mask that doesn’t filter well, add pantyhose to it. It may be the static electricity or pore size, but layer it over the mask. 

Have you gotten a haircut?

My wife cuts my remaining hairs. 

What about going to a restaurant or church?

Pull up the mental map and think of sitting next to a kid who is coughing and sneezing. How far away would you sit? Spit carries at least six feet. And who generally goes to church? Older people. When you sing you certainly belt out a lot of stuff. The next time you sing put up a piece of plexiglass and look at it. The virus will tend to spread very well at a church.

How long should someone quarantine after testing positive? 

Ten days after your last symptoms, with one important caveat: Keep washing your hands. The virus can linger in the system for up to six weeks. 

Can you describe a patient who presented to the ER with COVID? 

I had a lady 10 years younger than me, short of breath and her CT lung scan lit up with ground glass, completely consistent with COVID. To know that I’m standing at the crossroads for this person is difficult. Because I work in the ER, I very rarely find out what happens to a patient like that. 

In studying COVID, what new information is being learned? 

We are learning a lot more about blood vessels. 

Your blood vessels have three walls: the outer layer, like a brick, the middle muscular layer, and the inner lining with a slick surface of blood can slide through smoothly. The virus attacks this wall and blood clots form all over the lungs. The lungs are responding to these tiny blockages by growing new vessels around the blood vessels. They’re bypassing the air sacs, so likely not carrying oxygen.

Are those new vessels weaker? 

Yes, weaker. It may be why we’re hearing of athletes who still can’t walk two blocks without getting short of breath. 

How are staff at the hospital doing? 

In the beginning of this, everyone was terrified of COVID patients. Now the staff is much more matter of fact. They wear protection, respect the virus and take good care of patients. 

It reminds me of the HIV days. Boy, we screwed that up, being terrified of people with HIV. 

Now that a little time has passed, is more known about the mortality rate of this virus? 

The COVID death rate is about 10 times higher than seasonal flu.