An ER doctor and elected official, Sharon Meiran balances two roles during coronavirus crisis

Multnomah County Commissioner Sharon Meieran remembers serving on the front lines of a pandemic, working as an emergency room physician during the H1N1 influenza outbreak 10 years ago. As both a physician and an elected official, Meieran wears two hats through this current crisis, and Street Roots spoke with her online to get her perspective on dealing with the pandemic at hand.

Joanne Zuhl: The emergency room at any hospital is already a charged arena, but add on to it increased burdens on health care staff and elevated levels of stress and fear, and it’s a different job entirely. What does your background tell you about what mental impact this has on people who are already medically vulnerable?

Sharon Meieran: This is having a tremendous impact on the mental state of everyone in our community but especially those who are particularly vulnerable. It is hard enough to be worried about where you’re going to live; getting a roof over your head; finding a place to stay; where is your next meal going to come from; trying to manage other vulnerabilities like physical illness, mental health issues, substance use disorder. And throwing the stress and uncertainty of this virus on top of all of that is going to have a huge impact.

And it’s twofold. It’s people worrying that they’re sick, people worrying if they’re going to get sick from the folks around you, and then stress. Stress is never good for you. But that added stress just exacerbates underlying mental health issues or whatever else someone has.

It is really tough for the front-line health care community right now. We’re facing shortages of personal protective equipment. Front line workers are going home to their families and worried about transmitting this. And trying to just do the basic job of caring for people and supporting them in this situation of uncertainty and scarcity of some basic protective gear, and this is really impacting that well-being and mental health of health care workers as well.

(Meieran is working with the personal protection equipment donation group to help collect donations of equipment for health care providers. Scroll to the end of the article for information.)

Zuhl: Emergency rooms are also often the place of last resort for people with no health care coverage or money. This pandemic and the actions involved seem to amplify what it means to be that fragile. What, if any, light do you think this event sheds on our health care system?

Meieran: Some time will tell, because there is such an inundation and there is going to be such an overwhelming use of the hospital facilities that it’s going to be hard to separate who’s who within that.

I think where that might play out is in discharging people who are homeless to shelters. Where do these people go from the hospital? I think that’s going to be a really important aspect of this to be following. Because I don’t think we have nearly the resources we need, and I think that situation is really going to be exacerbated and we’ll need to be following that.

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Zuhl: It’s got to be very challenging, where your whole job is defined by your responsibility to the people, and this is a time when people, in general, need things the most.

Meieran: That is what has been the most challenging about this whole crisis that’s been unfolding, is that as an elected official, I do have a unique background having that experience in the emergency department and that kind of medical training and how we approach epidemics and pandemics and medical crises, and so my role and expertise on that as a physician is very different from what the role is as a local elected official.

As an emergency physician, at least on a one-on-one situation, we hopefully know the right thing to do and make the decision and act on that and have that control. As a local elected official, we do have this immense pressure and recognition and responsibility at the county for the most vulnerable in our community, but we have a very low level of information that we would need, or role in decision making. And so balancing those roles is extremely difficult.

Zuhl: There’s lot of activity in the city center, expanding shelter bed space, for example. What’s happening outside of the city center? There’s a lot more to the county than Portland.

Meieran: Absolutely. Just to clarify, the Convention Center and Charles Jordan Community Center — and there will soon be a place opening in East County — this isn’t increasing overall capacity for shelter beds in our system. This is allowing for the physical distancing that we know slows transmission of the virus. Clearly we need to be doing that throughout the county, and people are working on this day and night to figure out how we can expand that space for people throughout the county not just in the downtown area.

Zuhl: Is there talk of expanding actual capacity overall?

Meieran: There is talk about expanding capacity, and the question is in what way and for whom and to what extent; whether it’s in the county, or a more regional approach; and then how that ties into hospital systems and discharging people who are homeless who may have symptoms of coronavirus.

