Voices of Nurses and Allied Health Care Professionals in the US in the Coronavirus Pandemic


Scourge of Misinformation; Moderna’s Stumbling Block; What COVID Nurses Know

— A daily roundup of news on COVID-19 and the rest of medicine

Reporter: Gail S. Thornton, M.A.

Doctors reported battling not just the coronavirus but a “never-ending scourge of misinformation,” saying patients regularly resist their advice and are “more inclined to believe what they read on Facebook than what a medical professional tells them.” (New York Times)

And if you need a primer about what’s out there, Scientific American published a list of nine COVID myths that won’t go away.

COVID-19 is now the third-leading cause of death in the U.S., behind heart disease and cancer, said former CDC Director Thomas Frieden, MD. (The Hill)

Moderna’s phase III vaccine trial needs to enroll more minorities to succeed, Operation Warp Speed officials told CNN.

Regeneron signed a deal with Roche to triple its footprint in case its COVID-19 antibody cocktail works. (CNBC)

Nearly 50% of doctors surveyed believe COVID-19 will not be under control until next summer. (Physicians Foundation)

For-profit nursing homes in Connecticut had about 60% more COVID-19 cases and associated deaths per bed than nonprofit facilities, according to a state-commissioned study.

Two more universities suddenly reversed gears on in-person classes after COVID turned up on campus: Notre Dame and Michigan State. (NPR)

Cedars-Sinai researchers developed a machine learning tool to predict staffing needs by tracking local hospital volumes and confirmed COVID-19 cases. (Health IT Analytics)

What COVID nurses know: Chicago magazine tells the stories of frontline nurses during the pandemic.

Last Updated August 19, 2020





Harvard Medical School: Like No Other

Reporter: Gail S. Thornton, M.A.

HMS, HSDM Class of 2024 faces unique challenges, opportunities

screen capture of students on video call

Class of 2024 students attending the virtual deans’ welcome on Aug. 3.

“Your journey here begins in extraordinary times,” said Dean George Q. Daley, acknowledging the uncertainty, and even anxiety, that this year’s incoming Harvard medical and dental students may be feeling as they begin their studies remotely this month, in the midst of a global pandemic.

Daley’s remarks came during his welcoming address to members of the Harvard Medical School and Harvard School of Dental Medicine Class of 2024 on Aug. 3. Gathering via teleconference, they were joined by fellow classmates located all around the world.

Edward Hundert, HMS dean for medical education, talked about how the students were beginning classes during not only the worst global public health crisis since the flu outbreak of 1918, but also the worst looming economic crisis since the Great Depression and the worst racial crises in the U.S. since 1968.

But these challenges will give the Class of 2024 a chance, “more than any class in recent memory,” Hundert said, “to make an impact in public health and to address disparities.”

The first-year medical and dental students are the only class in the School’s history to begin their studies remotely. Most second- through fifth-year students who live off campus will be returning in person to pursue hands-on clinical rotations and laboratory research studies.

“In the face of the ongoing pandemic, we have taken unprecedented measures to protect the health and safety of you and the community to which you now belong, including initiating your medical education here virtually,” Daley said.

Because students, faculty and staff weren’t able to sit next to one another in the Walter Amphitheater, as they would normally do on the first day of their medical and dental school careers, Fidencio Saldaña, HMS dean for students, invited the attendees to scroll through the video screens to become acquainted with the nearly 250 participants on the call to get to know their faces and names.

A virtual White Coat Ceremony, where family and friends gathered online to get to know the incoming class, was broadcast on Friday, Aug. 7, at 1:30 p.m., and can be viewed here.

Saldaña’s advice to the entering class was to work hard, for their faculty, for their colleagues, but most importantly, for their future patients.

Wealth of diversity

The majority of the HMS and HSDM Class of 2024 are women. Of the 168 incoming HMS students, 101 are women and 67 are men. In the entering HSDM class of 35 students, 22 are women and 13 are men.

Faculty Associate Dean for Admissions Robert Mayer told the new students that the HMS students come from 35 U.S. states and six countries, with 21 percent from groups underrepresented in medicine, 38 percent Asian and 14 percent self-reporting as LGBTQ on the HMS secondary application. HSDM students come from 17 states and 4 countries, with 36 percent from groups underrepresented in medicine.

Having a diverse class is about developing relationships with, and learning from, the experiences of individuals who are from different economic backgrounds, of different races and express different genders and sexuality, said Hundert.

“It’s important to the mission of HMS to promote well-being for all,” he said.

Andrea Reid, associate dean for student and multicultural affairs at HMS, said her team works to promote a culture of care and success for all students.

“We’re here to support individual students … and to advance the cause of diversity across the medical school,” she said.

The School is developing an antiracism longitudinal curriculum, and the first class in the series was held on Aug. 4 during the incoming students’ first week. The goal is for students to develop the knowledge and skills that will prepare them to practice antiracism throughout their training and into their careers.

Course objectives include reckoning with the history of racism within U.S. medical institutions and learning how to integrate active antiracism practices into their work as part of their professional responsibility as physicians.

The makeup of the class reflects a wide range of academic interests and backgrounds, with the majority of students having taken one or more gap years: 73 percent of HMS students and 34 percent of HSDM students have pursued other interests during the gap between college and medical or dental school.

Two students are entering HMS with doctorate degrees and 24 have master’s degrees, while 25 HSDM students have research experience and 6 have published papers.

Awesome responsibility

Daley said it was an honor that the incoming students had chosen to bring to HMS and HSDM “your many talents, your diverse backgrounds and experiences, your dedication and passion for helping others.”

“Knowledge is, in many ways, powerless without compassion, empathy and trust,” Daley said.

For that reason, he said, the breadth of experience and backgrounds the class represents will serve them well as healers.

Daley added that it is “crucial to approach medicine with humility” because physicians have the privilege and “awesome responsibility” to help others when they are most in need, most vulnerable.

In his welcome, incoming HSDM Dean William Giannobile told students he looked toward a future of learning together.

