Dr Ming Lin says they were reasonable requests.

Set up a triage system outside the hospital, check the temperatures of all patients, visitors and staff before they can go inside, and give healthcare workers scrubs so that they do not risk taking the novel coronavirus home with them, were high on his list.

But about 10 days after the emergency physician made those recommendations for how to improve his hospital's response to the COVID-19 pandemic - sharing several posts publicly on Facebook and speaking to a local newspaper - he says he was fired.

"I was surprised. I got a couple of warnings, and then the next thing you know, about 10 days later, I got terminated," says Lin, who had worked for 17 years at PeaceHealth St Joseph Medical Center, a hospital in Bellingham, Washington state.

He told Al Jazeera that he felt he needed to voice his concerns on social media in order to protect his patients and colleagues from COVID-19, which has ravaged Washington state, among other places in the United States and around the world.

"Healthcare providers and healthcare workers are often silenced," he said. "We, as healthcare providers, take an oath to do no harm, and that includes pointing out any deficiency that may cause harm to patients. If we speak out, we can be reprimanded and terminated."

PeaceHealth did not respond to Al Jazeera's request for comment by the time of publication. TeamHealth, which has a contract with PeaceHealth to provide staff at the hospital, said in a statement that Lin was not terminated by TeamHealth and that the group is "committed to engaging with him to try to find a path forward".

Lin's case highlights a growing trend of healthcare workers sharing their experiences and concerns around the response to the coronavirus pandemic on Twitter, Facebook, Instagram and other social media sites, drawing attention to the often grim pictures they are seeing inside the hospitals.

Lack of equipment

Their sometimes harrowing accounts circulate online daily, from freezer trucks set up in hospital parking lots to store dead bodies, to physicians having to tell families their loved ones died over FaceTime and desperate pleas for more personal protective equipment.

As the pandemic grips the US, where the death toll is steadily climbing, social media has become the easiest way for some healthcare professionals to raise awareness and get people to take the contagious virus seriously.

Today.



I told a 28 year old that he needs intubation. He was scared. Couldn't breathe.



I told the wife of a 47 year old that he is dying over FaceTime.



I bronched a #COVID19 patient who mucous plugged. It saved his life. Risked mine. — Anna Podolanczuk (@AnnaPodolanczuk) March 29, 2020

In some instances, social media has also become a tool to lobby government and other officials to get them the tools they need, while it can also help build a sense of community and support amid a fraught pandemic response. A lack of masks, gowns, gloves and other equipment is one of the main issues that doctors, nurses and other healthcare workers are speaking out about.

A photo of nurses at a New York hospital wearing rubbish bags as protective gear to treat COVID-19 patients went viral last week. "NO MORE GOWNS IN THE WHOLE HOSPITAL," read a caption on the photo on Facebook. "NO MORE MASKS AND REUSING THE DISPOSABLE ONES."

Dr Richard Loftus, an internist in Rancho Mirage, California, also spoke out about the lack of equipment for healthcare workers on the front lines, comparing it to sending ill-equipped troops into battle in World War II.

"Your front-line troops right now wear medical scrubs, and they do not have helmets and they do not have weapons," he said in a video shared on Twitter on Sunday.

'Bold, loud truths'

In an interview with Al Jazeera, Loftus said he chose to speak out publicly after he realised that the public was not taking the threat of COVID-19 seriously enough, and that local government was not doing much, either. He said he raised serious concerns in February with his hospital leaders about the potential impact of the virus.

"I told them at the time, this is going to be a one-in-500-years event, like an asteroid hitting the earth. And I am sure they thought I was histrionic. Of course, now looking at what's happening in the world, my analogy was apt," he said.

Dr. Rick Loftus describes the dire lack of #PPE facing American doctors & nurses. "I welcome any support from any citizens who are enterprising enough to figure out creative means to get protective gear to the front line doctors and nurses. Our needs are DIRE." #MillionMaskMayday pic.twitter.com/XdSzVsSBHx — MasksForDocs (@MasksForDocs) March 29, 2020

Officials from Eisenhower Health, the hospital where Loftus works, did not respond to Al Jazeera's request for comment.

He said many doctors and nurses on the front lines of the COVID-19 response feel like "cannon fodder" because they are being told to work without the masks, gowns and other equipment they need to do their jobs safely.

In that way, the pandemic has exposed fissures between front-line workers and administrators who are trying to control the messaging around COVID-19, Loftus said. "Those of us who are front-line care workers know how much danger we're in and when we get told stupid things like you're not allowed to wear a mask it makes us angry because we know better."

He added that he believes "bold, loud truths is how we save the most lives" - and so that is what he will continue to do. "As a front-line doctor I can say things that my hospital cannot say," he told Al Jazeera.

A support network

Dr Uche Blackstock works at an urgent care centre in Brooklyn, New York, which has been hardest hit by the pandemic in the US. Like a walk-in clinic, the facility typically treats patients with moderate health problems, such as a cough or runny nose, or a laceration to an arm.

But last week, Blackstock said she noticed people were coming in with more serious respiratory issues - and many of their symptoms were similar, irrespective of age or medical history.

On March 27, she tweeted that "one patient after another came in with fever, cough, shortness of breath and muscle aches" and that she had to call an ambulance for three patients who had difficulty breathing. Blackstock told Al Jazeera that's when she realised that COVID-19 really had arrived.

"During that shift, it really struck me that COVID-19 is here and it's rearing its ugly head. And if anyone in the public had any doubt that this was serious - it's very, very serious," she said in an interview this week. "It's been incredibly surreal, and it was also very sobering."

I just finished an almost 13-hour urgent care shift in central #Brooklyn where one patient after another came in with fever, cough, shortness of breath and muscle aches. #COVID2019 is here. I called EMS for 3 patients in respiratory distress. #NewYorkers, please #StayHome.🙏🏿🙏🏿🙏🏿 pic.twitter.com/RydlAaOvfm — uché ‘STAY HOME & SAFE’ blackstock (@uche_blackstock) March 28, 2020

Dr Daniel Choi, a spinal surgeon practising on Long Island, New York, said doctors also have been sharing their concerns around COVID-19 in private group chats on WhatsApp and Facebook, which he said have become "a source of solidarity and community" for many.

In a WhatsApp chat seen by Al Jazeera, someone wrote that their emergency room in New York City intubated nine patients in 13 hours, and that seven of them were likely to be COVID-19 positive. All the patients were under age 50, the person wrote.

Report from front lines NYC borough hospital 3/29



"Our whole ED is now #COVID, as is our ICU + Overflow ICU, + CCU, we're about to open an ED ICU on an empty floor.



And we're on surge call, so other specialty staff attendings are likely gonna start getting called this week" — Daniel PLEASE STAY HOME Choi, MD (@drdanchoi) March 29, 2020

While Choi is not on the front-lines of the COVID-19 response, he said he feels compelled to amplify the voices of his colleagues that are. He regularly tweets out messages he has received from other physicians related to the crisis.

While doctors typically shy away from sharing their views publicly - often in fear of retribution - the coronavirus pandemic has changed things, Choi told Al Jazeera. "A lot of those fears and worries have kind of gone out the window … because doctors [are] feeling a pressing need to tell the public what's going on."

That was echoed by Blackstock, who said social media had become a platform for healthcare workers to have their voices heard and share their expertise on what needs to be done to combat the virus.

"To be able to control the narrative of what we think are the important points to make, what the priorities of the situation are, what our concerns are, is incredibly invaluable and social media definitely does that for us."