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Health care workers brace for a surge

Copyright © 2020 Albuquerque Journal

It’s the calm before the storm.

As health care professionals nationwide reel from the COVID-19 pandemic amid dwindling supplies, surging casualties and overworked staff – those in New Mexico anxiously wait their turn. And hope it doesn’t come.

Casey Vivian, a nurse at Presbyterian Rust Medical Center, said there is an ominous atmosphere in the quiet hallways and empty hospital beds.

“It’s kind of an eerie feeling,” she said. “Because you’re thinking ‘OK, when is the surge going to happen? When is it going to get to the point that we have no option but to fill these rooms?'”

The warning signs are there, Vivian said, with emails on updated policies and procedures flooding her inbox, the hospital designating a floor for COVID-19 patients and infection numbers soaring in surrounding Bernalillo County. She and her colleagues worry about getting infected with COVID-19 themselves and bringing it home to their families.

“Nursing in general, you go to work and you don’t really know what you’re going to get that day, but this is like a whole ‘nother ball game,” she said. “It’s just unreal and nothing we’ve dealt with before – the whole state is shut down, the whole nation is going through it.”

So far, the state has seen 1,174 cases and 20 deaths. As of Saturday evening, there were 78 hospitalized and 235 deemed recovered by the New Mexico Department of Health. State officials have said their modeling projects 2,100 to 4,700 deaths over the next 12 months, although modeling done by the University of Washington’s Institute for Health Metrics and Evaluation is estimating 192 deaths through June.

Law enforcement has been called on to enforce social distancing protocols and stay-at-home orders leveled by the governor in the hope of “flattening the curve” and preventing a possible catastrophe. State health officials are projecting that New Mexico will reach its peak later this month or in May. When that happens, they’re expecting shortages of hospital beds, intensive care beds and ventilators.

For those on the front lines, in converted COVID-19 units and hospitals turned “ghost towns” in anticipation of a surge, all there is to do is wait.

A new normal

The pandemic has created “a new normal” for those in the health care industry here.

Some workers are stripping down in their garages so they don’t bring the virus home. Others are considering moving out of their homes to ensure their family’s welfare while answering the call of duty.

Hospitals stockpile protective equipment to be disinfected and reused to protect their workers again when the expected surge comes.

If, and when, that surge does come, those who work to both heal the sick and comfort the dying will be some of the most at risk.

“You can feel the fear of the health care workers. What if they (contract the virus)? Or their loved one is the next one because they got involved and tried to take care of this patient?” said Dr. Irfan Kahn, the incident commander for the pediatric ICU and inpatient services at Presbyterian. “And there’s this innate urge to jump in and help patients who are (dying).”

In a trend being reported across the nation and world, thousands of health care workers are becoming sick themselves and putting a strain on an already fragile situation.

According to The New York Times, more than 3,000 doctors became infected with COVID-19 in China. In Spain, health workers made up 14% of the country’s confirmed cases.

In America, according to BuzzFeed, at least 5,400 doctors, nurses and other medical staff have contracted the virus. It’s hard to say where New Mexico stands as the DOH hasn’t released numbers on infected health care personnel.

Eleanor Chavez, the executive director for the local chapter of National Union of Health Care and Hospital Employees, said union members have reported some colleagues contracted the virus as others await test results in quarantine.

Meanwhile, Chavez said, they have been inundated with calls from hospital employees who have concerns about the virus. One respiratory therapist even sought guidance on creating a will.

“We have workers that have called and said, ‘I need to be away from work because I have an at-risk family member;’ we have other workers who have called about being immuno-compromised and will their hospital make accommodations because of their age or health; we have employees who are concerned about being contaminated, infected, exposed and having to go home,” Chavez said.

Vivian, the nurse at Presbyterian, said she doesn’t know any colleagues who have tested positive. But that doesn’t make treating COVID-19 patients any less stressful for those, like her, who have families at home.

“That’s the scary thing. I think most nurses, they’re more prone to being carriers and being asymptomatic because our immunities are so used to being around superbugs all the time in the hospital,” Vivian said. “My mind definitely does go there, like ‘OK, what if I am asymptomatic and then I bring it home?'”

