The Morning Journal (Lorain, OH)
Healthcare heroes reflect on COVID one year in
First local case diagnosed March 14
With troubling reports coming out of the Chinese province of Wuhan in January and February, and major American population centers starting to report suspected cases, Ohio hospitals were bracing for the storm that would prompt a statewide shutdown on March 9 with hospitals serving as the frontline defense.
Lorain County’s first positive case was confirmed by Lorain County Public Health on March 14, by Health Commissioner Dave Covell in a video uploaded to YouTube.
“I wanted to let you know that we’ve had our first case of a positive test for coronavirus or COVID-19 here in Lorain County,” Covell said in the video. “We’ve known that it was only a matter of time when this started that it would be in our community. We know that even though there is only one positive case, it’s probably in our community already.”
Foreshadowing what was to come, Covell asked the community for help in slowing the spread and helping look out for more vulnerable populations like senior citizens.
“In other countries, this disease has spread way too fast,” he said. “And it overwhelmed the health care community. What we want to do here in Ohio, and here in Lorain County, we want to slow it down so that when people do need healthcare services they can get them. So, that’s really the strategy.”
A realization
Ben Farber, chief nursing officer for UH-Elyria Medical Center, remembered exactly where he was when he realized COVID-19 was going to be different. A West Coast transplant, Farber was getting ready to head to a national nursing conference with around 2,000 attendees when it was abruptly cancelled four days before it was to start.
“I’m a Seattle guy and I talked to some of my friends out there and they talked about what they were seeing, and then California got hit and I talked to my friends there…,” Farber recalled. “We saw what happened in China and in Italy. And I remember thinking, ‘you know we’ll know a little more before it actually hits us in the states’ and then you kind of saw what happened in Washington and California.”
Then the cancellation hit with health officials recommending people stay in their homes and avoid large gatherings.
“When you see those 10,000-person conferences being cancelled with the acknowledgement that we all need to be in our homes and you realize that in our home hospitals that, it’s not just happening piece by piece in your environment but it’s happening all over the country,” Farber said. “And I realized that it hit really all of our regions at about the same time, within a 1012 day period.
“You realized it was going to be big,” he added. “I don’t think we anticipated the length of time we’ve experienced at this point. I don’t think any of us could have anticipated that.”
Changed plans
Respiratory therapist Nicole Wilbert-Stetak was at Kalahari Resort in Sandusky with her family celebrating her daughter’s birthday last March when she received an email informing her that her visit would be abruptly cut short by a day
“That was like, really?,” Wilbert-Stetak said. “Everyone’s just out swimming together and now everybody has to go home and I think at that point I was curious to come back to work in and see you know what had changed or watch the news and kind of see where things were going from that standpoint.”
Wilbert-Stetak has been with UH-Elyria for more than 13 years and as a frontline healthcare worker she describes those first few days wondering if they would have shortages of personal protective equipment and protocols for testing.
“I think in the hospital standpoint we did the best we could with conserving PPE, and making staff feel safe,” she said. “The hospital as an organization actually did excellent with resources and in reaching out. I never had any issues with having to reuse any PPE or thinking that my safety was in jeopardy.”
A safety plan implemented early set the tone for how UH-Elyria would address rising case counts in planning for the worst case scenario.
“So here specifically we never had to kind of enter that disaster mode,” Wilbert-Stetak added. “Everything was planned pretty accordingly; staff was pulled from other hospitals that were able to come here and fill in the gaps to make sure all the patients were taken care of safely.”
Extra cautious
There were, however, colleagues she knew who were taking steps to separate themselves by staying in hotels to limit interactions with friends and family while ensuring they were not infectious.
While Wilbert-Stetak didn’t go that far, she said she did bring different medical scrubs and was constantly wiping down surfaces with Lysol and bleach wipes.
Farber stressed his biggest concern early on was making sure their caregivers were supported and that they had enough. With new information rolling in quickly, adapting to the changing environment and guidelines was a task.
Hospital navigations
In addition, UH as a whole was taking part in clinical trials. On March 19, University Hospitals announced they had secured two clinical trials that would provide the investigational antiviral drug remdesivir to hospitalized adults with pneumonia due to the novel coronavirus.
One trial would focus on COVID-19 patients with moderate illness with the second will focus on patients with more severe illness who may require care in the intensive care unit.
“But they were just that — they were clinical trials,” Farber said. “So you’re navigating the issues between caregivers where you’re concerned about their health and safety and you’re navigating these issues with how do you treat your patients in the best way that they have the best chance of an outcome, which we obviously knew was through clinical trials. But, you didn’t necessarily know which ones were going to be effective.
“So, there was a lot of concern on our side for ensuring that we were doing the right thing with the information that we had at the moment, every day.”
President’s view
UH-Elyria President Kristi Sink said a disaster plan looked at scenarios through statistical modeling in the event they were at 300 percent patient capacity and what healthcare would look like.
“I think that, for us, was the point that we really realized this is real,” Sink said. “It requires from us a different kind of response. And the sense of pride of, this is our turn to serve. Most of us get into this, to help people and this one’s ours and let’s do it right.”
Sink recalled knowing immediately they weren’t going to hide in the corner.
“We had over 100 patients that were enrolled in that clinical trial and it wasn’t just the downtown facility, it was the delirium and across all of our community hospitals,” she said. “So, I think that the sense of ‘we have to fight back, we have to combat this as part of our mission’ was a really strong sentiment at the time, you know, and then we had to combat it for.
“We have to find masks, we have to find PCs, we have to find, you know all of the different things that then became scarce incredibly stressful.”
It was a hallway conversation with two nurses in May or June that set the tone for Sink in reminding her and other healthcare workers why they do what they do in drawing on hope.
The two nurses, she said, were reminiscing of all of the ‘firsts’ that healthcare workers had encountered in batting COVID: the positive case, the first hospitalized patient and the fear associated the unknown, and the first death.
“All of those firsts, every time was a learning,” Sink said. “Even when the (first) patient died, though, the need to handle that patient differently than we handled other patients in preparing them to be transported to the funeral home was different. So it’s an incredible learning curve over a year.”
On March 9, 2021 UHElyria had the first day in nearly a year without a positive case under their care.
Healthcare workers spend their careers preparing and training to be ready when crisis hits but as Farber noted, reading about the latest pandemic in a book can only go so far when compared to living through it and adapting best practices.
“I think we did a really great job of that in the healthcare environment,” he said. “Even though it sometimes felt like we were changing on a dime I think that we did a great job of making those transitions really quickly, and providing the best care that we could for each other, for our patients, for the community providing the best information that we could in a moment.
“And I will be open and say that information we’ve all seen changed throughout the pandemic,” he added. “I feel, you know, you know, for all those moments of concern I feel really good about what we were able to do.”