“You will also quickly see the many opportunities that await you in your dental and medical education—cutting-edge training opportunities in the rich environment of the Longwood Medical Area, the hospitals, the research labs, the Forsyth Institute and the surrounding environs.”

“While we are together remotely for the short term, we are so looking forward to the time when you will join us on campus and experience this in person.”

Compassionate care

On Aug. 5, students attended their first patient clinic. It too was virtual—a telemedicine conference where they met their first patients on screen.

Joanne Guarino, a patient who was homeless and now serves on the board of the Boston Health Care for the Homeless Program, shared her story with the students. She was joined by her physician, James O’Connell, HMS assistant professor of medicine at Massachusetts General Hospital and president of BHCHP.

The students also met Barry Nelson, a lung cancer survivor and patient of Christopher Lathan, HMS assistant professor of medicine at Dana-Farber Cancer Institute.

Nelson, who is Black, said he was undergoing standard chemotherapy and radiation treatments at a different hospital when he asked for a meeting with his treatment team for an explanation of the treatment plan.

He said he was told by a doctor that he was wasting their time and that he was going to die anyway. Nelson said he felt the doctor’s comment was driven by racism—similar to other situations he has faced all his life.

He said he returned to Lathan, who had given him an initial second opinion on his course of treatment. Lathan agreed that it was the correct course and took the time to explain the plan.

Even though Lathan didn’t make any promises that the treatment would be successful, the difference, Nelson said, was that Lathan and his team treated him with dignity and respect. They also told him that they would fight for him as hard as he would fight for himself, he said.

When standard courses of treatment failed, Nelson’s doctors tried an approach that was brand new at the time—immunotherapy. He was introduced to Gordon Freeman, the HMS scientist at Dana-Farber whose lab developed the new immunotherapy protocol. Nelson told the students that his story is one of “faith, health care and science.”

The students had many questions for Guarino and Nelson about how to communicate with patients if they were homeless, on drugs, or lacking resources or insurance. And they asked for the best way to broach sensitive topics, such as the possibility that a treatment might not work.

Hundert, who was moderating the session, said giving a patient one’s full attention is critical. He said the School will teach the students, through classes, research and practice, how to develop their patient-relation skills—even how to deliver bad news, which they will learn to do with empathy, he said.

“Compassion is the key. If you don’t have it, you’re not going to be a good doctor,” said Guarino.

Hundert closed the session quoting from Francis Weld Peabody’s essay, “The Care of the Patient.”

“The secret of the care of the patient is in caring for the patient.”

HMS and HSDM students are assigned to one of five academic societies that become their home base while they are in the School—a place where they can seek academic and career advising but also find camaraderie with their peers.

This year, instead of gathering with their societies in a classroom for lunch, each society held individual video calls, gathering the students together to meet their advisory deans and introduce themselves.





Medical nonprofits are struggling during COVID-19. Harvard group offers a survival roadmap

Reporter: Gail S. Thornton, M.A.

Karen Weintraub


Fundraisers that support research and activism have been canceled since March with no end in sight. Small-scale donors are struggling to make ends meet. Consumer-based companies have cut way back on sponsorship.

By one estimate, nonprofit income has fallen 70% since the pandemic began.

Kathy Giusti has a plan for that.

Giusti co-founded the Multiple Myeloma Research Foundation in 1998 after being diagnosed with the blood cancer herself. She spent the next two decades building up the foundation, getting donors and funding drug development to combat her disease.

For the last four years, she’s also worked through a grant at Harvard Business School to help gather lessons the MMRF and 300 other medical nonprofits learned through experience and hard work.

Kathy Giusti

“Disease advocates don’t talk to each other,” Giusti said on a recent call.

“No one has enough money, enough people or enough time,” added professor Richard Hamermesh, the other co-chair of the Harvard Business School Kraft Precision Medicine Accelerator.

Now, the duo have published a “playbook” to share these lessons with thousands more.

Advocates can learn a lot from each other, they said. Some are good at collecting the kind of patient data that researchers and companies need to run clinical trials on potential drug candidates. Others are expert at raising venture capital or setting a strategic vision.

And all of America’s disease-related nonprofits now have to rethink what they’re doing in light of COVID-19.

“There’s no better time than now to be understanding how to start your business – but also to reset,” Giusti said.

That was how Nicola Mendelsohn first learned about follicular lymphoma – in 2016 when she was diagnosed with the incurable blood cancer. Mendelsohn said Giusti’s guidance has “saved us years” in the formation of the Follicular Lymphoma Foundation.

Mendelsohn runs Facebook in Europe, the Middle East and Africa, so she obviously understands people and social media. Her expertise can help other nonprofits that might not be as skilled at communicating with patients and potential funders.

Michael Hund, CEO of the EB Research Partnership, which aims to cure a group of rare, inherited and life-threatening skin diseases called epidermolysis bullosa, has a different skill set. He’s an expert in getting “venture philanthropy,” investors who promote social good with their money.

So, at meetings at Harvard Business School and virtually, he has helped draw up advice to other nonprofits looking to access venture philanthropy. At the same time, by being part of the group, he has been able to learn from nonprofits that may have led hundreds of trials instead of 30.

Such sharing can allow nonprofits to pick up the pace of medical progress, helping people who can’t wait the decades it might otherwise take to come up with an effective treatment or cure.

Giusti said COVID-19 has presented some opportunities for medical nonprofits, such as advances in telemedicine that are allowing more aspects of clinical trials to move online.

The collaborations and focus that have enabled candidate COVID-19 vaccines and treatments to advance faster than ever before are also inspiring, she said.

“I honestly think we won’t ever go back to the way we were” before COVID-19, she said. “If we’re smart, we’ll understand from the COVID-19 world what we can do.”

Contact Karen Weintraub at kweintraub@usatoday.com

Health and patient safety coverage at USA TODAY is made possible in part by a grant from the Masimo Foundation for Ethics, Innovation and Competition in Healthcare. The Masimo Foundation does not provide editorial input.





Being sick and alone is miserable. Being sick at home with your family might be dangerous.

Reporter: Gail S. Thornton, M.A.

