Consider This from NPR - With Nearly 200,000 Dead, Health Care Workers Struggle To Endure

Episode Date: September 21, 2020

The coronavirus has killed nearly 200,000 people in America — far more than in any other country, according to Johns Hopkins University. And experts are predicting a new spike of cases this fall. It's not clear exactly how many of the dead are health care workers, who remain especially vulnerable to the virus. Dr. Claire Rezba has been tracking and documenting their deaths on Twitter. Christopher Friese with the University of Michigan School of Nursing explains how we all feel the effects of a health care system whose workers are stretched to the brink.NPR science correspondent Richard Harris reports on a crucial advancements health care workers have made that mean ICU patients are more likely to survive now than they were at the outset of the pandemic. In participating regions, you'll also hear a local news segment that will help you make sense of what's going on in your community.Email us at [e-mail] more about sponsor message choices: podcastchoices.com/adchoicesNPR Privacy Policy

Before she got sick, Cheryl Morrow spent a little time every night catching up with her daughter, Tiffany, on the phone. Some nights we would talk for 20, 25 minutes, just depends on how her day went. And then sometimes it was just a call, tell me goodnight, and she'd talk to me tomorrow. Tiffany says Cheryl's job kept her pretty busy during the week. She was a nurse at Batesville Family Practice Clinic in Arkansas. She and Tiffany met up on the weekends for shopping or lunch, usually on a Sunday, until one Sunday morning in mid-August. She calls me at like I think 7 15 and she was crying and I said mom what's

wrong and she said I had to go get tested for the virus and I said okay I said why and she said I woke up sick and I said it's going to be okay. I said, why? And she said, I woke up sick. And I said, it's going to be okay. I said, we'll wait for your results to get back, you know, and then we'll go from there. The results were positive. Within a week, Cheryl was in the ICU on a ventilator, and she spent 13 days like that, alone. And then on September 5th, less than three weeks since that Sunday morning, she was dead at age 53. I never thought at 31 that I'd have to bury my mama. Cheryl Morrow, one of 200,000 Americans dead from the coronavirus.

On Sunday in Washington, D.C., the bell at the National Cathedral rang out 200 times, once for every 1,000 people. 200,000 people. That's about 20% of total deaths worldwide from the virus. And the U.S. only has about 4% of the world's population. Healthcare workers remain some of the most vulnerable. Just because they're a frontline worker

and they're working and they haven't caught it yet doesn't mean that they can't. Consider this. We spent spring on lockdown so we could protect health care workers. Now we're not even sure how many have died. And experts are predicting a new surge of cases in the fall. From NPR, I'm Adi Cornish. It's Monday, September 21st. This message comes from NPR sponsor Twilio,

a customer engagement platform trusted by millions of developers, enabling you to reinvent how you connect with your customers. Whatever your use case, Twilio has your back. It's time to build. Visit Twilio.com. Support for this NPR podcast and the following message come from BetterHelp, online counseling by licensed professional counselors specializing in isolation, depression, stress, and anxiety. Visit betterhelp.com slash consider to learn more and get 10% off your first month. On Facebook, there are these three brothers who love guns.

Say guns are overregulated. Say the NRA is too quick to compromise. And they're gaining more followers every day. They're very in-your-face and offensive, and by God, I love them for it. Listen now to the No Compromise podcast from NPR. It's Consider This from NPR. 200,000 people, about the population of Salt Lake City. It's Consider This from NPR. 200,000 people, about the population of Salt Lake City. It's hard to process the toll of that loss. Back when Dr. Claire Resbaugh was in medical school,

she felt that way too, that processing death was hard, even when it was happening right in front of her. When I had patients die or pass away, I would keep a list of their names. And I took those names to a church and I lit a candle for them and I said a prayer. And it really helped me cope with those very sad feelings I felt about seeing so much death. Today, Resba is an anesthesiologist in Richmond, Virginia. To better process the deaths of health care workers across the country,

she's been counting them one by one, starting with Deidre Wilkes, a mammogram technician from Georgia. And she has, it was a terrible story. She had died at home and her young child was at home with her after she had died for many hours. I think it was maybe 12, 14 hours before there was a welfare check, and they found her. And that story really upset me. I mean, she was essentially my age. I have a child a similar age as her, and it just really resonated with me.

When Resba first heard the story of Deidre Wilkes, it was from a local news report that didn't even reveal her name. So she cataloged Wilkes' name and her death in a database that now includes more than 1,200 people. And she shares each one on Twitter. 1,200 health care workers across the country is almost twice as many as the official estimate from the CDC. I think there's a couple reasons for that. Respa says the CDC count may miss people who die at a hospital other than their own. Their job may be left off their death certificate

or not included on the form hospitals use to report data to the CDC. The other thing is the form itself, I think, is inadequate. It says, was this patient a health care worker? And it has doctor, nurse, respiratory therapist, housekeeping, and then other. Other is a huge category. And again, you might not realize that that person is a healthcare worker. You might not realize that the person who's involved in dietary services should qualify. You just might not realize that whoever's filling that death certificate out. That could mean people like 22-year-old Alexander Bernardo,

who was a dietary aide at Park Ridge Nursing Center in Jacksonville, Florida. He was 22 when he died on July 17th. He gave the virus to his father, Alvin, who died two days later. Or Pamela McRory, who supervised dietary services at Sister Hospital in Buffalo, New York. She died on April 18th, her daughter's 18th birthday. Those are the stories Resba is collecting, every day, for six months, with no end in sight.

