Julio Torres M.D., F.A.C.S. is an Otorhinolaryngologist and Head and Neck Surgeon with a practice based in Miami-Dade Metro Area in Florida who is on the frontlines during this COVID-19 pandemic. Dr. Julio Torres’ practice remained open during a portion of the pandemic stay-at-home policy that was in place in light of Florida Governor Ron DeSantis Executive Order 20-91 since the State of Florida recognized healthcare practices as essential businesses consistent with the U.S. Dept. of Homeland Security Guidance on the Essential Critical Infrastructure Workforce, he closed for a period of time to protect himself, his co-workers and his patients and prepare to operate under the “new normal” of COVID-19. Dr. Julio Torres has worked in several South Florida hospitals and has contact with other health providers including nurses and physicians throughout the medical field.
1. How do you feel the medical field is handling COVID-19 pandemic?
Dr. Torres’ perception is that the “medical field is doing a terrific job throughout the United States in treating and combating the COVID-19 virus,” despite reports that the United States is among the countries leading with the most cases and deaths due to COVID-19 in the world. Dr. Torres explains, that despite the U.S. having many COVID-19 cases the U.S. “has per hundred thousand people in the United States, has one of the lowest ratios in the world.” Dr. Julio Torres discussed that he had expected there to be a larger amount of deaths in Miami than the actual number of cases. Further, he explained that the medical field expected there to be more deaths in the United States than the present numbers demonstrating the success of the medical field’s approach to this pandemic.
2. As a doctor, in your opinion have you experienced hospitals or medical practices struggling to provide care yet needing resources?
Dr. Torres discusses, “that is a very serious problem. Personal Protection Equipment or PPE is in high demand and we could use more.” Dr. Julio Torres shares the reason for the lack of PPE. He explains that the reason for the low availability of PPE is because China is one of the main manufacturers of PPE. Once the outbreak of COVID-19 began China began to limit the amount of PPE distributed to the rest of the world which began to create a shortage. Dr. Julio Torres discussed that the PPE shortage really impacted the medical field especially medical providers such as nurses and physicians that had to treat patients without the optimal protection necessary under these circumstances and without the knowledge that the patients might have contracted the COVID-19 virus which resulted in an increased number of deaths among medical workers in the field.
3. What are some difficulties you have encountered with continuing to practice during the COVID-19 pandemic?
Dr. Torres states the most glaring difficulty is the lack of Personal Protection Equipment. As a doctor focusing on the care of patients with ear, nose and throat issues, he consistently sees, “patients with symptoms such as runny nose, sore throat, and cough. It is unknown to [him] when they arrive whether the patient is suffering a cold, sinus infection, strep throat, tonsillitis which are common reasons for visits to [his] office or whether the patient has COVID-19. [They] are taking patients temperatures, but a patient might present to [his] office without a fever thereby [he] cannot focus on a high temperature reading alone to determine if it is COVID-19. [They] do not have a rapid test such as for strep throat or flu. COVID-19 is highly contagious Personal Protection Equipment is essential in order for [him] to see patients.” Dr. Torres explains that it is likely that he as well as the vast majority of physicians and healthcare workers across the country have been incidentally exposed despite high levels of precautionary measures since COVID-19 testing was not readily available until late March or early April and is still not as available as necessary to protect the healthcare workers.
4. What are the signs and symptoms of those ill with COVID-19?
Dr. Julio Torres discusses that for all that have had COVID-19, it is terrifying because of the chance of having difficulty breathing or developing pneumonia or dying. Those that are candidates for testing for COVID-19 need to wait up to 7 to 8 days to receive test results. For anyone that thinks they might have COVID-19, waiting for results with no treatment could lead to the illness progressing to the point of being fatal. Dr. Julio Torres discusses that “80% of people recuperate, 20% might develop major complications, and anywhere from 12% to 13% can actually die.” Some people are candidates for early treatment but others that are asymptomatic might not receive treatment while waiting for a test result. A sign that some COVID-19. Dr. Julio Torres shared that some people lose sense of smell which is an early symptoms of COVID-19. Dr. Julio Torres explains that the reason COVID-19 is so terrifying is that one does not know if you are the lucky 80% that will recover or the 20% that needs to be hospitalized and may potentially die. Other signs of of COVID-19 include constantly being extremely tired, no appetite, and not being able to taste food.