By Ariana Eunjung Cha and 

April 14, 2020 at 6:00 a.m. EDT

Sandy Brown’s husband knew he was infected. The 59-year-old church elder had the trademark dry cough and fever of covid-19, but when she drove him gasping for air to the emergency room, the doctor’s advice was to go home and stay home.

So he did.

Soon, their 20-year-old son was sick, and within 12 days, both had died.

The standard prescription from the Centers for Disease Control and Prevention for the mildly ill to self-isolate at home is something doctors and nurses in coronavirus hot spots repeat hundreds of times each day. But there’s a devastating cost to the public policy decision: multiple families with multiple deaths.

An 86-year-old matriarch and her three adult sons in New Orleans.

High school sweethearts married for 57 years in Grove City, Ohio, and their son, who had visited recently.

Sisters in Chicago. A mother and daughter in Baltimore.

All dead within days of each other because of the coronavirus.

Amid the family tragedies come increasing calls for U.S. officials to isolate the mildly ill and infectious away from their homes — in convention centers, school gyms, anywhere else.

It’s not just a public health issue but an economic one.

Focusing restrictions more narrowly on the infected and their contacts, so that others can be freed from lockdown, has become a vital pillar of proposals to reopen the country.

The issue is especially critical in light of research that suggests genetics may partly explain the wide disparity in how people react to covid-19, with some shrugging off the virus without even knowing they are infected and others facing death.

On March 30, the World Health Organization’s Michael Ryan warned of a new stage of transmission in countries that instituted lockdowns and social distancing, but left many of the contagious at home.

“In a sense,” Ryan said, “transmission has been taken off the streets and pushed back into family units.”

China’s success with isolating family members separately has been held up as a model for breaking transmission chains. But images of Chinese officials forcibly taking people from their homes drew visceral reactions from many.

“We couldn’t under any circumstance do what China did,” said Thomas J. Bollyky, a senior fellow at the Council on Foreign Relations and director of its Global Health Program. “Large-scale, non-voluntary quarantines would be challenging from a legal point of view.”

Yale University’s Gregg Gonsalves, an epidemiologist, tweeted Wednesday that family separation “is a cruel overreaction and a violation of human rights.”

But other experts, such as Carl Minzner, a professor of law at Fordham University, believe isolation and quarantine can be done voluntarily, in a way that respects civil liberties. Minzner is especially worried about poor people living in dense housing, who, according to early reports, make up a disproportionate number of the infected.

“Many people,” he said, “are terrified about infecting their family members and want to self-isolate but have nowhere to go.”

Several U.S. communities recently began experimenting with isolation centers.

On April 1, Hillsborough County in Florida set up two motels for those who have suspected or confirmed infections and are concerned about exposing vulnerable family members. Wisconsin and North Carolina have done the same in their largest cities. Other jurisdictions have set up “safe” housing for first responders such as doctors and police.

Different countries, different experiences

South Korea, Singapore and Taiwan, which have been relatively successful at controlling the spread of the virus, isolated the mildly ill, while Italy and Spain, where infection rates skyrocketed, did not. Public health experts have said a steady stream of household infections may be to blame for that spike in numbers.

China’s experience may be the most instructive. The country initially ordered people to stay at home. But as infections mounted, it turned to isolation, separating those with covid-19 from non-infected people, and quarantine, separating those who had come in contact with an infected person to see if they also would become sick.

When China shut down Wuhan on Jan. 23, the scope of the lockdown was unprecedented in modern times. Flights and trains were stopped. Public transportation was suspended. All of a sudden, millions were told to stay at home.

Through late January and early February, the city’s hospitals were overrun. With intensive care units packed, people with mild illness were advised to stay home. The problem, of course, was that sick people spread the virus through households.

Some tried to keep family members with symptoms in a separate room. But the virus spread through the city’s apartment blocks. In some case, whole families got sick.

In early February, China adopted a new tactic: mass quarantine and isolation. In Wuhan, more than a dozen makeshift hospitals and quarantine centers were opened.

On a visit to Wuhan, Vice Premier Sun Chunlan ordered medical workers to scour homes for confirmed cases, suspected cases, people with close contact with confirmed cases, and people with fevers.

People who did not cooperate would be compelled into quarantine. The vice premier warned of “wartime conditions,” saying “deserters” would be “nailed to a pillar of historical shame.”

In some cases, healthy people were mistakenly sent to live in close quarters with the sick, fueling the spread of disease. In some facilities, patients languished without adequate care. Social media posts showed people being dragged away against their will to quarantine or isolation.

The opposite approach is also terrifying. Italy’s lack of isolation centers, along with multigenerational households, has been cited as a reason for its high infection and death rates.

Zeke Emanuel, a medical ethicist who was an adviser in the Obama administration; Scott Gottlieb, a physician who was President Trump’s first Food and Drug Administration commissioner; and others who have released detailed plans for how to safely end the crisis have argued that there is a middle ground.

They point to the threat of large fines and appeals to people’s sense of moral obligation to their families and communities as effective strategies used in other parts of the world to get those suspected or confirmed to be infected to leave their homes.

Harvey Fineberg, a former president of the National Academy of Medicine who now heads the Gordon and Betty Moore Foundation, has proposed that the United States consider what he calls a “smart quarantine.”

Anyone who shows symptoms would be separated in a temporary shelter until test results return. If they test negative, they would remain in quarantine and be retested at 14 days. If that second test is negative, they could return home. If they test positive, they would go into a different type of facility for care.

To be effective, he argues, the proposal must be part of a broader strategy: testing, isolating confirmed or presumptive cases, and contact tracing. Isolating the infected wouldn’t be possible in all cases. After all, scientists believe some people are asymptomatic. But it would slow down the rate of infection.

“We have seen from elsewhere, those who are most at risk are the family members of those who have been exposed,” he said.

He said many people would welcome the opportunity to shelter somewhere outside their home, provided there was adequate care.

“I think that a lot of people, when they really saw it as a way to provide maximum protection to their own family, would welcome this,” he said.

