Lifeline: Nurses, doctors and staff at local hospitals prepare for COVID-19 long haul

Those who have had to refit their lives to the current COVID-19 pandemic know that life is dramatically different now. Health care workers experience these changes to an even greater extent, as many risk exposure to the virus constantly, must distance themselves from their families, work without sufficient personal protective equipment and/or pull extra hours without hazard pay.These workers — including doctors, nurses and other staff — are frequently compared to soldiers at battle, fighting the enemy on the frontlines. Around the country, community members come out to cheer on nurses during change of shift. Some health workers have noted that they are always on the frontlines, pandemic or not, but only now are being recognized for it.As each state lays out its social distancing and reopening protocols for the next several months, hospital workers must deal with the uncertain future ahead and prepare for a possible high caseload. As of May 4, Virginia has reported 19,492 cases of COVID-19 and 684 deaths due to the coronavirus. Gov. Ralph Northam is considering relaxing restrictions later this month as numbers already are starting to show a downward trend.A projection model from the University of Virginia’s Biocomplexity Institute that has been presented to Gov. Ralph Northam in April indicated that social distancing has been effective at flattening the rate of infections in Virginia. According to the model, if the social distancing rules currently in place were to be partially lifted when Virginia’s stay-at-home order expires June 10, the peak number of infections would likely be in mid-August. But if the restrictions were lifted sooner, infection rates would rise more quickly, and the peak would come later, according to the model.Charlottesville has seen 63 cases of COVID-19 and two deaths, as of May 4, while Albemarle County has seen 110 cases and four deaths. Local hospitals, including the University of Virginia Medical Center and Sentara Martha Jefferson Hospital, have changed their policies and protocol in response to the coronavirus, such as not allowing visitors in with a few exceptions. Anyone who enters UVa Medical Center facilities must be screened for symptoms of COVID-19 and must wear a mask.In a three-part series, Charlottesville Tomorrow freelance reporter Kate Hidalgo Bellows spoke to eight doctors and nurses treating COVID-19 patients at local hospitals, as well as Dean Pam Cipriano of the Nursing School, about how the experiences of fighting a pandemic with an uncertain trajectory have affected them emotionally, mentally and physically. These are their stories.

Part One

Dr. Taison Bell. Credit: Credit: Submitted photo

Dr. Taison Bell — UVa Health System critical care and infectious disease physician, medical ICU director

Dr. Taison Bell is busy. A physician of pulmonary and critical care medicine and infectious disease at the University of Virginia, he directs the medical intensive care unit, which treats patients with the most severe cases of COVID-19. In that role, Bell takes primary care of patients and provides expertise about infectious diseases. Click here to read more.

Kendall Barger. Credit: Credit: Submitted photo

Kendall Barger — UVa Medical Center MICU Nurse

As a medical intensive care unit nurse, Kendall Barger tends to the critically ill, including those teetering at the edge of death. With the coronavirus crisis, Barger said, COVID-19 patients are separated from non-COVID-19 patients, and the COVID-19 unit is staffed by MICU nurses.Click here to read more.

Dean Pam Cipriano of UVa’s School of Nursing. Credit: Credit: Submitted photo

Pam Cipriano — Dean and Sadie Heath Cabaniss Professor, University of Virginia School of Nursing

Dean Pam Cipriano of UVa’s School of Nursing said she is not sure how many alumni work at the Medical Center. But she knows it’s a lot.Click here to read more.

