Inside the third wave: an overflowing hospital

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Jeanne Bishop and Kathleen Marble are huddled together on their laptops and their notes, quietly trying to figure out where they’re going to put all the children and infants who arrive at Sparrow Hospital with COVID-19. It’s Tuesday, April 20, and the 8:00 am Incident Command meeting has just ended. Now the real work begins.

“We didn’t really see it in the population until last week,” says Marble, the director of pediatric nursing at Lansing Hospital. Her eyes are tired and she has pushed her glasses off the top of her head. “And now our numbers are now increasing in both [pediatrics] ICU and pediatrics. “

The youngest child they admitted is only two months old.

“Those who are in intensive care need respiratory assistance. They are on a ventilator, just like the adults. Those in pediatrics have high flow [oxygen support]. “

“And there are still children arriving that we find out they are COVID [positive], because we test them when they arrive at the hospital. And they’re here for a broken leg, or they’re here because they had a car accident. And then we find out that they are positive.

It’s not unique to Sparrow. As of Friday, April 23, 54 children were hospitalized in Michigan with suspected or confirmed COVID (although Sparrow saw a drop in his pediatric admissions over the past week, a spokesperson said.) A few days earlier, the state struck a new record for COVID pediatric hospitalizations on April 20, according to the Michigan Health and Hospital Association: 70 inpatients under 18.

This represents a 311% increase in pediatric admissions in the past two months alone, MHA spokesperson John Karasinski said.

“The increase is likely due to a combination of factors,” he said by email on Friday. “The higher infection rates for children under 18 ultimately lead to more children requiring hospital care. The more contagious variants are likely to be responsible for the higher infection rates, as well as the higher rates of infection. ‘exposure to unvaccinated adults and resumption of activities at levels we had not previously seen during the pandemic, including sports, extracurricular activities, increased mobility and social gatherings.

A one-year marathon

These “incident command” meetings are a crisis measure launched by Sparrow during the spring wave last year. Back then, the meetings had an urgent and practical feel, say staff members. Now in the third wave the tone is different.

“It was a big adrenaline rush at the start. You had the command center: “Oh, we’re here and we’re going to help everyone!” »Says Dr Kenneth Thompson, family physician. “Now it’s, ‘Oh, you’re only six miles away. There are 20 to do. You must be kidding. I sprinted the first six.

On Tuesday, the day we were in Sparrow, the hospital was at 100% capacity, with 50 overflow beds. Twelve people were waiting in the emergency room, and they were no longer going to admit transfers from hospitals outside of Sparrow’s health system, said Jeanne Bishop, director of nursing operations.

There is, however, potential good news: It looks like COVID cases have stopped their rapid rise and could be at a plateau, says Dr Michael Zaroukian, chief medical information and chief transformation. In the Lansing area, the positivity rate fell “below 16% … for the first time in weeks,” according to Sparrow’s own test results.

Zaroukian hopes the recent decline in new cases will continue.

“People probably react to what they see by being more careful,” he says, nodding at the white boards lining the walls, covered with notes on new admissions and changes in protocols.

“I think it’s partly the behavior, and partly the fact that some of the [social] the mix, like spring break, is over. And so they don’t travel as much as they would in late March, early April. But I think the big picture seems to have settled in. And so what also helps [is] our winter sports, which we also think are a bit of a vector, these seasons are now over. And so the next round of sports is going to be mostly outdoors and that should help as well. “

What worries him, however, is the possibility of hitting a vaccine wall: getting to a point where vaccine reluctance keeps herd immunity out of reach. Given the spread of variant B.1.1.7, we will probably all need booster shots in six months to a year. But if COVID continues to circulate widely, it could make real progress difficult.

“This is the biggest concern I have right now,” says Dr Zaroukian. “Most [these variants] continue to spread and stay active, the more variations we will have …[and] the more likely it is that one of these variants will not respond to the vaccine. This is why time is running out. “

“I have always been the caregiver”

From the command meeting, everyone disperses to return to their own departments. We take the elevator to the ninth floor, where Annette Cyphert has difficulty breathing.

