'You just hope they can fight it off on their own' | Feature | Chicago Reader

'You just hope they can fight it off on their own' 

Interviews with a doctor and nurse as Chicago hospitals brace for a deluge of novel coronavirus patients.

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DIMITRI KARASTELEV / UNSPLASH
  • Dimitri Karastelev / Unsplash

These interviews have been edited and condensed for clarity.

Emergency room doctor

We had to fight to wear protective equipment for our first patient. We were told we were scaring the patient and nurses. The nurses should be scared, because they should have those N95 masks too. The patient's swab came back positive.

For some reason, our hospital didn't think that this thing was coming. No. This is what's happening. This is what's supposed to be happening.

After our first positive test, several nurses had symptoms who were there on that day, who were not wearing the right equipment. We didn't test them. I haven't been tested. If you don't have a fever and you're not a high-risk person, then you're not getting tested.

There was strong suspicion that this thing was airborne. Is it droplets? Is it contact? The scary thing is that the doctors want these N95 masks and the nurses are told that they can have one only if we're doing an aerosolizing procedure, like intubations. I have one that I've been reusing the entire week that's in a ziplock bag. Wiping it down affects the structural integrity of the N95. I'm not comfortable. It's loosened on my face.

In a normal world, you would change that mask potentially a few times in a shift, especially if the patient is coughing a lot. Every time you come out of the patient's room, you have to take it off. When you take the N95 off you dip it away from your face, but we're still at risk of inhaling the virus, or exposing the nurses.

We're seeing people who are sick with classic COVID symptoms. They're saturating 90 percent or lower on room air, they're having labored breathing. You'll get a CAT scan and you'll see ground-glass opacities, which is pretty classic. And then their chest X-rays show a viral pneumonia pattern, usually on both sides of the lung. Some people, if they have COVID or another viral pneumonia, both sides of their lungs will have all these white patches throughout. And it's thickening or inflammation of the lung tissue.

In younger people with asthma or COPD [chronic obstructive pulmonary disease], they're in their 50s, their oxygen is OK but their chest X-ray looks distinctive. But they just don't have enough symptoms to be admitted to the hospital. So then we're anticipating that in four or five days they're going to come back and be really sick. We are also not testing all these people. The numbers nationwide are grossly inaccurate and much lower than the actual number of people infected. There's nothing we can really do except tell them to go home and not see other people. We're not sending anybody home with medication. You just hope that they can fight it off on their own.

You would never feel good about sending a person like this home with no intervention. If they have an underlying medical disease, and if they have other medical problems, chances are if their chest X-ray looks like that they'll probably get worse. There's really nothing we can offer them. We don't have the ability to monitor them in the hospital. We're trying to free up our beds because these people are coming back. That first patient I mentioned was intubated, they're dying right now. That's what you're waiting for. Next week or the week after, we're worried that every patient that comes back is going to be like that.

We're all seeing the same trajectory as Italy, and we're all thinking that might happen in the next few weeks. I really hope we don't have to decide who gets a ventilator and who doesn't. It would be horrible.

I thought I would never feel this way. I can't believe the federal administration and science are clashing like this. The science and the evidence is there and they're still trying to pull the wool over our eyes. And they're doing that to a group of very intelligent people. They're recommending bandanas instead of N95s. Who do they think we are? Are you fucking serious?

All of us are just absolutely livid. There's no governing body that we really trust. Essentially everyone's really relying on their colleagues, stories that they've heard from each other. Our country was grossly unprepared for anything like this.


Nurse

This has been the longest week of my life. The ER was inundated with calls with people who thought they had COVID. It was packed in the lobby and the lines were not organized. Staff walked in along with patients and visitors. It's calmed down in the last few days. It's been a ghost town because there are no unnecessary procedures happening. No extra visitors. Yet everyone is still stressed.

The patients that are coming in, everyone's on red alert and concerned that they might have coronavirus. Staff who are maybe nonessential or in departments that are closed, some without clinical or nursing backgrounds, are being called to greet people, screen them, and take temperatures. They're just wearing street clothes and they're not wearing masks. Some people are hesitant to be in that role because you're so exposed.

Ideally we'd have enough masks. There's just not enough personal protective equipment like gowns, gloves, masks, and goggles. When nurses go into a patient's room, we ideally do as many things as possible. Our staff is reusing equipment. We put our masks in bags that have our names written on them. While it's not ideal, it is what the CDC recommends under adjusted guidelines. It's unnerving. It's alarming to see that. Infection-prevention-wise it doesn't seem right.

I found out last week that I was possibly exposed to someone. If you're possibly exposed, you have to still see patients until you present with symptoms like shortness of breath, dry cough, and fever. I waited days and days until I found out that person had tested negative. It's frustrating.

For a lot of us, reporting for work hasn't changed. We're not working from home. We're hospital workers and we know that this is what we signed up for, but it's difficult to be at work when the rest of the world feels like it's shutting down. It's a phenomenal thing. Still, it is kind of unifying. As much of a shitshow and as stressful as it is, there is a sense of camaraderie. There's a sense of human—I don't know how to say it—an impressive display of human dedication.   v

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