our numbers are increasing

It’s been three weeks since this last post about what is happening in my work life. Friday marked the end of my 16th week on the palliative care team that is seeing the COVID positive patients at my hospital. 

Here is a quick update from the front lines: 

Our numbers are increasing.  Today we had 35 COVID + patients.  Twelve of them sick enough to be in the ICU.  Four on ventilators, 2 more headed in that direction. Our ICU intensivists continue to try waiting longer before intubating patients; instead using high flow heated oxygen which is different than at the outset of the pandemic when we worried about aerosolization of the virus using this therapy. 

We anticipate a surge to numbers in the 50’s and 60’s is coming soon. At this time we have enough ventilators and enough ICU beds. We heard on Friday that our hospital just spent 3 million dollars on gowns in anticipation of this increase. Our supply of N-95's and other PPE remains good.  

Our infectious disease specialists tell us they are cautiously optimistic about the availability of a vaccine within the next number of months. Not a specific number of months. But less than a year.  

We are seeing a few very long term, extremely sick patients, who have been hospitalized for months getting close to discharge. Not back home, and not anywhere close to being as functional as they were prior to admission. COVID-19 is causing some fibrotic changes in the lungs and I have no idea what this means for patients long term. I worry that another infection in their weakened state may mean death. Maybe those changes will get better with a long long recovery. I just don't know. Patients are also extremely weak overall after months in bed. 

Other patients who have not been quite as sick have been able to go directly home from the hospital. Overall, the number of days in the hospital for these patients are decreasing. I think this is because we are learning more about therapies - how and when to use them. 

We remain vigilant at work. Watching out for each other. Cautioning each other if we are spending too much time in a room with a patient. Reminding each other that we can't touch (or remain too close to) patients and families as we comfort them - which is incredibly hard. Keeping the masks on. Wearing eye protection. Washing the hands. This is what team members should do for each other. It's easy to slip-up, which can lead to consequences we don't want to consider. 

What I want to say is we are taking this seriously. But you knew that. There is a lot of ignorance out there though. When I hear some of the ludicrous ideas, my instinct is to correct misinformation with facts. I haven't found that to be particularly effective. Let me share the most recent bit of idiocy... "the numbers of deaths are not that high, hospitals are inflating the numbers because they get money for patients who die with COVID-19". I have no words for this. 

Instead, here is a good link to an article about what we know about treatments for coronavirus. Which ones are showing promise, which are not effective, which could be considered fraudulent. 

For those who like graphs and numbers, see increases by date in Kansas. You might have to click on the photo to read it. 

Comments

[Karen Scudder]

Thank you so much for the work you do! Our numbers here in North Carolina are increasing, too. It makes me so mad to hear about people who are not taking this seriously and behave in ways that put everyone at risk.

[Chris]

Be safe.

[Claire]

My colleagues at Hopkins (and me as a retired employee) feel your pain. While Maryland isn’t as bad as some states, they younger people here are just being crazy! I not only want them to be smarter, but have some common sense! Keep up the great work! Your hospital should be proud to have staff like you! ❤️❤️❤️

[SusanS]

Oh, my. Until I read this, I hadn't considered palliative care work for COVID+ patients. God bless you and your team members for the work you do.

[Vicki in Michigan]

Thank you for all the work you do, including spreading truth. I am grateful to you for helping us keep it real.

Sending you "stay safe" vibes.

[Jan]

Thank you Carol, for your update and your honesty, as well as your work. Both of my patents were hospitalised with covid, my mother in ICU for 2 weeks then on a general ward for another 5. Both home now and recovering, thankfully. Bless you for your dedication, and please look after yourself.