U.S. experiments

One of the nation’s first voluntary quarantine and isolation facilities opened in early April in Florida’s Hillsborough County. Housed in two motels with 362 rooms, the center provides people concerned that they could infect elderly or medically vulnerable family members a free, out-of-home option for shelter.

Iñaki Rezola, operations section chief for Hillsborough’s emergency management team, said that while the center’s main goal is to help people at the beginning of infection — when they are typically shedding the most virus and pose the biggest risk — it is also accepting patients discharged from hospitals.

Rezola said 14 people have already checked in. Referrals for a spot are made by physicians to the county’s department of health.

Rezola said guests (he emphasized that they are not patients) are served three meals a day in their rooms, paid for by the county. While no medical workers are on site, the staff is available to deliver medicine and has access to doctors via telemedicine. Each unit has its own air conditioning and heating, so there is little concern of contamination from adjacent rooms.

“Placement is voluntary,” Rezola said. “You choose to go here. No one is being kept against their will.”

On Wednesday, North Carolina announced that it had secured 16,500 hotel and dorm rooms to be used as recovery centers for those who have recently left the hospital and are possibly still infectious, and, separately, for what the state calls “shelter-in-peace” sites for first responders such as doctors, nurses and police.

The recovery centers will provide medical support such as supplemental oxygen. The “shelter-in-peace” buildings will have reconfigured HVAC systems so that rooms don’t share air; after each room is vacated, it will be sterilized with 135-degree heat for three hours to kill any virus on surfaces, officials said.

Two funerals, three deaths

Marcos Melendez wishes that such facilities existed a few weeks ago near his home in West Jordan, Utah. A Costco cashier, Melendez said he believes he was the first in his family to become infected.

The second week of March, he said, he came down with a high fever and a cough so bad that he contacted his doctor at the University of Utah via video chat. He said he was told to quarantine for 14 days and call back if he got worse. It wasn’t long before the rest of his household — his wife; two sons, ages 22 and 28; and 24-year-old daughter Silvia — were infected.

“I was surprised they didn’t take me to the hospital. I should have gone to the hospital, and I should have stayed in the hospital so I didn’t infect my family,” Melendez said.

As he feared, Silvia, who a few years ago underwent open-heart surgery because of a genetic condition, became seriously ill. What he didn’t expect was that his wife would, too. Both were admitted to the hospital. His wife pulled through and is at home recovering. Silvia died on March 28.

On Friday, Sandy Brown buried her husband and her only son in a cemetery near their hometown of Grand Blanc, Mich. She recalled Freddie Brown Jr. as a gentleman who always opened the door for her and “dressed to the nines.” Her son, Freddie Brown III, or “Sonny,” was a defensive lineman for his high school football team and had planned to study kinesthesiology at Michigan State in the fall.

Just hours after her husband’s death on March 26, Brown said, her son suddenly developed a 102.8-degree fever and was having difficulty breathing.

“I know he got it from his dad. He was fine before,” she said.

Three days later, she was on FaceTime with Sonny at the hospital as medical workers were about to put him on a ventilator.

“I told him to stay calm. He was afraid. His dad died on the same floor. I begged them to be able to be in the room with him,” she said. The doctors refused because of the risk of infection, but a few hours later she got a call telling her to hurry to the hospital. By the time she arrived, he was gone.

“This is a horrible disease,” she said, “a horrible plague. And that’s the story.”

Alice Crites in Washington and Liu Yang in Beijing contributed to this report.

Ariana Eunjung Cha is a national reporter. She has previously served as The Post’s bureau chief in Shanghai and San Francisco, and as a correspondent in Baghdad.
Emily Rauhala writes about foreign affairs for The Washington Post. She spent a decade as an editor and correspondent in Asia, first for Time magazine and later, from 2015 to 2018, as China correspondent in Beijing for The Post. In 2017, she shared an Overseas Press Club award for a series about the Internet in China.Fol





April 20, 2020 at 11:10 a.m. EDT

NORTH BERGEN, N.J. — The caller was 18 years old. He was from Peru and lived with his father, just the two of them, everyone else back at home. The father, 56, had tested positive for covid-19 and now the son was unable to wake him from his bed.

When Dave Prina and the other EMTs arrived, there was nothing to do but express condolences and ask for the father’s identification for the paperwork. What’s the boy going to do? he wondered. How will he live? How will he pay next month’s rent?

“When we left, he was hysterical on the stairs,” Prina recalled.

The ambulance call that haunts him is one of thousands during several relentless weeks in which this region has become the world’s coronavirus epicenter. North Bergen is located at the other end of the Lincoln Tunnel from New York City on hilly cliffs, part of a constellation of densely populated, working-class cities and towns where the virus has flourished. As of Sunday, New Jersey had 85,000 confirmed cases with 4,200 deaths — and most are concentrated here in the northern part of the state.

While most Americans shelter at home, emergency medical technicians (EMTs) — who operate the nation’s ambulances — go toward the danger. Working in chaotic conditions in unpredictable environments, they are a resilient bunch trained to respond to everything from highway pileups and bar fights to people having seizures in their homes.

But operating against an invisible virus that kills so indiscriminately is different. At least 13 EMTs and 50 police officers and firefighters nationwide have died of covid-19-related complications in recent weeks. And in a pandemic that has killed mostly the elderly, a disproportionate number of the first responders who have perished have been in their 30s and 40s.

Two of the dead are this area’s own: Kevin Leiva was a 24-year-old EMT in North Bergen. Israel “Izzy” Tolentino Jr., a 33-year-old father of two, was a firefighter and EMT from neighboring Passaic. Both had second jobs as EMTs for Saint Clare’s Dover Hospital, where they sometimes worked together.

“We all know what the job is. But no one expected this,” said Pachay, 24. “Once his passing was made public, everyone — even people who didn’t work with him regularly — was upset. It’s a small community.”

