The News Herald (Willoughby, OH)
Lake Health doctors reflect on COVID-19
Former state Rep. John Rogers also details personal battle with virus
Dr. John Baniewicz understands nothing will ever be the same.
Reflecting on the one-year anniversary of the first documented case of coronavirus in Lake County, the chief medical officer of Lake Health realizes there is no “new normal,” and, in moving forward, every day becomes a new frontier of knowledge against the infection.
“As we continue to research and learn, we do know it can’t be encapsulated as one thing or as one model,” said Baniewicz, who is also a practicing physician with Lake Health Physician Group Mentor Internal Medicine. “And as confident as we are with decreased cases, rising vaccinations and loosened restrictions, we still have to be cautious in the face of COVID.
“We don’t know if this is a lull or if we’re truly turning a corner, just as no one believed the virus would claim over 500,000 lives, a figure that has, in no way, belies the tremendous efforts of health care workers and medical staff everywhere,” he added.
Those efforts, additional Lake Health officials noted, were all exercised for a common goal, while also producing varied realities over 12 months.
The Emergency Department physician
“We were fortunate in Northeast Ohio to have some lead time from the first reported U.S. case of COVID-19 until the first reported case in Lake County, with so much of the prep work completed well in advance,” said Dr. Richard Rowland, chair of emergency medicine at Lake Health.
Rowland noted there was a lot of anxious anticipation prior to the first local case.
“The emergency department, however, is always prepared for ‘worst-case scenarios,’ and the team was ready to do whatever was needed to care for our community,” he said. “I’m not sure exactly what I expected from this pandemic, but I certainly didn’t think it would impact our daily lives like we’ve experienced.
“We all recognized this virus had the potential to spread quickly, so while we hoped that stay-at-home orders and wearing masks might reduce illness in the community, our focus was on preparing to care for anyone that needed our help.”
Personal protective equipment, including eye protection, masks, and gowns were used to protect staff and patients, continuously, Rowland said.
In addition, Lake Health Emergency Departments are equipped with isolation rooms to reduce the airborne spread of viral illness.
Beyond the individual protections, the system also updated protocols for hospital visitation and ensured that COVID-19 and non- COVID-19 patients were isolated.
Clinical care protocols were also updated to reduce the transmission of the virus during medical procedures.
“The workload for our team, in general, has been manageable,” Rowland said. “It’s really been a test of the team’s mental fortitude, especially early in the pandemic when COVID-19 testing was limited and PPE stockpiles were at risk. It had to be presumed that every patient could potentially have COVID-19.
“For those working the front lines, you recognize the risk every time you step into the hospital that you could contract COVID-19,” he continued. “You arrive home after an exhausting shift and isolate from your family, change clothes in the garage, and hope that you didn’t bring the virus home with you.
“Many of our patients also have similar stories that highlight how stressful this has been for them,” he added. “We’ve seen many instances where a patient has said, ‘I would have come to the emergency department sooner, but I was scared.’ And instead of seeking care for their chest pain or arm weakness, they stayed home while having a heart attack or stroke.”
Rowland’s strongest emotional reaction in the past year has been watching the first doses of the vaccine being distributed, likening the early administrations to a small, flickering light at the end of a long, dark tunnel.
“The last year has been a test of both our health care system and the resilience of our teams,” he said. “The COVID-19 battle has been relentless and yet our teams remain so grateful for the opportunity to care for the people in our community on their worst days.”
The infectious disease specialist
Recalling the second week of March 2020, when cases were first reported in the Cleveland metropolitan area, Dr. David Hutt assumed it was only a matter of time before there were significant numbers of patients affected in Lake County and that Lake Health would be on the front lines in their diagnosis and treatment.
Hutt, an infectious disease specialist at Lake Health, and others looked to the Centers for Disease Control and Prevention and the Ohio Department of Health for guidance. But they also relied heavily on information circulating in the academic public health and infectious diseases world, and on conversations and collaboration with local and national colleagues.
Hutt believes everyone involved in the care of patients at Lake Health was apprehensive as daily news circulated, and in the anticipation of admitting and treating their first COVID-19 patients.
“We were concerned about our ability to diagnose and treat these patients successfully, and at the same time we had concerns over our own health and the health and safety of our families and colleagues,” he said. “Very early, senior leadership, under the guidance of Dr. Baniewicz, convened a group of physicians and lay leaders who met regularly to share information and create and revise policy and procedure.
“These efforts, along with the incredible efforts of our infection control practitioners, have made a huge difference in our ability to care for Lake County residents with COVID-19.”
When physicians began to treat patients last March, Hutt felt certain the staff would be on task for a long time, noting it was already clear, in Wuhan, northern Italy, Seattle, New York City, and many other places, that the pandemic would be like nothing they had ever seen or truly imagined.
