Norwalk nursing student helps COVID patient
STAMFORD — Adriana Rosario knew something wasn’t right.
Rosario, a community health worker, had come to drop off food for her client, Stamford resident José López. López was recently diagnosed with COVID-19, and he seemed to be disoriented and experiencing shortness of breath.
After she asked him to put a pulse oximeter on his finger, she saw that his oxygen saturation level appeared to be very low. She quickly convinced him that they should call 911.
“In reality, you were an angel who arrived here,” López told Rosario in Spanish during an interview with Hearst Connecticut Media. “If it hadn't been for you, when you came and took my oxygen levels, I think I would have died.”
Stamford’s community health worker program is a partnership between nonprofit group Family Centers and the city’s health department. The health workers offer assistance to residents, especially members of underserved communities, who have contracted COVID-19.
Rosario contacted López after he was diagnosed, and he told her that he needed help getting food while he was in isolation. On Feb. 25, she notified López, who lives alone, that she would be coming by to drop off groceries and bottles of water.
“As I was arriving to his home, I was in contact with him, and I noticed that he had an altered mental status, he seemed a bit confused, and that can be a sign of hypoxia,”
“People don't think that things like this can happen, but it can.” Adriana Rosario
said Rosario, 20, a Norwalk Community College student. “So usually what we do is drop off these items in front of their door, but just with the fact that he seemed hesitant to go downstairs, I just offered to bring it up for him instead.”
She went up to the third floor of the apartment building carrying the supplies. She had also brought along a pulse oximeter — something she normally does for her clients.
“His door was open, so I did take a look at him and I noticed that he had some difficulty ambulating while he was walking to his kitchen. He seemed like he had shortness of breath,” Rosario said.
Rosario gave the small device — which measures oxygen saturation in a person’s blood — to López, and he placed it on his finger. Many individuals who have COVID-19 experience low oxygen levels, which can be deadly, according to the Centers for Disease Control and Prevention.
“When he put it on, I just took a peek and I noticed that it was at 86 percent,” Rosario said. “And a normal result is usually 95 to 100 … So I definitely was a bit alarmed.”
She tried the device on López’s other fingers and on herself to make sure it was working properly. She then decided they needed to call an ambulance.
Rosario is a first-year student in Norwalk Community College’s nursing program. When she was helping López, who is 52, Rosario said used the patient assessment skills that she has learned in school.
That day, she explained to López that 86 percent was a low level, and he agreed to her calling 911.
“I think that's when he realized the situation because, previously, I think he was having some difficulty, but he was hesitant to go to the hospital,” Rosario said. “So I'm glad that I kind of urged him and just educated him about COVID and how that oxygen level can really affect the body and just how it works.”
When first responders arrived and López went downstairs with them, “that's when he completely declined,” Rosario said.
“He wasn't really able to speak anymore, just from going down the stairs,” she said. “His breathing was very rapid.”
The first responders didn’t speak Spanish, so Rosario continued talking to López and explained to him what would happen now that they had arrived.
Looking back, Rosario said she is happy she went inside and checked on López.
“If I didn't bring the pulse ox with me, or if I just left it at his doorstep … chronic hypoxia can lead to brain damage and decreased … cardiac muscle function,” Rosario said. “He could have maybe had an asthma attack or just — I really don't know exactly how long before … he could have just not been able to contact anyone.”
López was put on oxygen and spent several days in the hospital. During the interview with Hearst Connecticut Media, he told Rosario that he doesn’t recall being brought to the hospital or the initial part of his stay.
López also told her that he is still experiencing some weakness. López, who works as a cook at a restaurant in New Canaan, urged people to be cautious about their health.
“Really, what I want to say is a lot of people — we're irresponsible,” López said in Spanish. “But what we're dealing with now, the pandemic — it's real. It's not a game.”
“People need to monitor their health, especially with COVID, because he's only 52 and people don't think that things like this can happen, but it can,” Rosario added.
She has had about 30 clients since she started as a community health worker in late January. She said she learned about the job from an email she received through her school.
“I became interested when I realized the need for it, especially here in Stamford,” said Rosario, who lives in Norwalk. “I used to live here in Stamford, so I'm really familiar with this area. And when I was reading the posting, I felt like it was something that I want to get experience in and with my nursing school background, I could definitely apply that to community health work.”
Community outreach
The city’s community health worker program consists of five people, including a supervisor, Frank O’Driscoll. He said the program has so far helped 280 families — or a total of about 1,000 individuals.
The program launched in the fall, with a focus on assisting residents after they find out that they should quarantine or isolate.
“We were really concerned about people spreading the virus by just doing the things that they needed to get done in their daily lives, so that was kind of the genesis of the program,” O’Driscoll said. “As the pandemic has evolved … we've seen the needs kind of change over time.”
O’Driscoll explained that when contact tracers get in touch with people, and they indicate having urgent needs during quarantine, they are referred to the community health worker program.
