Urgent dispatch from the COVID front lines

Urgent dispatch from the COVID front lines

Guest Author
Guest Author

Cross-posted from Daily Kos


This is an anguished cry from the heart of a front-line Covid warrior. As most here know, he is Medical Director of an Emergency Department at a large regional medical center in a Southern state.  He wants to remain anonymous (initials AD) because corporate overlords don’t like the public to hear bad news/truth. He is a beloved Kossack who helped to guide and steady us here with his calm, compassionate explanations and advice, at the beginning of the Pandemic, and all through 2020. Most of you know of whom we speak, but for new people, just bear with us. Here is his dispatch, in two parts. The first part was written at the end of his shift on Monday.

Read this like an S.O.S. from the Titanic.


DISPATCH FROM MONDAY AFTERNOON:

We simply don't have time to waste. None of us.

I'll just cut to the chase. Our 9 y/o Kid#1 has COVID.

He tested positive today.

Mom took him in to our pediatrician because he looked awful. His eyes were swollen with big dark circles and he said he had a terrible headache.

No shortness of breath but a dry cough. He said he just hurt all over.

Our pediatrician is extremely sharp. She's been our pediatrician since Kid#1 was 10 months old.

We got all the usual prescriptions for kids with COVID, and now we wait.

Our 6 y/o Kid#2 had a PCR done. but the results won't be back until tomorrow or maybe the day after.

Mom and I had a PCR done immediately here, and had the results back in 45 minutes, because I could swing it here. We are both negative, for now.

We are both vaccinated, of course, but now most of the cases we are seeing, about 95%, are all Delta, which is a whole different animal.

Delta is as contagious as chicken pox, and creates a viral load 1,000 times higher than the original strain.

That's why people are getting sicker, quicker. And now it's not just older people or those with comorbidities.

It's young people, too.

My youngest patient was 8 weeks old.

Earlier this week I sent an 8 month old to the university with acute respiratory distress. She needed a pediatric ICU bed, but there are none. The Pediatric ICU is full. My patient and a bunch of others are being held in the ER, because there is nowhere to put them.

So, obviously, we are scared. Not just for our Kid#1. For Kid#2 as well. She has asthma. Asthmatic kids don't do well with this.

So, now we wait, and pray.

We give steroids, we are trying the experimental treatment with Cetirizine (Zyrtec) and Famotidine (Pepcid AC), and now we wait.

I cannot begin to tell you how bad it is.

The worst days of the pandemic before now were a picnic in the park compared to now.

When I went off shift Monday, every single bed in the emergency department had an ICU patient in it.

Most of them were on the ventilator.

I had three codes today, and intubated a patient in the hallway. We had to put him in a room with another vent patient, because we had to be able to connect to the wall oxygen and suction.

We are now doubling up patients in rooms. There are no places to put them and no staff to care for them.

At one point today, one of my nurses had five ICU patients.

To compare, in The Before Time, nurses never had more than two ICU patients per nurse. They are too sick.  More than that, and the attending ICU nurse cannot give adequate care.

We are so far past that now, we can barely remember how it was before.

We used to take pride in delivering top notch medical care. Now, it's just, "Try to keep them alive to the end of the shift".

Then the next crew will do the same.

Now we have psychiatric patients with COVID. There is only one COVID psych unit in the state. You can imagine how that is. We are holding positive patients that are suicidal for days. we try to watch them, but if they kill themselves, well, it happens. We can't take care of everyone anymore.
We are practicing third world medicine now. We have no choice. There is no more staff, supplies are constantly running low, and the patients just keep coming.  And coming.

We have several deaths a day now in the ER. We are just numb. We have talked about how guilty we feel when someone dies because of how we feel.  It means there's a bed available. Let that sink in. We are glad someone dies, because it means we get one of the patients who are in the hallway into a bed. And yeah, we feel guilty as hell about feeling that way.

I have to go lay down now. I can't stay awake anymore.

I'll write more tomorrow.

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DISPATCH FROM TUESDAY MORNING:

Ok. It's tomorrow. I just came on duty.
It's worse than when I left.

There are 6 more patients that are admitted but are on beds in the hallway.
The huge state teaching Hospital has opened two field hospitals in the parking garage, one government and one from a faith-based organization.

They filled up immediately. Colleagues there tell me they have patients in every closet there.

At least they have medical and nursing students, as well as residents, as staff extenders at the University medical center.  We're not as lucky as that, but better off than most hospitals. I have two students rotating with me, and there are two fresh nursing graduates orienting here. It helps, but I feel bad about it. We have thrown them straight into the fire. They are getting as hardened as we are, real fast. There are no innocents in medicine any more. Not down here. Like the line from Pennywise in the Stephen King novel, IT:

"We all float down here."

I had a nurse practitioner call me from one of the tiny rural hospitals not far from here. Unfortunately, she is across the state line, and state health has placed the entire state on diversion. We are not allowed to take out of state transfers now. She had a patient having an MI. Normally we would immediately accept the patient in transfer. Not anymore. When I told her I wasn't allowed to take him, she started sobbing. She had tried all the hospitals in her state, and had been refused.

People are dying because we can't care for them.

We all float down here.

Here, in our deep red southern state, Republican governor is still refusing to mandate masks. I've heard more than one of my staff say they hope he ends up [redacted].

We all float down here.

Our vaccination rate in this state is one of the worst in the country, just above 30%. When we do go out in public, most people—the vast majority—are unmasked.  Because "Muh rights!". One of the very prominent locals was a huge COVID denier, anti-masker and antivaxxer. His Facebook feed was a swamp. He's on the ventilator now. He gets appropriate care, because we are professionals and "first, do no harm". But our sympathy level is essentially zero. Yeah, I know that's horrible and we all feel guilty about feeling that... but we all get so fucking ANGRY at them. They don't have to be here, and yet there they are burning up our resources. Stupid fucking assholes. It didn't have to be this way. They put us here. Trump and Fox "News" put us here.

We all float down here.

We are, all of us, burned out, angry, drained and morally wounded.

I have to go. I've written this a few sentences at a time, between patients. I'll write more when I can, but I really don't know what else to say.

If y'all want to post this on DKos, it's fine. People need to know.

We all float down here.

--30--

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