A box full of hope
For American hospitals overwhelmed with Covid-19 cases, the arrival of the first vaccines promises a light at the end of a long, dark tunnel. John Tozzi and Angelica LaVito report.
Early on Monday morning, a FedEx truck pulled up at a University of Iowa Health Care loading dock to deliver a small, heavy box. It contained 195 vials, each about half the size of a stick of lip balm, packed in dry ice.
Each tiny bottle held five doses of the Covid-19 vaccine developed by Pfizer and BioNTech. It was the best news that UI Health Care workers overwhelmed by the pandemic had received in a long time.
Most of the precious doses went into an ultra-cold freezer that the clinic in Iowa City bought months ago in anticipation of this exact moment. Pharmacy staff removed 100 to thaw in a refrigerator, and nurses began administering those first shots to their colleagues.
Clinicians from intensive care and emergency departments who face Covid-19 daily became some of the first Americans outside clinical trials to receive immunisations.
Just one month ago, Iowa experienced its worst surge yet. Coronavirus cases began soaring there in early November, as they have throughout the United States.
By the middle of the month, Iowa was recording about 4000 new cases a day. At the peak, 1527 patients were hospitalised statewide. On the day the vaccine arrived, US coronavirus deaths surpassed 300,000.
Among the first to be inoculated was Allison Wynes, a 39-year-old nurse practitioner. She was up all night in nervous anticipation before her shift started at 7am on a fourthfloor surge unit. It was created in early November, when the system outfitted 10 extra beds for critically ill patients after the regular 26-bed medical ICU filled up. Both have been full for weeks.
About 9.30am, she went to an improvised clinic on the 12th floor of the children’s hospital building, which overlooks the 45,000-seat
Kinnick Stadium where the University of Iowa Hawkeyes play football. In normal times, at the end of the first quarter, the crowd and players would turn and wave to young patients watching the game from their windows. This year the stands are empty.
Wynes said she ‘‘bounced’’ into the immunisation area. ‘‘The energy in that room was so much different than the energy I’d been working in and living in for the past six, seven, eight months.’’
She was fifth in line for the shot. Cameras from press invited for the occasion clicked away. The jab was like any other, but Wynes cried quietly to herself when she got it.
Gregory Schmidt, 64, was taking a day off on Monday when he got the call. As a physician and director of critical care programmes, he’s watched the ICU fill up, expand, and then reach full capacity again. The hospital typically accepts complex critical patients transferred from smaller facilities in the region, but lately it hasn’t had space.
He got the hospital’s 50th Covid shot around noon. It was a glimpse of hope, and he texted a photo to his three sons, went to lunch with his partner, and planned to head out for a bike ride in the afternoon. ‘‘Everybody in that room, me included, has been so desperate for this moment for so long, and now here it is. It’s within our grasp,’’ he said.
Yet there’s still a long way to go. It will be months before there are enough shots to reach the broader public. ‘‘This has been a tragedy,’’ Schmidt said. ‘‘It still is, and for months is still going to be a tragedy.’’
Mike Brownlee, the health system’s 46-year-old chief pharmacy officer, met the box from Pfizer at the loading dock that morning. Part of the system’s incident command centre, he got the shot about 11.30am. He said he wanted to ‘‘demonstrate to our staff that we’re in this with them. We’re on the precipice of a change’’.
Chetana Daniels, a 32-year-old nurse in the medical intensive care unit, was vaccinated about 3.30pm. While she’s accustomed to working with critically ill patients, Covid’s death toll has been hard to take. Sometimes patients appear to be improving, and then she’ll return to find them even sicker than before. She’s lost more Covid-19 patients than she can count on both hands.
‘‘It’s a combination of losing so many people and people who are even young and otherwise healthy, and feeling like we need to do the work that we would normally do, and then the work of their families since they can’t be there,’’ she said.
The experience has drained healthcare workers across the country. Seth Jackson, another ICU nurse, has had to rush to organise
‘‘It’s going to take months, but every day it’s going to get brighter and brighter.’’
Zoom calls to enable dying patients to say goodbye to loved ones. ‘‘Sometimes you’re the only one there.’’
He was at the dog park on Monday morning when he got notice that the shots had come in. He ran home, showered, and rushed to the hospital, crying on the drive there. He was third in line for a vaccine, two spots ahead of his friend Wynes, and was glad to see familiar faces.
‘‘We’ve been in the thick of it forever,’’ he said.
The shots continued until 8pm and, by the end of the day, UI Health Care had vaccinated 178 people. More were planned the next day, and the day after that.
‘‘This is the light that’s finally come,’’ Jackson said. ‘‘And sure it’s dim, and it’s going to take months, but every day it’s going to get brighter and brighter.’’ –