Suiting-Up To Swab For Covid-19

“Turn around,” Dr. Harris says to me. “Let me look at you.”

She instructs me to adjust my mask strap. I take a deep breath in. My mask collapses inward. I have a good seal. I put on my hair bouffant, my face shield. I am ready to go in.

U.C. Davis decided to pull third-year medical students from rotations as the COVID-19 pandemic was quickly spreading coast to coast. Sacramento had issued an order for shelter in place and the Sacramento County Public Health Department called for volunteers to help with their COVID-19 drive-through testing at Cal-Expo. I signed up.

We were trained to don and doff PPE and perform nasopharyngeal swabs. Once we had mastered those skills, we were sworn in as official disaster workers for the State of California.

On my first day, it is 85 degrees outside and I am sweating under the plastic gown before we have even started. I breathe in and become acutely aware that my breath is tinged with the sharpness of the mustard and pickles on the ham and swiss sandwich I had for lunch. I regret not brushing my teeth.

Normally, the State Fair would be happening this time of year at Cal-Expo. Instead of the thousands of people who usually come for the Ferris wheels, concerts, midway games and food only found on fairgrounds, the slow line of cars snaking through the parking lot holds local residents who are anxious about whether they have a virus that has killed tens of thousands nationwide.

National Guard personnel in their army camouflage walk around the premises of the Cal-Expo concrete warehouse that is our base of operations. They are members of the medic team practicing to set up mobile testing sites for COVID-19. I hear the chop-chop sound of news helicopters hovering above. Voices echo across the vast concrete warehouse while orders flow over out of walkie-talkies.

I follow Cynthia, a public health nurse. She coaches me through the nasopharyngeal swabbing as traffic controllers direct cars toward the three lanes that have been set up for testing. There are cars of all types: gas guzzlers with rumbling motors spewing fumes to sleek shiny Teslas.

We motion to the first SUV to come forward then hold out our hands to signal to the driver, a young woman wearing a Sac State sweatshirt, to stop and roll down her window. We proceed to confirm her identity. The young woman says she is scared, and the facemasks and PPE that make us look like we’re in a scene from the X-Files don’t help.

She tells us she is frightened to get COVID-19 because she has a little daughter and an older mother living with her and she has heard from news reports that thousands of people are dying every day from this disease. As we prepare the swab, she asks us if the swab is going to go into her brain.

Cynthia explains the procedure to her and assuages her anxiety. I stick the swab in. When I pull it out, the young woman exclaims, “That wasn’t so bad!” She thanks us and drives off. Cynthia and I peel off our outer gloves, rub sanitizer on the inner gloves, a second skin we wear on our hands, then pull on a new pair of outer gloves.

Our next patient is a middle aged African-American man. He asks us how it feels to get the swab up his nose.

"Well, it is uncomfortable,” Cynthia replies. “It stings. It's like having wasabi in your nose."

He laughs. leans his head back on his head rest, pulls his face mask down to just below his nose, looks straight ahead, and declares, “I’m ready.” I place the swab in his nostril and his face bunches up. As I remove the swab, he starts tearing up.

"Yep, it does feel like what I would imagine wasabi up your nose would feel like," he says.

Most times, the procedure is straightforward and people accept the momentary discomfort of a swab deep in their nostril. But in a few cases, the driver gets confused and is shaking with fear. One woman was unable to state her name without pulling out her drivers license to look at it. Another older woman with frizzy hair jerked away with the swab in her nose, screaming, “I can’t! I can’t! I can’t!” She calmed down after a minute and let me pull the swab out for her.

By the end of the morning shift, we had collected more than 70 specimens. We took them to be inventoried and placed them in foam coolers which were labeled with red stickers emblazoned with the warning: Caution! Biohazard Contaminants.

At the end of the day, my colleagues watch me remove my PPE to ensure I do it properly. I start with a pump of sanitizer. I remove my shoe coverings. Pump of sanitizer. I pull my gown away from me and remove my gloves in one motion so that they all roll off into the bin. Pump of sanitizer. I tilt forward slightly over the waste bin and lift the back band of my face shield, letting it fall into the bin. Pump of sanitizer. I lift the back bands of my surgical mask and remove it. I can breathe with ease again. Pump of sanitizer. I remove the bouffant, loosening first from the nape. It was the last piece.

My face is sore from the pressure of the mask and the back of my scrubs are drenched with sweat. Dr. Harris holds up her phone camera so I can see the red indentations the mask left on my face. She nods encouragingly. I watch Cynthia doff her PPE and we all applaud each other.

I am exhausted and hungry. I decide tonight I will treat myself to a delicious hamburger and fries and a cold strawberry milk shake.

Mara Cao, MS3

June 2020