When I think I've gotten to a point where I'm done, I'll find a couple stories, and I think, well, just a few more. These people really deserve to be, their loss deserves to be known. Dr. Claire Resbaugh, find her Twitter account where she remembers healthcare workers who have died from coronavirus at the link in our episode notes. I think that it's been so painful and draining for the U.S. healthcare workforce to see our fallen colleagues. Dr. Christopher Fries is a professor of nursing

at the University of Michigan and a registered nurse himself. And even if it's not someone you work directly with, knowing that another healthcare worker has been lost, I think is very demoralizing. Fries has been an outspoken critic of the federal government's response to the pandemic. We talked about what the last six months have been like for health care workers and how their struggles affect us all. We came into health care to help people, and the fact that we're losing our own

is very tiring and very draining for those of us who do this on a day-to-day basis. How has this affected the industry in terms of the day-to-day workload going forward, right? You're losing important people and key positions. Some may have a lot of experience one way or another. What does this mean for the people they leave behind? Right. So we're losing people from death and illness, which is catastrophic. We're also, I think, probably going to lose some experienced personnel because they think that the risks are too high. And if they have an opportunity to retire, they will. And we can't replace that expertise. That's decades of expertise that will take us decades or more to recover from.

And it makes the entire healthcare system less safe and secure for Americans. And the final piece on this is that because of the pandemic, many patients, particularly those with cancer, are presenting at more advanced stages because they've waited for screening and testing and diagnosis. And so the care we're delivering outside of the pandemic is more complicated than it's been before. Were there any areas of the healthcare industry that were kind of more vulnerable than others, now that we're seeing kind of the numbers of health workers that have been lost? So what we do know, and part of it is from the data and part of it is anecdotally, is environments with fewer resources, places like nursing homes,

skilled nursing facilities, prisons, these places were particularly affected. They usually don't carry the kind of protective equipment that we need in this pandemic. And the results show that those workers were particularly hard hit. And many of those workers are of color and work in disadvantaged areas. One thing we're trying to understand is how this loss, these deaths and the loss of expertise, right, affects the care that patients receive. You mentioned nursing homes, you mentioned prisons, you mentioned senior staff that might retire. I mean, what does that mean for care going forward? Right. So the loss of these senior expert health care workers can't be replaced in short order. And when we have less experienced healthcare workers at the bedside, the care that's

available to our loved ones is of less quality. I also worry that the loss of experts at the bedside will make it harder to train the next generation of healthcare professionals, those in training. And then I also worry that this long-term depletion of our health care workforce will only exacerbate the weariness that I'm seeing in my colleagues today. As you see your co-workers and colleagues leave the field, either from illness or retirement, you become demoralized and stressed. Dr. Christopher Fries is a professor of nursing at the University of Michigan. Despite what health care workers are going through, it's worth noting they've also gotten a lot better at treating people for the virus. In particular, those patients who wind up in the intensive care unit. NPR science correspondent Richard Harris has this story of one man's recovery and how

improvements in health care made it possible. In early August, Don Ramseyer was helping his son pack up the car for his freshman year at the Citadel, the military college of South Carolina. Ramseyer wasn't feeling that well, but he tried to play it down. Got him ready, got the last box packed, everything was ready to go in the car, and I finally succumbed to my sister and my kids saying, Dad, something's wrong. Go to the hospital. Ramseyer, who's 59, had been diagnosed in November with a slow-moving form of leukemia. But the doctors at Emory Johns Creek Hospital, northeast of Atlanta,

ran a few tests and concluded that his new symptoms were due to COVID-19. He got sicker and sicker over the weekend, and Ramseyer recalls the doctors called his sister with the sobering news. Because they did not think I was going to make it. During this period of time, they basically started throwing everything in the kitchen sink at me, almost like Sherlock Holmes. What can we try here? What can we try there? Try to, you know, get in front of these things. Among other measures, Ramseyer was treated with steroids, which have recently been shown to save the lives of some seriously ill COVID-19 patients. He got the antiviral drug remdesivir,

as well as an experimental treatment called convalescent plasma. He also ended up on a ventilator for nine days under heavy sedation. Somehow, I got out of the straps. I completely unhooked myself and completely excavated myself and pulled the breathing tube out. Happily, doctors realized that Ramseyer could get along okay without the breathing tube. I continued to improve from that point forward. Ramseyer's story is remarkable considering his cancer and the many complications of his case. But Dr. Craig Coopersmith, director of Emory's Critical Care Center, says this story is far from unique. We have very much replicated what has been seen worldwide, which is

over time mortality in the ICUs have decreased. The decline in mortality varies month to month, but at Emory's hospitals, it has been in the range of 20 to 50 percent. Coopersmith says there's lots of reasons for that. A big one is that when the first wave of COVID-19 hit Atlanta's hospitals in April, doctors had no experience with the disease. Medical management of these patients is now, by comparison, routine. There's certainly nothing routine about the pandemic, but in terms of how we're managing it, once you're taking care of something for the 10th time, it is normal. Doctors can better manage common and serious complications like blood clots.

They realize that patients do better if they aren't lying on their backs all the time. And a series of studies showed that steroids can save lives. And so that's a tremendous success story. In just a few months, we have a drug which is easily available everywhere and quite cheap that improves survival significantly in the ICU patient population. Science has rapidly been brought to bear, but Coopersmith says it also helps that for the past six months, the ICU physicians at the five Emory hospitals have shared their personal experiences and ideas with one another in a daily text chat.

And in that, we find the art of medicine. Patient Don Ramsayer adds to the list his own deep faith in God for getting him through the ordeal. After more than six weeks in the hospital, he's finally getting ready to go. I'm walking, sitting, I can get around. My only limitation is just my oxygen requirement. He's eager to return to his job as a software designer and to keep working with his doctors to figure out the right treatment for his leukemia. NPR Science Correspondent Richard Harris.

It's Consider This from NPR. I'm Audie Cornish.