Doctors and nurses ‘live in constant crisis’ as Covid fills hospitals and Omicron Looms


SAGINAW, Michigan – On the top floor of the hospital, in the unit that houses the sickest Covid-19 patients, 13 of the 14 beds were occupied. In the only empty room, a person had just died.

Wave after wave, caregivers at the Covenant HealthCare unit in Saginaw, Mich., Have helped sick patients say goodbye to loved ones on video calls. Medical workers cried in the dimly lit hallways. They have seen the number of cases decrease, only to see the beds fill up again. Most of the time, they have learned to fear the worst.

“You come back to work and wonder who is dead,” said Bridget Klingenberg, an intensive care nurse at Covenant, where the workforce is so tight that the Department of Defense recently sent reinforcements. “I don’t think people understand the price this takes unless you actually have.”

The highly contagious Omicron variant arrives in the United States at a time of low capacity in hospitals, particularly in the Midwest and Northeast, where case rates are highest and many health workers are still struggling with the Delta variant. Some researchers are hoping Omicron may cause less severe disease than Delta, but health officials are still concerned that the new variant will send an already pressurized medical system to the point of breaking down.

About 1,300 Americans die from the coronavirus every day. National rates of cases, deaths and hospitalizations remain well below those seen last winter, before vaccines became widely available. In Connecticut and Maine, reports of new infections have increased by about 150% in the past two weeks. Hospitalization rates in Ohio and Indiana are approaching those seen in last winter’s devastating wave.

“Living in constant crisis for over 20 months is a bit overwhelming,” said Dr Matthew Deibel, medical director of emergency care at Covenant, where patients sometimes have to wait hours to be seen due to a lack of beds and staff.

With coronavirus hospitalizations rising 20% ​​nationwide in the past two weeks, to 68,000 people, doctors and nurses speak with new concern about the conditions and are pleading for people to get vaccinated.

In Minnesota, several hospital systems issued a joint message saying employees were demoralized and “your access to health care is seriously threatened” by the pandemic. In Rhode Island, Governor Dan McKee wrote a letter to federal officials requesting staffing assistance, noting that “hospitals are reporting their emergency departments are at full capacity and patients are leaving without being assessed.” In Nebraska, a hospital released a video showing a nurse responding to three requests for care for critically ill virus patients, but only having beds for two of them. Ohio Governor Mike DeWine on Friday mobilized more than 1,000 National Guard members to help with hospital staffing.

The outlook is particularly troubling in Michigan, which has the highest coronavirus hospitalization rate in the country. About 4,700 patients infected with the virus were hospitalized statewide this week, more than what had been seen in the state’s previous three peaks. And although daily case reports are slightly lower from the pre-Thanksgiving highs, more than 6,500 people in Michigan continue to test positive for the virus every day.

At Covenant, there are fewer coronavirus patients than last winter, but limited staff and a return of patients who delayed care for chronic conditions during the pandemic have squeezed resources.

Earlier this week, around 100 patients at the sprawling hospital had active or recently resolved coronavirus infections. Of the 68 patients whose infections were still active, about 70% were not vaccinated, hospital officials said. Among the vaccinated patients, only two had received a booster.

With Omicron, breakthrough infections are common, but scientists believe vaccines will always offer protection against the worst consequences. Booster doses may provide additional protection against infection, preliminary data suggests.

In Saginaw, doctors and nurses said they noticed colleagues struggling with the relentless nature of the pandemic – with fatigue, anger, post-traumatic stress and frustration with the unvaccinated.

A handful of Democratic-led states have reimposed some restrictions in recent days, including new mask rules in California and New York. But in many places normal life goes on and there seems to be a limited appetite for further restrictions, even as cases increase.

Some school districts have dropped mask warrants in recent days, and federal officials expect Christmas air travel to approach pre-pandemic levels. Unlike last year, few health directors have told people, especially those who are vaccinated, to skip holiday gatherings.

Around Saginaw, a town of about 50,000 residents 90 minutes north of Detroit, medical workers said they could sometimes feel like their neighbors had overlooked the pandemic. The use of the mask is irregular. Major events have resumed. In Saginaw County, around 50 percent of people are considered fully vaccinated, a figure that does not include booster shots. This rate is lower than the Michigan average, which is lower than the national rate of 61%.

If people saw what they were doing every day, said many employees of Covenant’s Covid service, they might behave differently.

“Unless you work in this unit alongside me to see the true devastation of the virus and what it is doing physically to the human body, how can you appreciate it? How? ”Said Jamie Vinson-Hunter, respiratory therapist.

Almost exactly a year ago, doctors and nurses at Covenant and other hospitals were among the first people to get vaccinated against the coronavirus. For many of them, it was a moment of optimism when it looked like the emergency response to the coronavirus could end soon. For a while, it seemed possible: for one day in June, there were no patients in Covenant with active coronavirus infection.

Since then, the picture has deteriorated considerably. The immunity of these early vaccines may be waning. While recent data on groundbreaking cases and deaths for all Americans is not readily available, recent federal nursing home data shows a sharp increase in cases among people who were fully vaccinated but had not yet. reminder received.

To see just how far things have come in Saginaw, just spend some time on the seventh floor of Covenant. There, in a slender hallway with low ceilings, nurses come in and out of the rooms. The room is busy but not panicked, with the hum and beep of the machines making up most of the soundtrack. Many patients are sedated and on ventilators, unable to speak with their doctors. Others are confused.

“This disease is dehumanizing,” said Dr Amjad Nader, who cares for people in this unit. He added, “Sometimes I don’t see the light in my patients’ eyes. “

Many caregivers on this floor have become virus experts. They talk about the satisfaction of calling a patient’s spouse if the patient no longer needs a ventilator after weeks of treatment. They lament the frustration of having no cure. They cry every time they lose a patient.

Ms Klingenberg, the nurse, volunteered to work with coronavirus patients at the start of the pandemic and passed up the opportunity to take on other duties.

“It’s mostly for my colleagues,” she says. “I don’t want to leave them. And someone has to do it. And we are apparently the ones who chose to do so.

But the pandemic was not something she could leave to work. Family members have tested positive. Earlier this year, when Ms Klingenberg was 26 weeks pregnant, she also tested positive.

Unlike most women in her twenties, she had a serious case and was hospitalized at the University of Michigan. For a while she was faced with the possibility of intubation. Then after about a week she started to improve. She was able to go home. Her baby was healthy and did not have to give birth early.

The experience and the fear, she said, are now helping her connect with her patients receiving the same respiratory treatments she received months ago.

“They have these times of distress because this lump is attached to you, you can’t take it off, it’s pushing air into your lungs,” Ms. Klingenberg said. “Your natural reaction is to fight this. So I can help, I want to calm them down and tell them exactly, “I understand what this does. I know exactly what you are going through.

At other times, she said, the trauma and relentlessness of the pandemic – wave after wave – seems too much.

“I’m going to take care of these patients and all of a sudden I’ll be back at M.’s University, and I get flashbacks sometimes,” she said. “So I’m still trying to heal from this near-death experience. And then I immediately returned to the Covid, which was my choice. But it’s a little scary.

About Jermaine Chase

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