‘A learning experience’

Lack of information early on tested area health centers as the pandemic took hold

For Dr. Erica Kaufman West, Franciscan Health’s infectious disease expert, it wasn’t immediately clear what the first reports of COVID-19 overseas in December 2019 might become.

“I didn’t think it would take hold like it did,” she said. “Back when I first heard about it starting in China, I thought it was probably going to be like SARS (bird flu), which burned out overseas.

“When we started hearing about cases in Chicago and Washington (state), I thought, ‘Well, maybe this is like Ebola,” she said. “By the end of March, when it was apparent it was everywhere, it just got really real and definitely scary.”

One year later, more than 520,000 Americans have died from the virus, including 887 people in Lake County and 276 in Porter County, according to the Indiana Department of Health dashboard Friday.

Both counties started testing in early March, with their first confirmed cases later that month. Lake County recorded its first death March 23, while Porter had its first death April 10. Indiana issued its first two-week shutdown order from March 25 to April 7.

Early on, there was much that wasn’t clearly known.

“There was a significant lack of information as to how severe it would get, how sick the patients could get, the treatments available,” said Alan Kumar, Community Hospitals’ chief medical officer. “Every clinician was working in a black box.”

The virus, in many cases, hit their own families.

Last spring, Lake County Health Officer Chandana Vavilala said her husband, now 51, a kidney doctor, caught COVID-19, despite precautions. He had a fever, chills and felt very weak.

At one point, they were wondering if he needed to go to the ER, but he luckily recovered. An avid runner who’s run the Chicago Marathon a few times, he experienced some chest tightness and shortness of breath for six to seven months.

“That was a huge learning experience for me, personally,” she said. “It was so surprising how long the symptoms would linger for someone without any under

lying medical conditions.”

Studying a pandemic was one thing, living through it was another.

“I’ve been teaching that we’re overdue for a pandemic for years,” said Amy Buckenmeyer, Valparaiso University’s Public Health Program Director and a registered nurse. “Did I in reality believe it would happen in my lifetime? Looking back, it’s hard to say.”

By Jan. 30, 2020, the World Health Organization declared the virus a public health emergency. Early on, she sent her husband to the pharmacy to grab gloves and bleach cleaner, but not masks.

“At the time, we didn’t realize the disease could be spread via airborne routes,” she said. “Had I had a crystal ball, that would have been my only regret.”

Others tried to make sense of the unknown.

I n d i a n a Un i ve r s i t y Northwest economics professor Micah Pollak — used to crunching numbers — has built a following on s o c i a l me d i a p o st i n g COVID-19 graphs since the start.

“It was purely for my own sake,” he said. “So, I could understand what was going on better. Regain some of that sense of control.”

At hospitals, plans were in place, but then the unexpected happens.

“You plan for crises all the time in health care, whether a mass casualty event, bioterrorism or a pandemic,” Kumar said. “You think you have a good plan.”

Early on, the PPE supplies in the U.S., sourced primarily from China, dried up. Things like isolation gowns and N95 masks were in short supply. Community, for example, anticipated they would need three to five times more PPE. The amount turned out to be 10-20 times normal, he said.

“It was really quite scary,” Kaufman West said.

But, hospitals learned to adapt and improve how they were treating patients, for example using planking, or lying a patient on their stomach and putting oxygen through their nose, instead of intubating them. They also learned how to create more isolation rooms. Nurses started hooking IVs outside of rooms to minimize a patient’s exposure.

Within two weeks of shutdown orders, Community got its telehealth running, Kumar said. Online appointments have helped to reach more people without a car or those who might be too frail to travel to the doctor, he said.

Scientists around the world have been working collaboratively to an unprecedented extent, including in Indiana. Some of the virus’s sequencing was done at Purdue University, which was shared globally, said Thomas Duszynski, Indiana University Fairbanks School of Public Health’s epidemiology director.

The mRNA technology behind the Pfizer and Modern vaccines could be used to develop more effective flu vaccines, he said. That technology came out of yearslong failed efforts to find an HIV vaccine, according to experts.

Many doctors have fought misinformation spread on social media — false claims the vaccine injects microchips or can damage a woman’s fertility. Open, frequent communication has been key, especially as the science changes, Kaufman West said. Patients “see something on the news, they see a post on Facebook,” she said. “If you can’t stop giving good information, they will see something else and it’s probably not going to be reliable.”

Meanwhile, vaccination drives are underway.

Community currently vaccinates 1,100-1,200 people per day, Kumar said. They are hoping to boost it to 1,500-1,600 per day with more supply. They primarily use Pfizer, since they have the ultracold storage, but expect to get a limited supply of the Johnson & Johnson vaccine soon.

The Lake County Health Department’s site at the county fairgrounds in Crown Point administers 2,000 vaccines per week. Right now, a second site at Wicker Park in Highland is indefinitely on hold, since they don’t have the supply, Vavilala said.

Other states haven’t been as organized, several noted.

“My parents are in Iowa. For them, they do not have a centralized website. They have to call around,” Pollak said. “Often, they’re just told, ‘Sorry, we don’t have enough vaccines allocated. We didn’t get anything this week.’ ”

The long-term consequences of the pandemic are still not fully known. A big worry is folks who have missed critical early cancer screenings or annual exams that lead to later diagnoses of cancer and lung disease.

“The number of stories I have around that was sad,” Kumar said. “You avoid getting something that you have a 0.5% of killing you versus something that would kill you if you don’t get treated.”