Her daily routine involved bleaching all her items before leaving the hospital, taking her shoes off at the door, stripping down and throwing the clothes in the washer before jumping into the shower.

“And then, when I’m done doing all of that, I hug my daughter and my husband. But until then, I’m like, ‘Don’t touch me,'” Vivian said.

Dr. Jake Imber, whose team cares for COVID-19 patients at the University of New Mexico Hospital, has talked about moving out of the house to protect his fiancee, who is pregnant and due in early May.

Jake Imber

“We’re in a situation where you’re trying to do a risk-benefit evaluation on something where risks are not well understood,” Imber said. “I think, especially if the situation worsens, I will probably move away.”

Safeguarding supplies

Those who work in the UNMH Intensive Care Unit, where COVID-19 patients are treated, are saving personal protective equipment, or PPE, and masks after each shift. Presbyterian Hospital, near Downtown Albuquerque, is saving PPE to be disinfected and used again.

“There is a short supply of the masks. We are not using (protective equipment) for all the patients that we see. Which is probably not the best thing to do,” Kahn said.

At Rust, Vivian said they “have all the PPE they need.” At least for now.

“There is always that worry, like ‘what if we run out?’ Because there is a shortage – are we going to get what we need if this huge surge happens, are we going to have adequate protection?” she said.

Possible shortages and availability is especially concerning with the virus’ ability to live on surfaces for long periods, be airborne and its lengthy incubation period.

“Especially in the hospital, you could be exposed anywhere, you touch one surface and then touch your face and there you go,” Vivian said.

She said, initially, the delays in test results in patients – up to five days – were especially “frustrating.”

“The whole time they are getting ruled out they are in precautions,” she said. “It can be a lot, gowning up and gowning down and really trying to prioritize your care.”

Now Vivian said she doesn’t regularly see COVID-19 patients, or those with symptoms, as there is a designated unit and staff to handle the virus. But it could only be a matter of time.

“We’ve really just been taking it day to day and we don’t know what to expect, hoping for the best obviously, but it is kind of a weird, eerie feeling, not knowing what’s coming,” she said. “They’re definitely expecting it to get worse before it gets better.”

Scarlet letter

As health care workers try to look after themselves, they also feel for the emotional anguish and needs of the patients. With strict protocols and hospitals allowing no visitors, Vivian said COVID-19 is like a scarlet letter.

“We’re all going to be hyper-vigilant and limit how many times we come in the room…. I imagine that feels crappy for them on that end,” she said.

Brianna Benzinger, the chaplain at Presbyterian Kaseman Hospital, said the loneliness and fear a patient feels is often a void left for hospital employees to fill.

“They don’t have family, friends and loved ones with them right now, which is really trying emotionally and spiritually,” she said. “We’ve seen so much in the media of horrible, worst case outcomes. So people who do contract that virus, they are very scared and very alone.”

Benzinger said patients often feel ostracized due to the stigma around COVID-19 and alienation of only seeing health care workers sparingly and behind a mask.

In that respect, both doctors and nurses said they’ve taken on more of a counseling role.

“Everyone who tests positive and is hospitalized is very worried that they are going to die,” Imber said. “This is a different type of care. …I do think there is more time and effort and energy being spent counseling patients and emotionally supporting them.”

Vanessa Johnson, a nurse in the UNMH Intensive Care Unit where COVID-19 patients are treated, said some cases are more difficult than others. She said one patient in particular comes to mind. A woman who is not only sick and alone, but also doesn’t speak English.

“I feel awful because every time I walk in the room with my terrible Spanish I can tell her very little. It must be terrifying,” Johnson said. “She doesn’t speak the language and she’s not from here. … It’s only me. And I’m wearing a big mask, I’m, wearing eye shields, a bonnet, a gown. She can’t see my face. She must be terrified.”

NM’S LATEST NUMBERS

Number of positive tests: 1,174

Number of negative tests: 27,518

Reported recoveries: 235

Number of deaths: 20

source: NMDOH

Coronavirus Hotline: 1-855-600-3453

Non-health related COVID-19 questions: 1-833-551-0518

 

 

 

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