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I spent last week talking to those on the front lines of the battle against #COVID19, and I tried to capture a slice of each of their lives here: https://thehill.com/policy/healthcare/493787-coronavirus-stories-from-the-frontline-one-week-in-americas-battle
A thread on what I learned talking to people who know they're risking their lives to save others. 1/x
A thread on what I learned talking to people who know they're risking their lives to save others. 1/x
Amy Arlund has worked the night shift at a medical center in Fresno for 19 years. The first #COVID19 case showed up March 8, and she volunteered. She and her colleagues didn't think there'd be too many cases in Fresno, so far from a metro area. 2/x
The cases kept mounting. Now Arlund, a critical care nurse, is caring for one of her fellow nurses, in critical condition on a ventilator. "She has been fighting for her life for several days now." She texted me at 1am today to tell me the nurse is still alive, but critical. 3/x
Arlund's union is tracking 50 other nurses at that ONE hospital who've been exposed. Some of her colleagues are making a point to update their wills. "There's exposure everywhere, and our nurses are getting sick." 4/x
Anthony Rosania directs the emergency dept observation unit at at University Hospital in Newark. He's used to seeing gun shots, broken bones, heart attacks. Not anymore. "The diversity of illness we see has just gone down." 5/x
How many of his patients have #COVID19? "Speaking sort of generally, all of them. Pretty much every patient we see." 6/x
One thing lots of ER docs told me: #COVID19 patients are showing an incredibly broad array of symptoms. It's not just fever, cough, trouble breathing. It's kidney problems, headaches, loss of taste/smell, vomiting, even pink eye. 7/x
"There's definitely no other disease state that we've seen before that manifests in such a diverse number of ways," Rosania says. "It can impact any organ system, any part of the body." 8/x
One new trick docs are using: Lying patients on their stomachs, or "proning." Apparently it recruits more healthy lung tissue to help get oxygen into the blood "You can do that for people who aren't even on a ventilator," Rosania says. 9/x
James Phillips's dad was one of the first fire fighters in the Murrah building in Oklahoma City after the bombing. Now he's chief of disaster operations at GWU. He took note of #COVID19 when one of the first announcements out of China came from President Xi. 10/x
Phillips's first #COVID19 patient was a 50-year old physician from another DC hospital. Guy didn't meet testing criteria. Phillips tested him anyway. Positive. 11/x
Patients are showing up at the ER with oxygen levels in their blood so low they should be blue and incapable of speech. But they can hold a conversation. Docs call it "happy hypoxia." But those patients deteriorate rapidly, and they can be on ventilators within hours. 12/x
Phillips is particularly angry with what he hears from the WH daily briefings. "To have your leader come out and say, ‘We're doing fine, everything's fine, nothing to see here,’ -- it's counterproductive to what we're trying to tell our patients." 13/x
Phillips's wife is due in less than a month. He's about to move into their basement. "If I get sick sometime in the next week, not only am I going to miss the birth of my son, I also run the risk of having my wife get sick too." 14/x
Deborah Visconi is the CEO of Bergen New Bridge Medical Center in NJ. The CEOs of all 6 hospitals there are constantly texting each other to check in, share news, ask each other for help. She hasn't taken a day off since the 1st week of March. 15/x
Visconi is worried about her employees' mental health, so she's set up psych visits, both one-on-one and in group settings. "We know that the next pandemic is going to be one of mental health," she says. 16/x
"At the end of the day, this is a virus. We can beat it, we're smarter than it. As humanity, we've beat lots of stuff before this," Visconi says. "While I'm in the middle of all this I'm stoic and strong like the captain of a ship." 17/x
Rob Davidson works in a rural hospital in Western Michigan, where he might be the only doc on an ER shift. He's seen #COVID19 patients, but he's worried about a larger surge that has yet to hit rural America. He gets 1 N95 mask that's supposed to last 5 shifts 18/x
Davidson says social distancing rules are changing the way he treats patients. "Most of my encounters with patients are standing at the doorway. That in and of itself is so contrary to the way I was trained and the way I practice." 19/x
Front-line workers feel an incredible amount of stress about the risk they pose to their families. "The biggest mental strain ... is when do I make the decision that I've been exposed at a high enough level that I'm going to isolate myself from my family," Davidson said. 20/x
Hospital admins are spending a lot more time reading studies than they usually do, because so much is coming out about #COVID19 so quickly. Kevin Carney, who oversees pediatric ER rooms at Children's Hospital Colorado, said guidance can change on an hourly basis. 21/x
Carney says his docs & nurses think #COVID19 has been around longer than we realize. "We've all been realizing that there's been something out there that's been a little bit different from the normal flu and the normal viruses that are out there this time of year." 22/x
Zoom isn't just for business, it's helping docs and nurses blow off steam. Some of Carney's employees are having Zoom happy hours, and at least one Zoom book club is meeting regularly. 23/x
Abraar Karan worked in Rwanda, so he knows what it's like to lack medical supplies. He just didn't think he's experience it in the ER of Brigham & Women's in Boston. 24/x
Karan is struck by the speed at which #COVID19 patients can deteriorate. "We've had patients who were totally on room air, admitted breathing comfortably. A few hours later, those patients are having trouble breathing, on oxygen, and the next day they could be in the ICU." 25/x
Some hospitals in the tri-state area are filling up, fast. "The sheer numbers of patients are exponentially going up over the last few weeks. The fear in both the community and the staff has gone up as well, and rightfully so," says Matthew Scro, an ER doc in Paramus. 26/x
Carl Shrader runs an assisted living facility in Morgantown, WV. He got scared when he saw what #COVID19 did to the nursing home in Kirkland, WA. Then his facility became home to the first community spread case in WV. 27/x
Shrader's nursing home locked down, isolating residents, constantly taking vitals and cleaning, switching to disposable food service items. They created their own isolation ward, and they averted disaster. 21 of 98 residents have tested positive, just 3 have died. 28/x
But even those who didn't get sick are hurting. Some don't understand why their families aren't visiting. "We have seen an overwhelming amount of depression in some of those people, to the point where they didn't want to eat or drink." 29/x
Shrader sent his 3 kids, age 6, 8 and 10, to live with their grandmother. His daughter wrote him a letter on Easter Sunday: "Dear Dad, I love you and I hope this corona stuff stops," she wrote. "I love you to the moon and back Daddy." 30/x
These front-line health workers are exhausted, they're stressed, they're worried about themselves and their families. Almost all of them change clothes at least twice after a shift. Almost all are self-isolating from their families or making plans to do so. 31/x
I'm grateful they took some of their precious time to talk to me. I asked them what they wanted people to take away from their stories. They all said: Social distancing is a sacrifice, but it works, please keep doing it. https://thehill.com/policy/healthcare/493787-coronavirus-stories-from-the-frontline-one-week-in-americas-battle 32/32
