Why Psychiatric Wards Are Uniquely Vulnerable to the Coronavirus

B. spoke to me by Zoom from the car parked outside their house—we couldn’t talk when B. was at work, or inside the house, where B.’s children were playing. B. has also used the car to Zoom with colleagues about trying to devise safety protocols for their workplace, because those, too, are conversations B. can’t have at work. B. is the medical director of an inpatient psychiatric unit in a small hospital within a large for-profit network. The hospital’s administration, B. told me, was not permitting doctors to wear their own N95 masks or other protective equipment, even though the hospital had little equipment to issue. Nor were doctors able to test or isolate patients with suspected cases of covid-19. Psychiatrists, B. told me, were still being required to appear for in-person consultations, when remote communication would have been possible and safer. There was no way and no real effort to enforce physical distancing, B. told me. Patients could be isolated only once they were symptomatic and had tested positive, but patients with whom they had been in contact continued to intermingle on the ward.