In northern New Jersey, ambulance crews are almost a family business, with every one linked in some way to every other one in the region. The job pays $16.50 to $20 an hour (with an extra $10 an hour thrown in these days as hazard pay) for a 12-hour shift. It’s not enough to make a living on its own, so many of those who work in North Bergen have two jobs, some three, with other EMT services in places such as Union City, Passaic, Paterson and Jersey City. Many have spouses, significant others, siblings, cousins, parents, and aunts and uncles who are also on the front lines on ambulances or at hospitals. Most are bilingual Spanish speakers who were born in the United States or who immigrated at a young age, reflecting the area’s increasing diversity.

For many who serve with North Bergen’s Emergency Medical Services, the job is a calling.

Liz De Bari is one of the crew’s oldest, at age 44. She joined after witnessing the collapse of the twin towers on Sept. 11, 2001, from a street not far from the ambulance bay on Granton Avenue where she now works. Marco Navarro, 30, is a former Marine reservist who did a tour in Iraq. Estafania Castaneda, 29, was working at Dunkin’ Donuts when a customer suggested she consider becoming an EMT. She thought, “Why not?” and ended up loving it.

As for Leiva, he had always dreamed of becoming a doctor, says his wife, Marina, but his parents didn’t have much money and he realized he probably wouldn’t be able to pay for medical school. Then one day when he was in college, he received an email meant for someone else about a scholarship for a student who wanted to go into emergency medical services. He applied, and got it. Marina said he felt it was “an act of God.”

Unlike some medical centers where doctors and nurses are facing shortages of masks and other protective gear, the North Bergen Township has plenty because of stores it created during the Ebola panic. It has N95 masks, goggles, face shields, gowns, hats and gloves.

Yet EMTs are still somehow becoming infected.

A 30-hour shift

Officially, 47 people are on the North Bergen EMS roster. After Leiva’s death on April 7, however, three co-workers went AWOL — “just disappeared,” scheduler Gendi Santiago said. A fourth called in to say that her husband didn’t want her to work while covid-19 was still tearing through the town. A fifth broke down crying last week with two hours left to go in her shift and went home early.

Brigdon Campbell, 39, was one of them. When he first noticed symptoms — he lost his sense of taste and smell, a trademark of the infection — he wondered if he would die, too.

“I was like, ‘We had a good run.’ I accepted it,” Campbell recalled. But nine days later, he was feeling fine and cleared to return to work.

He thinks becoming infected was inevitable, almost a mathematical certainty based on his close contact with so many infected people. “It doesn’t matter how careful you are,” he said. “The more times you do it, the more chances you have to catch it.”

Those who remained worked back-to-back shifts as the volume of 911 calls soared from about 600 a month to more than 1,000. One particularly bad day in April, De Bari worked 30 hours straight. She said afterward that she felt as though she couldn’t breathe, even though she wasn’t sick, and she had to take time off. “It was PTSD,” she said — post-traumatic stress disorder. She said she just sat at home for two days and thought.

“I didn’t know what was going on. Everyone was dropping dead. I just wanted to be with my family. At that point, I started thinking, should I say goodbye to my parents? Am I going to die tomorrow?” she said. “Now I came to terms with it. I’m not a quitter. I’m going to keep going.”

Other EMTs are dealing with similar stress.

Navarro’s daughter was born two weeks ago at 1 pound, 13 ounces, and is still in a neonatal intensive care unit. He couldn’t be there for the birth and hasn’t dared to go anywhere near her for fear of transmitting the coronavirus. “I go visit by the window,” he said.

Campbell wears a mask when he’s at home 24/7, even when he sleeps, because he doesn’t want to infect his 2-year-old.

Castaneda hasn’t seen her elderly parents in a month for the same reason.

Following the deaths of their fellow EMTs, there was an outpouring of support from the community. The local pizzeria sent pies. School parent associations delivered bag lunches. And Starbucks offered free coffee. The Justice Department clarified that a federal program for first responders that provides benefits for the survivors of those who die “in the line of duty” will include covid-19, if it’s “more likely than not” that they were exposed during their work. Politicians from New Jersey, including Sen. Cory Booker (D), have argued that in a pandemic, it can be impossible to pinpoint the source of an infection, and that all working first responders who perish from covid-19 should be included.

The EMTs say they are grateful for the support, but don’t feel like heroes when so many are dying.

Everyone has that one coronavirus call that they think about over and over again. For Castaneda, it was the man who had collapsed on the floor, dying, with his three children, wife and mother saying prayers in Spanish and begging her to “please bring him back to life.”

“When you are treating the patient, the adrenaline is rushing, but when you get off shift, that’s when it hits,” she said. “The kids crying and screaming and screaming.”

For Pachay, it’s the 50-year-old man who suffocated in front of him. “Just watching him going from talking to you to being dead a few minutes later. . . . His wife was there. She saw everything,” he recalled.

For Prina, it’s the mounting number of DOAs, or dead on arrivals — the people dying in their homes — that make him feel helpless. In normal times, they might see one, maybe two a month or every few months. Now it’s more like six or seven a week.

“It’s just call after call after call. I have never seen anything like it,” said Prina, a former firefighter. “Every other [call] is ‘flu-like symptoms.’ I have been an EMT for 25 years. I see death all the time. I have seen some awful things. But it’s the repetition that gets me. If you go on shift now, it is a guarantee you will see death.”

Prina thought again of the 18-year-old boy and his 56-year-old father. His own son is 18. He’s 51.

“I heard they are putting people on the malaria drug and a Z-pack, which works great for some people. My friend’s father took it early on and he had a fever for one day and was better,” he said, referring to the anti-malarial hydrochloroquine touted by President Trump and the antibiotic azithromycin. (The combination, which can cause dangerous cardiac effects, has not been recommended to prevent infection but some hospitals are trying it for sick patients.) “I have a stash in my house.”

As chief of the North Bergen crew, Prina has had to make dozens of decisions, big and small, over the past few weeks that weigh heavy. Many times, he’s facing only bad choices.

In early April, all seven nearby hospitals went on “divert” status, signaling that they were too overwhelmed to handle any more patients. But Prina calculated that the next closest hospital was 20 to 25 minutes away — too far for a patient in cardiac arrest or respiratory distress. A one-hour round trip, including the time to hand off the patient, would also mean leaving others who called 911 waiting. So he ordered the trucks to take patients to the closer hospitals anyway.