“It was quite clear that this wouldn’t be ‘quickly handled,’” he said. “Actually, I imagined the opposite — that our health care system would become overwhelmed. But I must say that I didn’t imagine the far-reaching and prolonged effect this virus would have on our ‘civilian’ lives, our families, our economy, and our society.
“I don’t have adequate language to express my admiration, respect and gratitude to everyone who pitched in to care for these patients.”
While many people played an important role, Hutt places the nurses, nurse assistants and respiratory therapists at the top of his list.
“Nearly without exception, their attitude was, ‘Tell us what we need to know and give us the equipment we need, and we’ve got this. This is what we do,’” Hutt said. “They took the steps needed to protect themselves at work, and were generally flexible and understanding when emerging evidence required us to modify those recommendations.
“They spent what must have felt like endless hours at the bedsides of these patients, and some of them did become infected, but most of them had relatively mild illnesses and have recovered or are recovering well,” he said. “I have seen the many ways, big and little, in which team members have supported one another.”
Early amid the pandemic, Hutt’s own life and schedule changed rather drastically, as his hours spent in the hospital and out, engaged in medical-related matters, expanded tremendously.
“I think at some point in May or June, I began to sense that we would get through this, that the Lake Health system was unlikely to be overwhelmed, and that I expected personally to survive,” he said. “Since then, the stress has been keeping up with the care of individual patients, trying to stay on top of all the emerging information, new developments and changing directives, and responding to the endless specific COVID-19-related questions.
“I am 67 years old, and began my career in infectious diseases as HIV was appearing, and I was the first specialist with an established practice in Lake County,” Hutt said. “There is a sort of symmetry in helping to understand and treat COVID-19 in Lake County at this stage in my career.
“There remains a lot to learn and a lot to do, but I remain optimistic,” he added. “We need to be careful, continue to learn, go where the science leads us, and do our very best.”
The state representative
Among the Lake County residents who were hospitalized by COVID-19 was John Rogers, who contracted the virus in his final month as a state representative.
The Mentor-on-the-Lake Democrat believes he was infected in early December while in Columbus. Rogers was one of four members of the House Finance Committee who contracted the disease early that month.
Rogers took a COVID-19 test on Dec. 7 and it came back positive the next day.
In a Dec. 9 interview, Rogers told The News-Herald his symptoms included low-grade fevers, scratchy throat, cough, headaches and congestion.
At the time, Rogers said it felt like a bad case of the flu and was hoping it wouldn’t
get any worse. However, on Dec. 13, Rogers was taken to Hillcrest Hospital in Mayfield Heights where he stayed until Dec. 19.
The worst he felt came on Dec. 16. Rogers said he had a very high fever, “almost to the point of being delirious.”
“When I got into the hospital, even though the bed was down to the floor so you don’t fall, I could hardly get out of bed, literally,” he said. “It was difficult for me, I just had no strength. And then Wednesday night (Dec. 16) when I had the fever, it was high, for three or four hours. I will say it was uncomfortable to say the least.”
Rogers said the overall feeling is hard to describe.
“The fever compounded the fear of not being able to breathe,” he added. “When you can’t catch your breath, it’s a scary feeling.”
He likened his condition to when he was a scuba diver.
“If you’re down and all of the sudden your tanks
are getting low, you’re trying to breathe in and you’re breathing harder because the tanks are not full,” he said. “There’s a fear, you need to keep control of yourself, but you become very apprehensive about what’s going to happen next.”
Fortunately, Rogers didn’t have to be placed on a ventilator.
Now, three months after he first tested positive, Rogers said he is still feeling some of the effects of his illness.
“Coming home and even to this day, I’m winded, so that if I walk upstairs or if I exert myself, you know, it’s not like I can run a quarter-mile anymore,” he said. “But I get stronger every day, so that’s a good thing.”
Rogers said he still has headaches in the mornings, though they’re less severe now than they were a few weeks ago.
“I saw a neurologist about those and he basically indicated that it’s not uncommon for people to have severe headaches after
having been diagnosed with COVID for a period of time,” he said. “He did an MRI to make sure there were no problems because there’s susceptibility for people who have COVID to have more fluid around the nervous system, which can cause potential problems.
“But I guess that came back negative, so he’s basically saying to me, ‘John, you’re going to have to deal with the migraines and hopefully they’ll go away,’ and he gave me a prescription for medicine to take when needed.”
Rogers said he got the first shot of the COVID-19 vaccine on March 5.
“I consider myself lucky,” he added. “There are a lot of people that go to the hospital and (they) don’t come home.”