Part Two: The fight continues

It was a busy week for health care workers in Charlottesville, with both sad moments and reasons for optimism.On April 26, Dr. Lorna Breen — the medical director of the emergency department at Manhattan’s NewYork-Presbyterian Allen Hospital — died by suicide in Charlottesville, where she was staying with her family, according to The New York Times. Breen had contracted the coronavirus, recovered and gone back to work before she was sent home again and her family brought her to Charlottesville, the Times reported. In a news release, Charlottesville Police expressed their condolences.”Frontline healthcare professionals and first responders are not immune to the mental or physical effects of the current pandemic,” Police Chief RaShall Brackney said. “On a daily basis, these professionals operate under the most stressful of circumstances, and the coronavirus has introduced additional stressors.”The Breen family has established a fund in her memory through the Charlottesville Area Community Foundation to provide mental health support to health care workers.The National Suicide Prevention Hotline may be reached at 1-800-273-8255.On April 27, the University of Virginia Health System announced plans to furlough some members of its nonpatient care staff, with Executive Vice President for Health Affairs Dr. K. Craig Kent writing in an email to staff that the Health System has seen an $85 million deficit per month due to a drop in surgeries and clinic visits as a result of COVID-19. According to Kent’s memo, surgeries have declined by 70% and clinic visits by 90% since mid-March. Executives, including Kent, will be taking pay cuts, as well as physicians and leaders across the Health System, who will have their pay slashed by 20%.There may be some relief, however, in Gov. Ralph Northam’s decision to let a ban on non-emergency hospital procedures expire May 1. According to The Daily Progress, hospitals have not seen the uptick in COVID-19 cases they had expected and, with the caseload being manageable, had asked the state to consider lifting the ban.On April 29, National Institute of Allergy and Infectious Diseases Chief Anthony Fauci announced that clinical trials of the antiviral drug remdesivir had demonstrated positive results in speeding up the recovery time of patients with COVID-19. The drug reduced the death rate from 11% to 8% percent, but Fauci said that was not statistically significant. The University of Virginia was part of the clinical study, which according to the Washington Post involved 1,000 patients at 68 sites across the world.These stories are part of a series about the experiences of doctors and nurses treating COVID-19 patients at local hospitals. Charlottesville Tomorrow freelance reporter Kate Hidalgo Bellows spoke to these essential workers about how the experiences of fighting a pandemic with an uncertain trajectory have affected them emotionally, mentally and physically. These are their stories.

Miriam Karunakaran. Credit: Credit: Submitted photo

Miriam Karunakaran — UVa Medical Intensive Care Unit Nurse

University of Virginia medical intensive care unit nurse Miriam Karunakaran said she never thought she would have found herself fighting a pandemic. She said the experience has been “absolutely humbling.”

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Dr. Mark Mandichak. Credit: Credit: Submitted photo

Dr. Mark Mandichak — Sentara Martha Jefferson Lead Hospitalist & Jennifer Downs — Sentara Martha Jefferson Director of Marketing and Communications

At the privately owned Sentara Martha Jefferson Hospital, Dr. Mark Mandichak oversees the care of patients in the hospital’s two COVID-19 units, which opened in March.

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Billy Burris. Credit: Credit: Submitted photo

Billy Burris — UVa Emergency Department Nurse

With the Virginia stay-at-home order in place until June 10, the daily (and nightly) rhythms of the University of Virginia Emergency Department have looked a bit different lately.

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Part Three

Charlotte Brouwer. Credit: Credit: Submitted photo

Charlotte Brouwer — UVa Medical Intensive Care Unit Nurse

University of Virginia Health System medical intensive care unit nurse Charlotte Brouwer’s newest self-care purchase is a bit unique. Her purchase was also good for the community.

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Jessica Denomme. Credit: Credit: Submitted photo

Jessica Denomme — UVa Medical Intensive Care Unit Nurse

Jessica Denomme, a medical intensive care unit nurse at the University of Virginia Medical Center, has taken on a special project in addition to treating COVID-19 patients — collaborating with the School of Engineering to build personal protective equipment for health care workers using 3D-printing technology.

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Scott Darrah. Credit: Credit: Submitted photo

Scott Darrah — UVa Clinical Nurse Specialist, Advanced Practice Nurse

Scott Darrah is an advanced practice nurse at the University of Virginia Medical Center, where he tends to COVID-19 patients in an acute care setting. And he is a leader in developing three acute care units to handle coronavirus patients as special pathogens units, or SPUs.

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