Another big issue was a nearby nursing home with several dozen deaths. He did not want his EMTs going inside, if at all possible, because he thought the entire complex was probably contaminated. So he worked out a compromise: The nursing home staff members wheel patients outside so the crew can treat them there.

CPR, or cardiopulmonary resuscitation, which involves chest compressions and tends to aerosolize the virus, putting EMTs at increased risk, was another big concern.

“All the rules are different,” he said. “We do three rounds of CPR and then it’s over. They just leave you there. In the past, they would work you all the way to the hospital.”

He said the town is bringing in antibody tests so that every EMT will be tested this week to see if they have been exposed to the virus. And it has set up a mental health counseling service that will allow everyone to have up to 12 one-on-one sessions.

Reinforcements arrived at 3 a.m. on April 11, finally: six fresh-faced men and women from Indiana, all in their early 20s, hired by the Federal Emergency Management Agency, who had driven all night to get there.

“They thought they would be transporting people to the covid hospital ship,” Prina said. “They never had any idea they be doing 911, never had any idea they would be thrown into hell. Some had never done CPR. The first day, our guys were like, what the [expletive] are they doing here?”

What ensued was an almost comical culture clash, between the loud and cynical New Jersey natives and the more soft-spoken and mellow Indiana visitors.

Some issues were technical. None of the Indiana EMTs knew how to use stair chairs or lifts, which are critical for getting patients downstairs in the narrow rowhouses in North Bergen. A genuine observation: “It’s like they don’t have stairs there. Like maybe everything in Indiana is one story?”

When the New Jersey crew asked about the types of 911 calls they got in their area, the Indiana EMTs talked about “shooters” — people with guns shooting themselves or others by accident — a concept that left the urbanites agape. But it wasn’t long before the FEMA group earned their respect.

“They are totally not like us,” Prina said. “But they learned in 12 hours what took us months.”

With up to six ambulance trucks operating instead of three and the volume leveling off somewhat as it has in New York City these past few days, things have felt more in control, he said.

Yet the calls keep coming. A recent weekday morning brought some good news. A mother had called about her 20-something son, saying she couldn’t rouse him. The crew feared the worst, but when they arrived he was sitting up and chatting. Everyone smiled, but the reprieve was brief. The radio had started up again.

“She’s turning purple and fainted.”

“He’s blue and nonresponsive.”

“Reporting shortness of breath, back pain.”

The requests inevitably end with: “Use universal precautions.” That’s dispatcher lingo for “This is probably a covid-19 case” and a signal that the team should put on masks, face shields and other equipment to avoid the contagion. The reminder, of course, is unnecessary.





A day in the life of an ICU nurse during the COVID-19 pandemic in Houston

Reporter: Gail S. Thornton, M.A.

Demond McDonald, an ICU nurse at Memorial Hermann Hospital, says ICU beds aren’t staying empty for long.

 Ron Trevino

HOUSTON — One of the busiest ICUs in Houston is at Memorial Hermann in the Texas Medical Center.

One of its busiest nurses is Demond McDonald.

“It’s been really crazy to see all these people come in with COVID,” McDonald said.

McDonald said his unit has 22 beds, and as soon as one bed becomes available, it’s quickly back in use with another COVID-19 patient. No visitors are allowed.

He said some patients are able to do Zoom calls and regular phone calls. McDonald said he’ll never forget a patient from two months ago whose wife called every day. He held the phone up to the patient’s ear.

“Actually having me to just have the phone to where she could sing to him, that was big for me.”

That patient recovered, but McDonald has seen many COVID-19 patients not recover. He’s witnessed a lot of death in the past few months. He said it’s a reality check for those who aren’t taking the coronavirus seriously.

“I wish they would just see what I see and understand the severity of wearing masks out in public because it’s real.”

He sometimes works up to 60 hours a week and welcomes the nurses now coming into Houston from other parts of the country.

“I’m appreciative that we have people that can come help us like we had people that were able to go help them.”





U.S. Workers Honored

Reporter:  Gail S. Thornton, M.A.

The following article is reprinted from MedPage Today.

Honoring U.S. Healthcare Workers Who Died From Coronavirus

— MedPage Today lists those who have lost their lives to COVID-19

An In Memoriam graphic

While all life lost during the coronavirus pandemic is invaluable, MedPage Today is highlighting the names of U.S. healthcare workers who have died while working on the front lines.

This list will be updated regularly. If you would like to add a fallen healthcare worker to this list, please email Kristina Fiore at k.fiore@medpagetoday.com.

Updated June 4, 2020.

Milagros Abellera, RN, Nix Health, San Antonio, Texas

Romeo Agtarap, RN, New York Presbyterian/Columbia Irving Medical Center, New York

Nancy Ajemian, MD, Beaumont Hospital, Grosse Pointe, Michigan

Larrice Anderson, RN, New Orleans East Hospital

Jeff Baumbach, RN, St. Joseph’s Medical Center, Stockton, California

Earl Bailey, RN, Broward County, Florida

Celia Yap Banago, RN, Research Medical Center, Kansas City, Missouri

Glenn Barquet, MD, Mercy Hospital, Miami, Florida

James Boudwin, MD, Robert Wood Johnson University Hospital, New Brunswick, New Jersey

Ronald Brisman, MD, Columbia University Medical Center, New York (retired)

