Michael Suguitan / Sun Staff Photographer

Cornellians and the greater Ithaca community joined the nation in protest against racist police brutality in a march from Ho Plaza to the Ithaca Police Office on Wednesday, June 2.

June 3, 2020

An Emergency Department Doctor’s Tips for Protesting During a Pandemic

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In the days following George Floyd’s death in police custody, protests erupted in over 140 cities across the U.S. While the majority of these protests are peaceful, protesters must consider certain health risks including exposure to tear gas, bleeding, blunt trauma and exposure to COVID-19.

To ensure everyone is as safe as possible, individuals can take multiple measures to protect themselves and other protesters. The key to safely demonstrating is wearing appropriate clothing and protective equipment, and removing oneself from dangerous circumstances when necessary, according to Dr. Radhika Sundararajan, an emergency medicine physician at Weill Cornell.

“There are a range of possible exposures that can happen when you’re protesting depending on where you are and what use of force you are experiencing,” Sundararajan said. “Most broadly, irritants are probably the thing that affects the largest number of people because these are potentially airborne chemicals that can spread over a lot of space very quickly.”

To prepare for these various risks, protesters should pack items that can protect against viral infection and airborne chemicals, along with other items that can effectively treat injuries.

Protest First Aid Infographic

Individuals going to protests should wear masks and goggles if possible, according to Sundararajan. Masks that cover the mouth and nose are necessary to prevent a second spike of COVID-19 cases. While N95 respirators are ideal, they should be reserved for healthcare workers.

“For the purposes of being involved in a demonstration or mass gathering just having something that covers your face, like a cloth or surgical paper mask, is adequate,” Sundararajan said. “The thing about any mask is that you probably need to have more than one, because if that is contaminated or gets very wet — for example when people are crying or yelling or it gets body fluid or some sort of irritant on it — then you need to change it.”

Goggles can protect from COVID-19 and exposure to irritants like tear gas and pepper spray. Police in cities nationwide used tear gas and pepper spray to disperse crowds of protesters because they cause irritation to the eyes, skin and respiratory tract.

These sprays can increase the risk of transmission of COVID-19 because irritation in the eyes causes people to touch their eyes and face, and transmission of the virus is particularly high through the mucus membranes of the eye, Sundararajan added.

As a result, many protesters are using milk to neutralize irritation in the eyes, but Sundararajan cautioned against this practice because it directly exposes bacteria in the milk to the eyes.

Sundararajan and other emergency department doctors use water with small amounts of soap — specifically baby shampoo — to treat eye irritation. For skin irritation, the most effective solution is copious amounts of water to wash out the irritants, and if possible, removing any clothing that could have these chemicals on them.

Sprays — like tear gas and pepper spray — are often oil based, allowing them to spread easily from clothes to other surfaces, while prolonging the irritation individuals experience. The easiest way to reduce skin irritation is to wash the affected area with plenty of water and to remove any articles of clothing that may have these chemicals on them.

“If possible bring a spare change of clothes, if you do need to decontaminate it helps to be able to just take off the clothes that have been exposed,” Sundararajan said. “It may just be a question of wearing layers, so you can take outer layers off if you feel those layers have been contaminated in some way.”

Those that wear glasses or contact lenses should wear glasses when going to protests because contact lenses prolong the irritants’ exposure to the eyes — making the effects more severe.

It is also important to keep one’s hands clean to prevent contracting COVID-19. Sundararajan encouraged protesters to frequently use hand sanitizers instead of gloves. Wearing gloves without frequently removing and replacing them spreads pathogens. However, gloves are useful when offering assistance to others because they prevent contact with blood or other bodily fluids.

A full first aid kit can also be helpful, but Sundararajan stressed the importance of having some form of gauze on hand. When someone is bleeding, one must apply pressure on the wound — gauze can be useful in covering wounds because it gives a surface to apply pressure on.

Additionally, protesters should be conscious of their location. Generally, Sundararajan recommends covering as much skin as possible with clothing — it will protect individuals from the sun and the environment. But for those in warmer areas, wearing layers of clothing may not be possible.

Sundararajan also encouraged protesters to bring water not only to disinfect areas, but so they also stay hydrated to prevent heat strokes and heat exhaustion.

Violence has broken out in some areas, causing injuries to protesters. Sundararajan said protesters should distance themselves from potentially dangerous environments before seeking medical attention.

Two of the most common types of injuries after exposure to irritants are bleeding and blunt trauma.

If an individual is bleeding, they should use copious amounts of water and apply pressure to the wound to stop bleeding. Water from a tap is ideal because it applies pressure on the wound while cleaning out any present debris.

Some skin wounds will heal on their own, but if there are foreign bodies in the wound, they should be examined in an emergency room setting, Sundararajan said.

It is also possible for a protester to find someone else’s blood on themselves. In this situation, the primary concern is the transmission of diseases like hepatitis, Sundararajan said. People should thoroughly wash off the blood as soon as possible.

Blunt trauma, or an injury caused by the impact of an object, can be dangerous, depending on the location of the trauma. With blunt trauma, the main concern for protesters are injuries resulting from rubber bullets. While rubber bullets are designed to be nonlethal, they can cause deep tissue damage, lead to facial fractures and vision loss, if shot at the face.

Trauma to the head, neck and back can be life threatening, while trauma to the abdomen can seriously damage internal organs. Sundararajan said to seek medical attention when there is significant pain, vomiting, changes in vision, numbness or weakness.

Due to a lack of social distancing and other protective measures at these protests, the spread of COVID-19 is another underlying concern.

“We may see a resurgence of COVID-19 because of the lack of social distancing that’s impossible in a demonstration setting and also the fact that many people are not necessarily wearing masks but are taking masks off,” Sundararajan said. “The hygiene we usually follow with regard to reducing transmission is really going out the window.”

Sundararajan promoted measures like social distancing, wearing a mask, frequent hand washing and not touching one’s face. Those feeling unwell should stay home.

While younger protesters may not experience severe symptoms of COVID-19, they run the risk of exposing their communities, including family members that may be older or have other medical conditions.

“One of the things that is really concerning is that we have already seen this virus disproportionately impact Black and brown communities,” Sundararajan said. “With protests that are intended to serve social justice and address racism we want to make sure that we don’t continue to disproportionately affect communities that are already impacted negatively by this infectious disease.”

One way that those protesting can slow the spread of COVID-19 is getting tested for the virus – even if they are not experiencing symptoms – following protests.

Regardless of the nature of a medical concern Sundararajan encouraged protesters to seek medical attention, especially in cases of severe pain or clear deformations — when a bone structure appears out of place or altered. Sundararajan emphasized that protesters should feel comfortable seeking medical care without concern of arrest, because receiving care for injuries does not typically involve notifying local law enforcement.

“A lot of people might not be able to or feel comfortable seeking medical care right away but the emergency department is always there and we really have a duty to help people who need help, that’s our job,” said Sundararajan. “We really want to see you if you’re worried at all, obviously if you’re really hurt, we want you to come right away so we can help.”