REPORT FROM FRONT LINES
U of W professor battles COVID-19 in New York
New York City is in trouble.
On the front lines of the COVID-19 pandemic, a University of Windsor nursing professor is helping lead the charge to bring America’s hardest-hit city back from the brink.
Working alongside Navy Seals, Green Berets and other military veterans, Kate Kemplin spends days and nights inside a massive air-locked field hospital known as the Bubble, where every patient is infected with the deadly virus.
Kemplin is the chief nursing officer and deputy director of the Ryan F. Larkin New York Presbyterian Field Hospital. It’s the size of two football fields.
“It’s emotional for me because I feel for these patients being away from their families,” said Kemplin, 40, a nurse specialist in trauma and emergency medicine who previously worked for the U.S. military. “The good thing about being a mix of former military and military-adjacent people is that we’ve been away from our families or our spouses have been deployed, so we treat patients like they’re part of our military family. But a lot of these patients, their spouse has COVID. There’s been families of five or six people. They all got COVID. That’s been really difficult to imagine your patients going through.”
By Friday afternoon, the last time the city’s health department updated numbers, New York City had 176,086 confirmed cases of COVID-19 with 43,913 people hospitalized. The city’s confirmed death toll had climbed to 14,389 people, with another 5,313 “probable deaths.”
The New York Presbyterian Hospital said in a May 1 social media post it had discharged a total of 6,067 COVID-19 patients up to that point. It has not made more up to date figures available.
“When the pandemic took off, New York was under such extreme stress, and their medical systems were just overwhelmed and overloaded,” said Kemplin, who was born in Owen Sound but raised in Florida. Kemplin, whose last job was at University of Tennessee, was so new to Windsor that she still didn’t have a licence to practise in Ontario when COVID-19 hit.
“We would have loved to have had her stay in Windsor and be part of the pandemic team here,” said Linda Patrick, dean of the faculty of nursing at the University of Windsor. “But this is where she can do the most good because her licence is in the U.S.”
She said Kemplin is flying the University of Windsor flag in New York. Literally.
Patrick, who has been in contact with Kemplin, said there is a spot at the field hospital where workers place mementos of the places they’re from.
“She took one of our banners with her,” said Patrick.
“She has a special place where she has put the University of Windsor banner so they know the University of Windsor is in New York through her and through her work.”
Kemplin is running the field hospital with medical director Dr. Melissa Givens, a physician and retired U.S. colonel who established overseas field hospitals for the U.S. military.
It’s only miles from Ground Zero, which Kemplin also rushed to after the 9/11 terror attacks. Fresh out of university, she arrived in New York City on Sept. 12, 2001. She lived for several weeks on a fireboat caring for the crews pumping water into the debris of the World Trade Center, which burned for months.
“It definitely made me cognizant of public service and being part of a team and doing things that are scary that are for the greater good,” she said. “I played a really insignificant, very small role in all of that.
But it definitely instilled a strange or particular kind of love for New York City and the toughness of its citizens and its spirit.”
When the pandemic struck, there was no question Kemplin would return to the Big Apple.
She took a leave of absence from her new job at the University of Windsor.
“I didn’t want to abandon my fellow Canadian citizens, but I knew there was something for me to do in New York and I owed it to them.” Dr. Givens saw it the same way. She had been doing emergency shifts back home in Bethesda, Md., to help out during the COVID crisis.
“But the crisis was here in New York,” she said. “This is where the shortage was. It’s where people were dying. Not only did I have my own personal skill set I could apply to the problem, I knew I could gather others who also had incredible talents. Together you can make such a bigger difference than any one person alone.”
Kemplin and Givens hatched a plan to take a team of special operations medics into the struggling city.
The plan was for the team, made up of Navy Seals and Green Berets, to relieve swamped emergency departments, ICUS and other medical services. “We’re here for the patients but we’re also here to relieve the stress on our colleagues,” said Kemplin.
“Hardly any of us on our team is from New York, but it doesn’t matter. These are all our colleagues and we care about them. They’ve been under so much pressure and so much strain. They’ve lost colleagues. They’ve had to intubate and take care of their own co-workers. It’s taken a toll on the entire city.”
As their plan went into motion, Kemplin and Givens learned Columbia University had given New Presbyterian Hospital permission to convert its practice dome into a field hospital.
But in a city crippled by the pandemic with front-line health-care workers already overburdened and in short supply, there was nobody to staff it.
Kemplin and Givens put out a call to their Special Ops colleagues. Within 48 hours they had 700 people ready to roll.