Irving Buterman, MD, Lenox Hill Hospital, New York

Patrick Cain, RN, McLaren Flint Hospital, Michigan

Luis Caldera Nieves, MD, gynecologist, Miami, Florida

Evelyn Caro, RN, Holy Cross Hospital, Maryland

Ricardo Castaneda, MD, psychiatrist, New York

Rosary Celaya Castro-Olega, RN, Los Angeles, California

Paul Constantine, MD, family practice, Orange County, California

Kenneth Conte, MD, private practice, New Jersey

Ydelfonso Decoo, MD, pediatrician, Queens, New York

Ernesto DeLeon, RN, Bellevue Hospital, New York

Danielle DiCenso, RN, Hialeah Hospital, Florida

Daisy Doronila, RN, Hudson County Jail, New Jersey

Orlando Espinoza, MD, family practicioner, Broward County, Florida

Lisa Ewald, RN, Henry Ford Hospital, Detroit

Christopher Firlit, DMD, MD, Ascension Macomb Hospital, Michigan

Jessie Ariel Ferreras, MD, Valley Medical Group, Waldwick, New Jersey

Frank Gabrin, MD, East Orange General Hospital, New Jersey

Deborah Gatewood, phlebotomist, Beaumont Hospital, Michigan

Michael Giuliano, DO, Mountainside Medical Group, New Jersey

James T. Goodrich, MD, Montefiore Medical Center, New York

Harvey Hirsch, MD, Pediatrician, Lakewood, New Jersey

James House, RN, Omni Continuing Care, Detroit

Alex Hsu, MD, Northwest Medical Center, Weston, Florida

Araceli Buendia Ilagan, RN, Jackson Memorial Hospital, Miami

Kious Kelly, RN, Mount Sinai West, New York

Satyender Dev Khanna, MD, surgeon, Clara Maass Medical Center, New Jersey

Kim King-Smith, EKG technologist, Newark University Hospital, New Jersey

Robert Lancaster, MD, psychiatrist, Louisiana

Theresa Lococo, RN, Kings County Hospital, New York

Maria Lopez, RN, University of Illinois, Chicago

Felicisimo Luna, RN, Trinitas Regional Medical Center, New Jersey

James Mahoney, MD, University Hospital of Brooklyn, New York

Mike Marceaux, RN, Christus Highland Hospital, Louisiana

Celia Lardizabal Marcos, RN, Hollywood Presbyterian Medical Center, Los Angeles

Sydney Mehl, MD, NYU Langone Medical Center, New York

Lois Merrell, RN, Pine Bluff, Arkansas

Anjanette Miller, RN, Chicago

Francis Molinari, MD, Clara Maass Medical Center, New Jersey

Matthew Moore, radiologic technologist, Staten Island, New York

Nola Mae Moore, MD, physician, Washington state

William Vincent Murdock, MRI technologist, University of Miami Health System

John F. Murray, MD, San Francisco General Hospital (retired)

Kimberly Napper, RN, Mississippi

Darioush Nasseri, MD, Baltimore, Maryland (retired)

Freda Ocran, RN, Jacobi Medical Center, New York

Sandra Oldfield, RN, Kaiser Permanente Fresno Medical Center, California

Pamela Orlando, RN, Valley Hospital, New Jersey

Joyce Pacubas-Le Blanc, RN, Chicago Medical Center

Angelo Pastalas, MD, family physician, Detroit

Tomas Pattugalan, MD, primary care physician, Queens, New York

Bredy Pierre-Louis, MD, family medicine, Brooklyn, New York

Nisar Quraishi, MD, internal medicine, NYU Langone, New York

Maria Roaquin, RN, New York Presbyterian, Cortlandt Manor, New York

Ivan Rodriguez, MD, internal medicine, Brooklyn, New York

Burton Rose, MD, Creator of UpToDate

Victor Rivera, MD, pediatrician, Langhorne, Pennsylvania

Charlie Safley, MD, dermatologist, Memphis, Tennessee

Barry Sakowitz, MD, internal medicine, Paramus, New Jersey

Elliott Samet, MD, pediatrician, St. Mary’s Hospital, New Jersey

Eugene Sayfie, MD, cardiologist, University of Miami Hospital

Ellyn Schreiner, RN, Dayton, Ohio

Stephen Schwartz, MD, University of Washington, Seattle

Gary Sclar, MD, Mount Sinai Queens, New York

Noel Sinkiat, RN, Howard University Hospital, Washington, D.C.

Javier Sloyer, MD, anesthesiologist, New York

Charles Rodney Smith, MD, psychiatrist, New Orleans

Joshua Suzuki, MD, ob/gyn, Seattle

Arthrur Sydeco Tayengco, MD, ob/gyn, Las Vegas

Jesus Villaluz, patient transport services, Holy Name Medical Center, Teaneck, New Jersey

Diedre Wilkes, mammogram technologist, Newnan, Georgia

Petal Williams-Richards, respiratory therapist, BronxCare Health System

Judy Wilson-Griffin, RN, St. Mary’s Hospital, St. Louis

Sina Zaim, MD, Hackensack University Medical Center, New Jersey

Jesus Zambrano, MD, pediatrician, Oceanside, New York

Jack Zoller, MD, ob/gyn, New Orleans

Last Updated June 04, 2020
  • author['full_name']

    Kristina Fiore leads MedPage’s enterprise & investigative reporting team. She’s been a medical journalist for more than a decade and her work has been recognized by Barlett & Steele, AHCJ, SABEW, and others. Send story tips to k.fiore@medpagetoday.com. Follow 





Nursing Accounts During the Pandemic

Reporter: Gail S. Thornton, M.A.

The following article is reprinted from The Smithsonian Magazine.

‘I feel defeated’: A nurse details the unrelenting pressures of the frontlines

As coronavirus cases in Maryland increase, photographer and nurse Rosem Morton shares her frustrations, fears, and coping strategies.

AS CORONAVIRUS PATIENTS have filled hospital wards, medical staff across the country have had to adapt quickly to shifting working conditions. For Baltimore nurse Rosem Morton, this means monitoring her hospital’s limited personal protective equipment (PPE), dealing with delays in surgical procedures, and grappling with grief and anxiety around her. On their days off, she and her husband Ian, a nurse at a different hospital, try to relax and enjoy their time together, but the mental and emotional toll of the crisis lingers.

Morton, a photographer and recipient of a National Geographic Explorer grant, has been documenting her daily experiences as the novelty of the pandemic wears off and the crisis becomes normalized. This is what it’s like to be a frontline medical worker fighting against COVID-19.

Read Morton’s journal from the first eight days of the pandemic here.

Please click on the link below to read more of this story.