My personal feeling both as a physician and a commissioner is that we need to be not only increasing the physical distancing space for our existing capacity, but we need to expand capacity, and we have the potential to do that in some creative and some alternative ways that can really reach people that are in the community that need help.

Zuhl: Is there an opportunity here to do more than just address the pandemic concerns? It sounds like maybe this pandemic event has opened up dialogue to spark new approaches to addressing and helping solve homelessness in our community. Is that a fair statement?

Meieran: The hopeful optimistic part of me would agree with that statement. I think that right now everybody is in such crisis mode that it’s hard to step back and see how this could play out in the future. But what our approach to this pandemic is showing us in a lot of ways is that there are lots of things that we can do that we thought we couldn’t, or that the hurdles were too great, or it was so bureaucratic that it couldn’t be done. And what this has shown us is we can have some creative approaches to that, actually it can be done, and we can decrease our jail bed use, and things like that.

I hope that as we move through this from crisis mode and looking at the impending storm that we will have new relationships and ways of thinking about things that could expand our approaches once we get back to some semblance of normalcy.

Zuhl: There has been some concern from county staffers about being asked to volunteer at the homeless shelter additions. What are your thoughts on that?

Meieran: No one should be required to work in conditions that are not safe — period. So to the extent that we are able to provide the appropriate protective equipment and the appropriate social distancing, et cetera, that is one aspect. The second is determining who is going to be doing this work. Ideally, we would be calling on people who would volunteer, people who would be less likely to have concerns about transmission, et cetera. It is a very complex process of addressing staffing even in the best of times, and right now I know people are working on this at the county very diligently. People who are asked to work are a.) being asked and b.) their decisions are being respected, and if they choose to work at these facilities, they are protected.

Zuhl: What do you think of how the federal government is dealing with this?

Meieran: What’s a word worse than pathetic? Reprehensible. Unconscionable. We have been on notice that this pandemic would be affecting us in the United States really since it started in China. I do get frustrated a lot with hearing people say this is something brand new that we never could have foreseen. China might not have been able to foresee it. We are able to foresee it. And to have abdicated the responsibility to prepare for this and take the appropriate measures that could have been taken is, like I said, unconscionable. We could be forcing the supply chain to be producing the personal protective equipment, the ventilators, et cetera, that we know will be needed to care for people. We need an economic recovery program that is going to be effective to support people and their livelihoods as we recover from this unprecedented event. We know that we have to have preparations for surge force in our workplace as people become sick. We have none of that and instead have obfuscated and denied, and then acted too little too late. That is how I feel about the federal response.

(Editor’s note: This story was updated to remove inaccurate information regarding the new shelter space opening in East County. Information was removed to avoid confusion regarding the number of beds and clients served at the new facility.)

DONATIONS

A collaborative volunteer and donations management unit has been established between the city of Portland and Multnomah County to coordinate COVID-19-related donations and volunteers. Offers of assistance can be communicated through the Volunteer and Multnomah County Emergency Operations Center.

Up-to-date donation information is available through the Multnomah County website (as well as questions about donation sites, hours, etc). These donations will be distributed based on life safety priority and to fill resource requests submitted that due to scarcity of supply were previously unable to be filled.

DONATIONS ARE ACCEPTED AT:

Portland Fire & Rescue (Fire Marshal Office, 1300 SE Gideon St., Portland)
Noon to 4 p.m. Monday through Friday

Multnomah County (Multnomah Building, 501 SE Hawthorne, Portland — loading dock on Sixth Street)
9 a.m. to 4 p.m. Monday through Friday
10 a.m. to 2 p.m. Saturday and Sunday

Yeon Building (1620 SE 190th Ave.)
8 a.m. to 5 p.m. Monday through Friday
(See instructions on the drop box located outside of the building.)

More information about donating is available on Multnomah County’s website.

Email Executive Editor Joanne Zuhl at joanne@streetroots.org; follow her on Twitter @jozuhl