“They were an untapped pool of medical skill that, due to the civilian community not being familiar with how extensive their training is, is often not recognized or utilized,” said Givens, who retired from a 30-year military career just before the COVID crisis struck.
“The reason we were able to kind of pull together staffing when the rest of New York City was clamouring for nursing support is we were able to reach into this community that was unrecognized.”
The advance team raced into New York City.
They made the 220-bed facility operational in six days.
“On our side it was logistics, getting staff in here, preparing the space for patients,” said Kemplin. “What kind of patients? How sick are they going to be? What resources do we have? And getting the clinical guidance ready, which was a pretty big task.”
“We just worked long, long hours and relied on each other. Everybody pulled more than their own weight.”
They named the site after Ryan Larkin, a Navy Seal and medic who served in Iraq and Afghanistan. Larkin, who had undiagnosed brain injuries, died by suicide in April 2017. He was 29.
“He was such a caregiver and a compassionate guy,” said Kemplin. “Naming the hospital after him was a message in disguise. Everyone who knew Ryan knew exactly what we were trying to accomplish with this mission simply by naming the hospital after him.”
The first patients arrived April 14. They were admitted to a fully functional hospital, covered by a mammoth white dome and sitting on top of a soccer field. The turf has been covered with linoleum floors.
Kemplin said even she was “awestruck” at the size of it.
We’re here for the patients but we’re also here to relieve the stress on our colleagues . ... They’ve been under so much pressure and so much strain.
“You have prior military medics and personnel walk in who are used to deploying out of the back of a truck,” said Kemplin, who spends about 14 hours a day there.
“They’re used to really rough living when they’re deployed. They walk in and they’re kind of like, wow, this place is the Ritz. Other than the external structure you feel like you’re in a hospital.”
Or a space ship. The interior of the massive Bubble is a positive-pressure environment.
“We have airlocks,” said Kemplin. “So it’s almost like going onto a spaceship. You walk in and the air is kind of sucked into the Bubble versus in hospitals where we try to suck it out.”
Givens, who has experience setting up field hospitals in “austere circumstances” in places such as the Middle East and Africa, said the New York site presented a whole new challenge.
“Because it’s a positive-pressure and Covid-positive, we’re really separating it from the outside world,” she said. “It is a positive COVID environment, so assuming everything inside that tent is exposed to COVID, which adds a layer of complexity to everything.”
One of the biggest complexities is protecting the caregivers.
Kemplin oversees 120 staff, and caring for them is as important as caring for patients.
The rules for personal protective equipment are strict. Going on rounds requires full body suits, hair covering, gloves, goggles and two different kinds of masks.
“Very deliberately and carefully and slowly, you put on a lot of PPE,” said Kemplin.
Givens said the PPE process had to become as routine “as brushing your teeth.”
“In order to do that you have to have a level of discipline that comes secondary to us in the military,” she said. “We’ve operated in other protective gear before and so we used a lot of those processes.”
Everything goes on before they enter the Bubble. There’s an “extra level of cleaning.”
Hand washing is constant. They don’t touch anything they don’t need to. When they do touch something, they wash their hands before they do anything else.
“And then a very deliberate exit of the area when you’re taking off your gear,” said Givens. “It’s called doffing procedures when you take your equipment off. It’s just being extra careful about the fact that whatever you’re wearing is assumed to have COVID on it and being super alert.”
When they take off one layer, they immediately wash their hands before removing the next.
“When you separate it between either you’re in the Bubble or out of the Bubble, it helps those processes require less energy to think about because they’re just part of your routine,” said Givens.
It can be stressful and emotionally draining, but New Yorkers, despite that reputation for being gruff and rude, are doing their part to make it a little less difficult.
Kemplin said the majority of people have bought into physical distancing, wearing masks and staying home. But every night at 7 p.m., the “incredibly kind” people in the neighbourhood emerge from their homes to clap for the healthcare workers.
“We’re part of the neighbourhood now,” said Kemplin.
“Everybody from the hotel where we’re staying to the deli where we go to get a sandwich has just been great. New York City is like that. It seems intimidating at first. But once you’re part of it, you’re part of it. It’s really refreshing because in the midst of this kind of terrible event people are still kind and funny and polite. Maybe a little rough around the edges in New York City. But they are really grateful and supportive of us being here.”
The patients also provide inspiring moments.
In another show of love for the Navy Seal that the hospital shares a name with, a nautical bell was installed at the site. Every patient who is discharged gets to ring it.
From her office, Kemplin can hear it clanging.
“There are days where it’s ringing and ringing and ringing,” she said. “It’s so exciting because it’s another survivor, another survivor, another survivor. It’s a really happy sound.”