From the Marine Corps to the medical field, Onur Yenigun has exemplified a commitment to service in remarkable ways. A first generation American, Yenigun was the child of a Turkish immigrant and though he always knew he wanted to be a doctor, first, he wanted to give back to his country.
He served in 1st Battalion 5th Marines after telling his recruiter he "wanted to get his butt kicked." After his service, he used the G.I. Bill and graduated with highest honors from UC Davis, before attending medical school at UC San Francisco.
Now, he's in his third year of residency in the ER of Stanford Hospital, fighting on the front lines of a new threat: COVID-19. I had the chance to talk with him about the virus, what it's like for our medical professionals right now, and why it's still important to "flatten the curve."
Here's what he had to say:
WATM: What is your job like right now?
Yenigun: It keeps changing because we're learning new things all the time. Our overall volume is down. There are fewer patients -- but the ones that do come in are sicker. People who are sick keep waiting it out at home because they're afraid to go to the hospital so when they do come in, they're really sick.
And then there's more overall fear in the hospital. I used to greet my co-workers with a hug and now we can't do that. We're a close-knit family and that camaraderie means a lot to me, so it's really hard to not be able to high five everyone. One of the interesting things about it, though, is that usually our [attending physicians] are the ones doing the teaching, but due to the nature of the virus, we're all learning together. We're growing together and I like that aspect.
WATM: What would you say to citizens who are putting off health treatments because of the virus? When should people go to the hospital?
Yenigun: People should call their doctor for advice. A lot of out-patient visits are shut down, but physicians are still pretty accessible and they can give medical advice.
Anyone with serious symptoms should come in, but if someone feels like their symptoms are manageable at home then they can safely do that. It is risky to come to a hospital if someone doesn't need to be there — not just because of COVID-19.
People's primary care doctors are still a really good resource.
WATM: What treatments have been effective for patients with COVID-19?
Yenigun: Supportive therapy is still the most effective right now. There are a lot of drug and vaccine trials and antivirals being studied right now but if you were to come into the hospital today with COVID, the major things would be supportive treatments: administer oxygen, control fevers, monitor symptoms, and intubate when necessary.
WATM: Is your hospital doing proning?
Yenigun: Proning is something that has been around for so long. Proning has been an effective treatment for patients with bad lung diseases like ARDS [acute respiratory distress syndrome], which is what we call the syndrome these patients are getting with bad COVID. It's not always effective, but in certain cases it can improve outcomes.
WATM: What kind of recovery rate are you seeing for COVID-positive patients?
Yenigun: The majority of patients I see are healthy enough to be discharged and they go home to get better. I don't know the exact percentage, of course. I have seen some very sick people who end up in the ICU. Most of them have been elderly or they've had risk factors that we know lead to more serious infections. The big four that we know about are diabetes, hypertension, obesity, and lung disease, so when we see COVID patients at higher risk then we monitor more closely.
WATM: What does the hospital do to help prevent COVID-19 from spreading to patients/staff?
Yenigun: Even just to get into our hospital, staff members have to get their temperature checked. People with fevers have to go home. We also have very strict policies with regards to our PPE [personal protective equipment].
For patients, we can see many who are less critical in a drive-through outside and they will "iPad in" — we can tell a lot about a person from looking at them. Looking at you, I can tell that you're breathing comfortably, that your color is good, that you can talk easily. I can tell that you don't have a bad respiratory condition. We could swab you, you could go home, you could call in and get results.
For patients who are "persons under investigation" or that we think might have COVID in the hospital, we try to place them in negative pressure rooms. We also have HEPA filters in the rooms that are purifying the air. Anytime we go into those rooms, we wear full protective gear: gloves, N95 masks, goggles.
We're fortunate now to have a rapid test so we can quickly determine who has COVID and who doesn't so we're able to separate COVID-positive patients from other patients.
WATM: Why is social distancing and "flattening the curve" important?
Yenigun: I don't really like the term "social distancing" — I prefer "physical distancing" because I don't think anyone should be forced into complete isolation, distancing themselves from the people they care about most in their social circles because that's going to lead to a whole host of issues surrounding mental health.
It is important, however, to reduce the number of infections at any one time. The whole point of flattening the curve isn't necessarily to reduce the number of infections — it's to reduce the number of infections at once.
The worst thing we could do is have everyone go out and spread this thing like wildfire; suddenly everyone would present critically ill, flooding our emergency department. Many would need to get intubated, we would run out of ventilators, the ICU would fill, and then people would die in the waiting room. That's our biggest nightmare — we don't want people to die.
The whole point of distancing is to provide time for this virus to trickle through the population. The people who are going to get sick will get sick, but it will be manageable for hospitals. We'll be able to take care of them and save as many lives as we can.
That time will also give us the opportunity to run these clinical trials and develop vaccines.
WATM: Have you seen any cases of reinfection?
Yenigun: I haven't seen any reinfections. There has been talk about reinfections overseas, but we haven't seen anyone personally who has gotten sick, gotten better, then gotten sick again here.
WATM: Are you worried about getting the virus?
Yenigun: I'm not too worried about my own personal well-being. I don't think I would get critically ill. I'm more worried about the fact that I interact with multiple people and patients every day. I don't want to pass it on to other people.
WATM: What is life like for doctors and nurses right now? What's your work-tempo like and how is morale?
Yenigun: Work hasn't necessarily increased because we're able to manage the patients as they come in. I've personally been able to volunteer with Team Rubicon to staff a convention center here we've turned into a medical respite. I've had a lot of 24-hour days, but this is what I love and I'm happy to do it.
As far as morale, our community has really come together. We've been getting donations of food and snacks and letters from grateful locals. We had a great Black Rifle Coffee Company donation — shout out to those guys. Our staff has Zoom social hours. I put together a Zoom work-out for nurses and staff. We've found ways to come together.
WATM: What can people do to support hospitals and people in the medical field?
Yenigun: Everyone in health care would really appreciate it if everyone can just take measures to stay healthy. That's what's going to get us through this in the long run — that's how we're going to end these lockdowns. Wash your hands. Stay healthy. If you feel like you just have a cold, stay home. Unless you become afraid that you cannot manage the symptoms, you might be safer at home.
WATM: What are the benefits of taking an antibody test?
Yenigun: If you have been exposed, even if you were asymptomatic, you should have developed antibodies. In most cases, when you have antibodies for an illness you're most likely protected from it. We can't say that for sure about COVID-19. Antibody testing is interesting from an epidemiological perspective, but it might not necessarily mean anything conclusive for individuals yet.
WATM: Finally, and this is arguably the most important question, there's an article about whether COVID-19 could be spread through farts...would you like to comment on that, Doctor?
Yenigun: Oh god…
WATM: I just want people to stay safe.
Yenigun: Do I think it could be...spread through a fart?
Yenigun: They have isolated the viral RNA in stool but that doesn't necessarily mean it could be passed fecally…still, this is probably where common sense and courtesy come in.
WATM: Thank you for that and, sincerely, thank you for your continued service.
I really appreciate you taking the time to talk to me, too! Thank you.
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