It’s not just delivering groceries and other necessities. He said the program’s workers have also been helping clients get medical insurance, they check in on their clients’ mental health and the program even helped pay for families’ internet to ensure that children could do virtual learning.
O’Driscoll said “one of the pride points for the program” has been helping people facing the financial challenges that come with quarantine or isolation. Many clients, he noted, haven’t
had the option of working from home.
“By the time they got to us — kind of in the October, November and beyond timeframe — they've already exhausted their savings,” he said. “And one of the things that I started to notice was looking at kind of the demographics of Stamford, there were a lot of people that were very young, who were supporting larger families. It wasn't just themselves that they were taking care of. They had this deep responsibility to their extended family that they lived with.”
The program was initially funded by a more than $200,000 grant from the Connecticut
Health Foundation. The foundation, which aims to address racial and ethnic disparities in health care, also provided grants to health departments in Norwalk, Danbury, Bridgeport and Hartford.
O’Driscoll said the program received a $100,000 grant extension. A major part of its focus now is helping members of underserved communities get vaccinated and answering questions about the vaccine.
Rosario, who has been vaccinated, said she plans to help López sign up for a vaccine appointment once he is eligible.
A few days before the Connecticut legislative judiciary committee held a public hearing on some gun legislation, the advocacy group Connecticut Against Gun Violence hosted Zoom sessions to train advocates how to testify.
One of the bills to be discussed in the public hearing, H.B. 6355, seeks to update a late ’90s law that created a process for temporarily removing guns from people who are a threat to themselves or to others, also known as extreme risk protection orders, or ERPO. Connecticut was the first state to enact such a law after an employee at the state lottery headquarters killed four co-workers and then himself in 1998.
Other states have followed Connecticut’s lead as mass shooting proliferated around the country. That’s been the pattern for extreme risk protection orders. Every mass shooting is followed by states passing legislation that creates a process to remove guns from at-risk residents. The most recent wave came after the 2018 Parkland school shooting that left 17 dead.
Connecticut’s updated bill would require a court hearing before a gun is returned, would prevent someone at risk from purchasing a gun, and would broaden the list of people (family, loved ones, health care professionals) who can petition the court for gun removal, among other changes.
Despite studies that show this law helps keep people
safe, any time a piece of gun legislation comes up, people who nearly uniformly oppose gun legislation — including the ailing NRA, which called 6355 the “firearm seizure bill” — come out in force. Written testimony for a similar bill last year was four-to-one against, said Jonathan Perloe, CAGV communications director.
So for this early March public hearing, CAGV wanted to engage people who support responsible gun legislation.
As people settle in to the call, Perloe tells the faces on the screen that pro-legislation written testimony is fine, but in-person testimony is more effective. Take that extra step
outside your comfort zone, he tells the trainees. If you’re nervous, that’s OK. Nerves give an air of authenticity.
This bill makes sense. A 2017 study from Duke, Yale, and University of Connecticut researchers looked at 762 gun removals, and found that for every 10-20 risk warrants, one suicide was prevented. Since, according to the Centers for Disease Control and Prevention, roughly half of suicides are completed by firearm, that’s a significant amount of prevention. In fact, Perloe said roughly twothirds of these warrants are used to prevent suicide.
But one-issue gun voters, said Perloe, “worry that someone’s coming to their
home in the middle of the night and taking their guns without due process.” That is not true. There is a process, and people who ask for these warrants do so at risk of perjury. Still, lying about a gun grab is an effective way to rile up the base who oppose any and all gun legislation, the glazed-eyed pry-it-from-mycold-dead-fingers people. We would all be so much safer if we didn’t reduce all gun safety laws to “anti-gun.” The arguments are more nuanced, though you couldn’t necessarily tell that from past legislative committee testimony.
More tips from Perloe: Watch the public hearing on CT-N. Log in when it’s nearly your turn. Keep your comments
to three minutes, and then be prepared for questions. Most legislators save their questions for officials and people who run organizations, but if someone has a question, says Perloe, don’t let legislators take you down rabbit holes. It’s OK to say “I don’t know.”
Then that Friday, the hearing starts promptly. Early on, Sen. Rob Sampson, a Wolcott Republican who has called himself “Connecticut’s strongest defender of our Second Amendment Rights,” opined that there is a “sizable part of our population that would agree any person possessing a firearm might be a danger to themselves or others.”
Boom. It is not a nuanced opening, and somewhere, a gauntlet clatters to the ground.
But if that is the case, that supporters of gun legislation are basically just opponents of guns, that was lacking from the testimony. CAGV executive director Jeremy Stein talked about the importance of preventing gun violence, and he spoke movingly about an uncle who’d received a difficult medical diagnosis and died by suicide, with a gun, in 1989.
One woman talked about her troubled son, whom she feared.