The 63-year-old has been here for over a week now. Sitting in bed with her bare feet clinging to the edge, Cyphert says COVID has made it difficult even to speak to her children on the phone from her hospital room.

“I have to tell them to go,” she said, managing a chuckle between long, laborious inhalations of the nasal cannula pushing oxygen into her body. “I said, ‘I’ll call you back later when I can breathe.'”

Cyphert, who works in the baking department at Walmart, says the experience is a role reversal. “I have always been the caregiver. And I can say it, because my daughter has many problems. Now even the little things, like going for a walk – something that relieves her anxiety – are no longer options.

She still manages to talk to her adult children on the phone every day, she says. And she thinks of the great-granddaughter on the way – her third. And just being able to sit down, or “hear my own voice”, is an improvement. But it’s an effort to get out even a few words at a time.

As we walk out of Cyphert’s room and wish her good luck, I ask her: What made her agree to be interviewed? She is in such a vulnerable position: sick, struggling to breathe, wearing only a thin dress, while the reporter and photographers are dressed in head-to-toe PPE and specialized oxygen hoods, as if we handling toxic samples.

“It’s lonely here!” Cyphert said. “This is the main reason.” She just wanted to see people. “I have three faces here now,” she said, nodding to us.

“I was so close” to get vaccinated

Quinita Glynn’s bedroom is a few doors down. The 42-year-old has spent the past 13 days here, and nurses say her remarkable improvement is a morale boost for the entire floor. When Glynn was admitted, she needed oxygen so badly that she had to have a special feeding tube, so as not to remove her oxygen mask even briefly.

Now it looks like Glynn will be able to return home with her four children soon, albeit with an oxygen machine.

“I feel 100% better,” she says. “When I got here about 13 days ago. My body just felt beaten up.

Glynn suffers from asthma. She knew COVID could be life threatening for her, so she has been extremely careful over the past year, only leaving the house when absolutely necessary.

Last month, she went for an exam with her pulmonologist, who said her lungs looked fine. She doesn’t know how she contracted the virus – possibly her youngest daughter, a 6th grader, brought her home from school.

But what Glynn initially assumed was a sinus infection just wouldn’t go away. One afternoon, her sister forced her to go to the emergency room, as Glynn was increasingly disoriented. It was then that she began to deteriorate rapidly and was taken to intensive care. During those first few days, she thought she was dying. But she fought hard, she said.

“And I called COVID ‘devil’. I’m not going to let the devil get the better of me. You know, it’s bigger than that. I’ll get out of here. Now… I have a testimony. It is part of my testimony. It’s part of my story.

But she can’t help but think that she fell ill just days after being vaccinated.

“I was so close, you know? I fought the fight. I’m determined, you know, to wait until April 5th. And here is COVID. And so I tried to push him and quarantine him. I almost succeeded.

For healthcare workers, the marathon continues

In the hallway, Dr. Kenneth Thompson walks with a resident. He’s tried to keep the mood light, he says, and the nurses affectionately roll their eyes at his jokes about a box of gloves that “only have hands!” It must be a reduction. “

But everyone is exhausted. Just a few months ago, Thompson and his team lost one of their own: Dr Enrique Lopez, 67, another family doctor, died of complications from COVID-19 on February 5.

“He was a good friend,” says Thomspon. “[He] picked it up in his office. Dr. Lopez’s wife also works at Sparrow, Thompson says. “She’s been here for 33 years. I just saw her the other day. She is still working because she says, “If I don’t work, I’ll just sit at home and cry.” “

Thompson is silent for a moment. Then a resident pokes her head out of a patient’s room, waving her hand. “I must be a hero,” he jokes as he walks away. “Alright, guys. Enjoy. Wear a mask. Save a life.”

The Detroit Free Press, Bridge Michigan and Michigan Radio have teamed up to report on Michigan hospitals during the coronavirus pandemic. If you work in a Michigan hospital, we would love to hear from you. You can contact Kristen Jordan Shamus at [email protected], Robin Erb at [email protected], or Kate Wells at [email protected]

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