After long shifts treating covid-19 patients in New York hospitals, emergency room doctor Calvin D. Sun goes home and works for another 45 minutes. He cleans. He peels off his shoes, scrubs his jacket and places his protective suit outdoors to bake in the sun. Finally, he takes a shower, hot and scouring, to eliminate any microbes that could cling to his body like invisible thorns.

This new homework is as stressful as it is tedious. A misstep could mean spreading a coronavirus infection to a loved one. “Even with 30 to 45 minutes of prep, coming back home and doing all this, I still am worried I screwed it up in some way,” said Sun, who shares an apartment with his mother, who has Parkinson’s disease.

Across the country, exhausted health-care workers have changed the rhythms of their daily lives — sleeping away from their families and performing meticulous cleansing rituals — to protect family members and roommates and keep the pathogen contained behind hospital doors.

Some avoid going home altogether because they live with elderly or immunity-compromised relatives.

About 200 doctors, nurses and other medical personnel are staying at the Four Seasons Hotel New York, for instance, which has pared down its thousand-dollar-a-night rooms to function as a medical dorm, said a spokesman. Hotel staffers check the temperature of each clinician entering the hotel. Instead of dining on room service, guests take boxed meals to their rooms. Bathrobes, extra pillows and throw blankets were removed to reduce the number of items that could be touched.

The novel coronavirus is a giant magnifier of concerns about infection. More than 9,000 U.S. health-care workers have tested positive, according to the Centers for Disease Control and Prevention.

Experts believe that household infections — in which family members or roommates transmit the microbe — could be responsible for the covid-19 spikes in Spain, Italy and other countries where the isolation of sick individuals was uncommon.

“There is a tremendous amount of fear and guilt that we could bring this home and hurt people that we love,” said Jane Gerencser, a nurse who has been working 12-hour shifts tending to coronavirus patients at a Westchester Medical Center Health Network hospital in New York state. “We have had colleagues who lived with elderly parents, who unfortunately have gotten sick and have had their parents get sick and passed.”

Sun, a physician who described himself as a “gun-for-hire” filling staff shortages at New York City’s public hospitals and other emergency departments, said that by the end of March, each shift had become potentially a “mass casualty-level” situation. Loudspeaker calls for a “rapid response team,” signaling that a patient had gone into cardiac arrest, came once per hour during his 12-hour shifts.

The number of new coronavirus cases appears to have plateaued in New York thanks to strict social distancing, stay-at-home orders and the closures of many businesses. The rate of new hospitalizations has slowed. Now, a few times an hour at the Montefiore Medical Center in the Bronx, the intercom plays the Jay-Z and Alicia Keys song “Empire State of Mind” — signaling that another coronavirus patient has been discharged.

But the toll on health-care workers remains. “I’ve intubated my own nurses. We’re getting down to where we keep taking care of our own. …. We’re dropping like flies,” Sun said.

Before he leaves the hospital, the doctor removes his protective suit in a cramped break room — or outside, on the sidewalk, if it’s late and “nobody’s watching” — and stuffs the gear into a plastic bag. He throws on a ski jacket. He wears a mask and glasses until he leaves the hospital, then he hails a ride by Uber or Lyft.

At home, in one of New York City’s prewar walk-up apartment buildings, Sun removes his shoes in the hallway and then cleans his gear, scrubbing his mask or heat-treating it in the oven so it can be reused. He takes the white hazmat suit, also called a bunny suit, out of the bag and places it outside, where it joins a rotating set in the sunlight.

(Sun cycles through his own supply of 11 donated suits, extra protective equipment hospitals permit him to wear because he works as a per diem physician. “This is not normal. I don’t think many doctors have a college friend that buys them chemical bunny suits,” Sun said.)

He showers, taking particular care to scrub his hair, which might still have “virus floating on it,” Sun said. No part of this ritual is perfect. “I’m still at risk,” he said.

Gerencser, the Westchester Medical Center nurse, changes out of her hospital clothes in her garage, where she cleanses the inside of her car with Lysol and sanitizing wipes. She places the clothes in the laundry hamper.

“I immediately go take a shower and scrub up from head to toe, before I talk to anyone, speak to anyone, touch anyone,” she said. She and her husband, who also works in health care, are sleeping in separate beds as a precaution. “We’re trying to stay apart as much as possible.”

Gerencser said she considers herself “fortunate” to have a garage where she can change. Some of her colleagues live in apartments so small that, to protect the other people living there, “they will sleep on the kitchen floor.”

Not embracing her small children has been difficult for Ruthie, a New Jersey clinician who spoke on the condition that her last name not be published to avoid identifying the nursing home where she works. When she arrives home, she strips her clothes off at the door and places them in a bag. “It’s an ordeal you do,” she said. “A whole routine.”

Her children are afraid for her, but she cannot console them. “They’re scared. They can’t hug me when I come home,” Ruthie said. “They’re scared about stuff coming home.”

For some health-care workers, going home is not an option. An emergency room doctor who went to volunteer in Manhattan and stay at his brother’s apartment told the New York Times that the co-op board banned him from the building, afraid he would bring the virus in.

Hotels have opened their rooms to provide local and visiting hospital staffers with much-needed space to rest. When Cayuga Medical Center, a 200-bed hospital in Ithaca, N.Y., sent 60 critical care clinicians and support staffers to New York City last week, they were put up in the Sheraton in Times Square. Each day, those relief workers take a shuttle to New York-Presbyterian hospital.

Sun said U.S. hospitals should look to other countries for ways to protect workers at the end of shifts. “In China, they spray you down with Lysol, bleach, water. Every time you walk out of the hospital, it’s a free shower,” he said.

“What do you think is going to happen after covid-19, when people have died, your friends died, your nurses died? You are like, ‘Should I even go back to work?’ That’s how I feel when I take off my clothes,” Sun said. “All this, for the 45 minutes, that’s going on in my head.”

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