Several of the people who opposed the bill talked about angry ex-spouses who might make a false accusation to come for their guns, or they talked about women gun owners who might not seek mental health treatment for fear of losing their guns. That’s not how the law works. (One can only guess at the state of these folks’ relationships, but the testimony smacked of the Trumpian “many people are saying.”) Someone else mentioned tyranny, though court challenges against these protective orders don’t usually get very far.
In all, testimony went quickly, with only a few hiccups. Absent, for the most part, were the histrionics that often accompany gun zealots’ love of all things weapon-like.
Afterward, Stein, an attorney who has argued Second Amendment cases in court, said this legislation is written clearly, and responsible gun owner support it, as they support safe storage rules and other safety measures.
So let the gun zealots rail. Common sense, data, and peer-reviewed studies say this legislation saves lives. Still, let’s take a moment and hope those gun zealots’ relationships are OK.
Nearly a year after California Gov. Gavin Newsom ordered the nation’s first statewide shutdown because of the coronavirus, masks remain mandated, indoor dining and other activities are significantly limited, and Disneyland remains closed.
By contrast, Florida has no statewide restrictions. Republican Gov. Ron DeSantis has prohibited municipalities from fining people who refuse to wear masks. And Disney World has been open since July.
Despite their differing approaches, California and Florida have experienced almost identical outcomes in COVID-19 case rates.
How have two states that took such divergent tacks arrived at similar points?
“This is going to be an important question that we have to ask ourselves: What public health measures actually were the most impactful, and which ones had negligible effect or backfired by driving behavior underground?” said Amesh Adalja, a senior scholar at the Johns Hopkins Center for Health Security.
Though research has found that mask mandates and limits on group activities such as indoor dining can help slow the spread of the coronavirus, states with greater government-imposed restrictions have not always fared better than those without them.
California and Florida both have a COVID-19 case rate of around 8,900 per 100,000 residents since the pandemic began, according to the federal Centers for Disease Control and Prevention. And both rank in the middle among states for COVID-19 death rates — Florida was 27th as of Friday; California was 28th.
Connecticut and South Dakota are another example. Both rank among the 10 worst states for COVID-19 death rates. Yet Connecticut Gov. Ned Lamont, a Democrat, imposed numerous statewide restrictions over the past year after an early surge in deaths, while South Dakota Gov. Kristi Noem, a Republican, issued no mandates as virus deaths soared in the fall.
While Lamont ordered quarantines for certain out-of-state visitors, Noem launched a $5 million tourism advertising campaign and welcomed people to a massive motorcycle rally, which some health experts said spread the coronavirus throughout the Midwest.
Both contend their approach is the best.
“Even in a pandemic, public health policy needs to take into account people’s economic and social well-being,” Noem said during a recent conservative convention.
Lamont recently announced that he is lifting capacity limits at retail stores, restaurants and other facilities, effective March 19. But bars that don’t serve food will remain closed and a mask mandate will continue.
“This is not Texas. This is not Mississippi. This is Connecticut,” Lamont said, referencing other states that recently lifted mask mandates.
“We’re finding what works is wearing the mask, social distancing and vaccinations,” he said.
As new COVID-19 cases decrease nationally, governors in more than half the states have taken actions during past two weeks to end or ease coronavirus restrictions, according to an Associated Press tally. Some capacity limits ended Friday in Maryland and Oklahoma. Michigan, Minnesota, New Jersey, New York and Wyoming are relaxing restrictions in the coming week.
In almost all cases, governors have lauded their approach to the pandemic, while critics have accused them of being too stringent or too lax.
California’s slow reopening is expected to gain steam in April. But Republicans in California are helping organize a recall effort against Newsom that has drawn nearly 2 million petition signatures from people frustrated over his long-lasting limits on businesses, church gatherings and people’s activities. He also faces intense pressure over public school closures and the glacial pace of getting them reopened.
Newson asserted that California has been a leader in combating the virus while delivering his State of the State address this past week from Dodger Stadium, where the empty seats roughly equaled the state’s 55,000 COVID-19 deaths.
“From the earliest days of this pandemic, California trusted in science and data, and we met the moment,” Newsom said.
He added: “We’re not going to change course just because of a few naysayers and doomsdayers.”
In his own State of the State address, DeSantis asserted that Florida was in better shape than others because its businesses and schools are open. Florida’s unemployment rate ranked below the national average, and significantly lower than California’s, at the start of this year.
“While so many other states kept locking people down over these many months, Florida lifted people up,” DeSantis said.
Determining which approach is best is more complicated than just looking at statewide policies and overall case rates.
Like Florida, Missouri had no statewide mask mandate, ended business restrictions last June and has a cumulative COVID-19 death rate similar to California’s. In the absence of statewide orders, many of the largest cities in Florida and Missouri imposed their own mask requirements and business restrictions. In Missouri, that meant about half the population was still subject to mask mandates.