5. What were some struggles for those medical professionals being affected with COVID-19 and later returning back to the medical practice or the frontlines in hospitals?
Dr. Torres closed his medical practice after the stay-at-home order closures recommendations were issued for elective medical care because he found that the PPE he sought to purchase and use to be most protective for his staff and patients was completely unavailable. He did not want either his staff or himself examining patients that might have COVID-19 without proper protection. He closed his office for two weeks. Dr. Torres recounts that he felt like he needed to treat patients despite the risk of contracting COVID-19 because it this was “his war” that he was thought to fight in medical school and in his career there had not been any pandemic to this degree. However, closing the office was quintessential because he felt like he was, “going to war without any bullets.”
6. What were some difficulties that came with having family members living in your house while you were still seeing patients and at risk for contracting COVID-19?
Dr. Torres recounted that everyone in his home, including this wife, maintained social distancing including sleeping in different rooms, utilizing different bathrooms, and eating in separate areas. For maximum protection, he chooses to eat meals outside on the porch of his house and use different silverware and plates than his other family members. He maintained a distance of 6 feet or more from all family members at all times. Anyone in his home uses masks and gloves at all times in his house. Many of his colleagues in the healthcare field are doing the same. Luckily no family members in his household contracted COVID-19. However, he has not been able to see his mother since early March that is a resident at an assisted living facility due to the strict protective measures to protect assisted living facility residents from contracting COVID-19. He also has not been able to see his out of state family members.
7. What is your opinion on government involvement during COVID-19?
Dr. Julio Torres views the “United States as a victim of the lack of transparency of other countries specifically China.” He continues, “in the scientific world when you make a discovery of a disease or a cure of a disease you are suppose to ethically disseminate the truth and warn everybody so the other countries and mankind will benefit.” Dr. Julio Torres opines that China’s lack of transparency does not only affect the United States but has also hurt the entire world.
8. How did COVID-19 impact your practice?
Once the government issued the stay-at-home orders and the number of testing increased reveling the numbers of those impacted by the pandemic, the number of patients begins to decline. This resulted in many medical practices having to temporarily furlough employees while practices were closed. However, generally, the United States given the situation, is done very well and much better than many countries in the world.
9. What is your perspective on the issue of occupancy in hospitals?
Dr. Torres shared that the medical industry knew there would be more issues with greater population densities such as New York City when combating any communicable disease equipment that can be necessary in critical cases of COVID-19 include ventilators. Dr. Torres discusses that in his home state of Florida they have adequate number of hospital beds to met demand and they have an adequate number of ventilators, but testing is slow which remains an issue.
10. The government is aiming to begin lifting stay at home orders do you believe this is the best for the United States?
Dr. Julio Torres explains that the need for the stay-at-home order was to socially distance people especially in dense communities, make testing available, and allow time to develop treatments or vaccines. However, he believes that beginning the lifting of the stay-at-home orders is “reasonable and makes sense to open certain areas depending on the incidence of the disease.” Dr. Julio Torres compared the incidence of the COVID-19 cases in Italy and the age of the population as compared to the United States. Despite Italy is a smaller country, the number of cases was high and the average age of the population was older thereby impacting how orders would be handled. In the U.S., there are states that have had very few cases of COVID-19 and in many residents’ point of view, the economic impact of staying at home and not working outweighs the risk of contracting COVID-19 where there are so few cases. Dr. Torres states even in areas with a low number of cases, or areas that lift the stay at home orders, people still need to follow precautionary measures such as safer-at-home, continue social distancing, washing hands, and taking other the necessary precautions but he states, “it makes perfect sense to open certain areas to get the economy moving again depending on the prevalence of the COVID-19 cases.” Healthcare works will continue to be in the frontlines, providing care for those impacted by COVID-19.