Elaine Hernandez and her husband were in a store when someone started to make fun of her for wearing a mask.
“Anyway, I mentioned COVID and he started screaming at me,” Hernandez, a nurse serving as a navigator/care coordinator clinician at University of Iowa Hospitals and Clinics’ post-Intensive Care Unit COVID unit, said as she recalled the incident. “He said, ‘Fake news, it’s a hoax.’ You know, he was like, he was very adamant about it. And, I was just crushed. I mean, I was shaking down to me knees.”
The stark difference between a stranger in a store aggressively telling her the highly contagious, potentially deadly coronavirus is fake news and the patients she sees suffer each day at work was hard to take.
“I wanted to cry. I was just in shock that he would scream at me like that,” Hernandez, of North Liberty, said. “You think this is a hoax?”
Despite all of the reporting, public announcements and warnings from health care professionals, community leaders and elected officials, health care workers IowaWatch spoke with as 2020 drew to a close said many people still don’t understand the severity of suffering that the people hit hardest with COVID-19 have to endure. Unless, that it, they have seen it up close, themselves, with someone they know.
“It’s been taxing, and there’s just a lot of fear,” said Dr. Nate Andrews, a UnityPoint emergency room doctor at several hospitals in the Quad Cities area and Muscatine.
“Things like this, they bring out the best or the worst in people,” Andrews, a front-line worker since the virus showed up in Iowa in March.
Concerns in general about the virus, amplified by family gatherings during the holidays, have driven health care professionals to push a message they’ve delivered all year: wear a mask, social distance, avoid crowds, wash hands frequently, among them.
Mayo Clinic researchers announced a study last month that showed social distancing and widespread use of masks reduce COVID-19’s threat. They announced their findings before publishing their data because of the importance of what they learned, clinic officials said.
The study showed that physical distancing from others reduces exposure to respiratory droplets, the most common way researchers say the virus spreads. Being 3 feet apart helps but being 6 feet apart reduces exposure to the droplet to near baseline levels, the researchers said.
“We found that both disposable paper medical masks and two-layer cloth masks were effective in reducing droplet transmission and we did not find a difference between mask types in terms of how well they blocked aerosol particles emitted by the wearer,” Dr. Matthew Callstrom, chairman of Mayo’s department of radiology in Minnesota, said in a prepared statement.
More than 3,650 people had died in Iowa with COVID-19 afflictions going into the Christmas holiday, the state’s coronavirus data web page shows. The death toll could reach more than 4,300 by April 1, a University of Washington health data tracker and predicter showed in mid-December. Projections like these change as trends play out. For example, the estimate in late November had been a little more than 5,000 deaths by March 1.
Andrews said instances of COVID-19 are increasing at hospitals where he works. They are anything but pleasant. “I mean you can see people that are literally suffocating in front of you,” he said. “We’ve never seen anything like this before.”
The situation worsens when doctors have to make choices between who gets to stay in the hospital and who goes home, Andrews, who got a COVID-19 vaccine, said. People who aren’t as sick as others are sent home and monitored by medical professionals.
“We’re sending home people that I would have admitted every day of the week, twice on Sunday, and now I have to send them home,” Andrews said.
Andrews gives this grim advice: “You really have to have difficult decisions about code status and end of life care decisions.”
One of the difficulties health care workers IowaWatch talked with say is that people who haven’t seen COVID’s effect sometimes think that people with only the most severe cases suffer.
Hernandez’s unit at the University of Iowa cares for patients who have left intensive care but still need help, even after leaving her unit.
“Are they going to need some kind of rehab facility? Skilled nursing facility? Or, if they go home, are they going to need to be watched by telemedicine?” Hernandez said, giving examples of what lies ahead for some patients. Some are sent home on oxygen treatments and a monitor to measure the oxygen level in their blood. Others have kidney or cardiac issues that require following up, or need physical therapy.
Hernandez told of how she and her husband, Jesse Hernandez, wore masks when going to a house to inquire about buying a puppy. “They were, like, ‘OK, that’s cool but why do you feel that’s necessary?’” she said. “And, I said, ‘Well, I case manage the COVID unit and I take all my precautions. … I always got to be vigilant and not only protect myself but to protect others. I could be, unknowingly, a carrier.’
“And then, the guy kind of got more curious and he was asking, ‘Well, what happens in the hospital with these COVID patients?’ And, this couple was just totally taken aback because they were like, ‘we had no idea.’”
Healthcare providers have been talking about conditions their patients have endured and needing safety precautions throughout the pandemic. Some University of Iowa Hospitals and Clinics providers recorded their thoughts in video blogs in September and October.
“Not everyone believes that this is real. So many still just think this is the flu, and we’re over-reacting, and we need to back to normal,” Allison Wynes, a lead medical intensive care unit advanced-practice provider hospitalist at UIHC, said in one of those video blogs.
“Trust me, I desperately want to go back to normal,” Wynes says in the video. “I think everyone I work with wants to go back to normal.”
That was before state and health industry leaders felt a need to call, again, in November for public help in curbing COVID-19’s spread and a surge that month during which UIHC hospital saw an average of 80 to 90 patients daily, Laura Shoemaker, UIHC public relations manager, wrote in an email Tuesday, Dec. 22.
Numbers were back at pre-surge levels of 20 to 30 COVID-19 inpatients a day at UIHC, Shoemaker wrote.
LONG-TERM RECOVERY FOR SOME PATIENTS
An X-ray of healthy lungs shows the white-gray outline of the patient’s chest, the heart, and the ribs and sternum. Black areas on the image would show air in the lungs.
An X-ray of lungs affected by COVID-19 light up with more areas of white in both sides of the lungs. That shows fluid, infection or scarring, said Dr. Matthew Neil, a 20-year physician with Genesis Health Group’s clinic in Eldridge, near the Quad Cities, and a graduate of the University of Iowa Carver College of Medicine. Neil said he sees patients in his family medicine practice who have battled the coronavirus and now some of them face the longer-term issues such as brain fog, heart problems and breathing difficulties.
These X-rays were from a seemingly healthy, 40-something man, Neil said, although the man was not a direct patient of his.
Neil said what most people may not see is the severity of COVID-19 and how it affects some patients longer. “Even though he lived through COVID, he is likely going to never recover to where he was at baseline. He is likely going to have shortness of breath and other symptoms,” Neil said.
The Friday before Christmas, Neil saw a patient who had had coronavirus in November. The patient reported being fatigued, still. “It’s slowly improving so we’re hopeful that he will get back to baseline. But it’s just a waiting game,” Neil said.
Neil has been vaccinated for the coronavirus.
His advice on vaccines: “Ask somebody who you have faith in and who you trust because the more people that we can get to do this, the closer or the faster we get back to our normal lives back. And, that’s where all of us want to be. We want to save lives. We want to keep people healthy, we want to stop this disease from doing the destruction that it’s doing.”
This story was republished by The Des Moines Register, The Courier (Waterloo-Cedar Falls, IA), The Leader (North Liberty-Tiffin, IA), The Mount Vernon-Lisbon Sun, The Bloomfield Democrat and Newsbreak.com under IowaWatch’s mission of sharing stories with media partners.