Doctors, Nurses and Other Health Professionals Speak Out About Treating Patients

Reporter: Gail S. Thornton, M.A.

The following article is reprinted from The New York Times.

Scores of Times staff members worked to present the stories of doctors, nurses and other health care professionals who are risking everything to care for Covid-19 patients.

Credit…The New York Times


May 11, 2020

For the health care workers on the front lines of the coronavirus pandemic, the strain comes in an unrelenting wave of nexts. Across the globe, they live with exhaustion, fear even guilt — without “beginning or end,” one nurse said.

To understand the sacrifices of doctors, nurses and other professionals caring for Covid-19 patients, The Times invited them to share their stories in their own words. Their selected accounts and photographs have been published as a developing special collection, “In Harm’s Way.”

Early on, editors recognized the experiences of health care workers “would be like no one else’s,” said Sam Dolnick, an assistant managing editor, who launched the project with the deputy managing editor Steve Duenes. “And a visual, global gallery seemed the best way to capture their stories.”

Ultimately, that gallery would include the work of more than 65 editors, developers, photographers, reporters and researchers. To date, it has garnered more than 600 responses. Catrin Einhorn, a reporter and senior staff editor, and Clinton Cargill, assistant national editor, shepherded the effort. “We wanted to bring readers inside the world of health care workers,” Ms. Einhorn said, “both inside the physical hospitals and inside their emotional lives.”

Becky Lebowitz Hanger, the photographers’ chief, worked with photographers across the globe to seek out candidates, take portraits and invite them to contribute.

Narratives from Salina, Kan., to Feroz Koh, Afghanistan, reflect the emotional turmoil medical professionals endure every day. Saving lives. Bearing witness. Saying final goodbyes.

Daniel Akinyemi, an intensive care nurse who lives in Montclair, N.J., sang “Blue Bayou” to an ailing female patient — her favorite song. Claudio Del Monte, a chaplain in Bergamo, Italy, layered his gloves so that he could still hold patients’ hands, telling them, “don’t be afraid.”

Becky Williams, a paramedic in San Bernardino, Calif., loaded an 88-year-old man with a 103.9-degree fever into an ambulance, while a family member quickly called his loved ones. “The family members are telling him on speaker phone, ‘We love you, Pop Pop — we’re praying for you, Pop Pop,’ over and over as fast as they can,” she recalled.

The senior audience editor Sona Patel helped craft the questions health care workers filled out online. (Among them: “Tell us about the most intense experience you have had fighting Covid-19.” “How has being a health care professional during the Covid crisis changed you?”) The team sent the callout in English and Spanish.

“The conversation was always around the idea that health care workers were really thrust into this front line position, which is not how we typically think of their work,” Mr. Cargill, the assistant national editor, said. “So we wanted to delve into the sense of identity that people feel in these roles and how working against the coronavirus has impacted that identity.”

Aidan Gardiner, a news assistant, has so far combed through 517 submissions — confirming every person’s identity — and “they keep coming in,” he said.

Working from home, editors parsed through stories to identify unrepresented locations; reporters across the globe filled in gaps and conducted additional interviews in heavy-struck cities and countries. Jonathan Ellis, an editor on loan from the Politics desk, played a prominent role finding medical professionals, interviewing subjects and editing accounts.

From her laptop at her dining room table, the graphics and multimedia editor Rebecca Lieberman designed the digital presentation. She sought to achieve a “delicate dance between the form and the content,” she said, aiming to “give readers that sense of scale but also allow them to meander the content, consuming a lot of stories without having to do a lot of work clicking or swiping.”

Since the initial online publication on May 4, the team has received some 160 additional entries. Submissions will remain open during the pandemic, and the design may evolve as the project builds. Reporters and editors also plan to follow up with some of the featured medical professionals.

“Hopefully we are signaling to health care workers that we really want to tell their stories,” Ms. Patel, the senior audience editor, said. “This is a two-way thing. It’s not the last time that we’ll connect with them.”

If you are a health care worker and would like to share your story, you can do so here.






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Preparing to Go Back to the Bedside During COVID-19: A Nurse-Turned-Bioethicist Reflects

April 30, 2020 The Petrie-Flom Center Staff Bioethics, Emily Largent, Featured, Patient Care, Public Health

By Emily Largent



An ICU nurse opens up about the good, the bad and the ugly during the pandemic – Mass General Hospital News





Nurses are the coronavirus heroes. These photos show their life now


CHINA: A nurse sheds a tear while discussing the situation at Jinyintan Hospital in Wuhan in central China’s Hubei province, where the coronavirus outbreak began, on Feb. 13.
(Barcroft Media / Getty Images)


‘It’s Like Walking Into Chernobyl,’ One Doctor Says Of Her Emergency Room

April 9, 20205:00 AM ET





Nurses on the frontlines speak out

Updated 1 day ago

Registered nurses across the U.S. are grappling with a global supply shortage of masks and personal protective equipment that is making it challenging for them to care for patients in a safe and productive way, according to hundreds of comments on LinkedIn from nurses across the country. To make matters even worse, many hospitals are facing nurse shortages as caregivers of coronavirus-infected patients are among the highest at risk of contracting the disease themselves.

I currently work in NYS Buffalo region in the ER. We have seen cases confirmed and unconfirmed. We receive daily updates at minimum, however can be updated and changes made multiple times during a shift to keep up with WHO and CDC recommendations. We currently are not short supplies, however we have implemented recommendations to reserve as much as possible by re-using N95 masks. I personally am doing well with the crisis and am on the volunteer list for Covid designated hospitals if needed. I as well feel some frustration with the lack of concern by some in the community and all over after witnessing first hand the disease and it’s impact. I believe NYS has down a phenomenal job in keeping the public updated and informed with multiple resources to meet peoples needs or answer questions. I am shocked though by how many people are still showing up to ER’s and such for non emergent issues that can easily be resolved at home or through contact with a primary. It also shows the need to really look at our health system and public education on the abuse of ER’s for primary care. I could go on but for now I with everyone the best and pray this will be contained soon.

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