While the rest of us sheltered at home to buy them time, pitching in where we could, and maybe taking part in salutes to them every evening at 7, frontline medical workers have been putting their health on the line to fight a highly communicable disease. BOSS spoke with three of them who have different specialties and from different parts of the US to get a sense of what life has been like inside hospitals. Dr. Christopher Barrios is a pulmonary disease and critical care specialist at Saint Louis University Hospital. Dr. Naveen Kukreja is an anesthesiologist and ICU doctor at the University of Colorado Anschutz Medical Campus in Denver. “Claudia” is an emergency room nurse in the Boston area, one of the hardest-hit metropolitan areas. BOSS granted her anonymity for fear of retribution for speaking out.
One of the trickiest things about COVID-19 has been recognizing the symptoms. In some people, it presents as a classic respiratory illness called Acute Respiratory Distress Syndrome (ARDS), Barrios said.
“But we have had people test positive that did not have any respiratory symptoms. I’ve had people come in with abdominal complaints, get a CT scan of their belly—which usually catches the lower lung fields—and have the lower lungs be abnormal, and they test positive for COVID-19,” he said.
In other cases, patients have presented to the hospital with diabetic ketoacidosis (DKA) without respiratory symptoms and tested positive for COVID-19. Typically, people with diabetes presenting in DKA have a pre-disposing factor such as infection or medication non-compliance that causes their blood sugar to become elevated.
“If you can’t really find a reason for DKA, you start to wonder, ‘Is there something else?’” he said. “What we are seeing is that the diagnosis of COVID-19 is sometimes difficult to make because its presentation can be variable.”
If you’re one of those who thought—or still thinks—COVID-19 is just the flu, you’re not alone. Claudia even thought so initially.
“When it first started, I was on that bandwagon of, ‘It’s probably going to be just like the flu. It isn’t going to be that big of a deal,’” she said. “But then when we actually saw these patients come in, it’s like nothing I’ve ever seen.”
Usually if someone is not getting enough oxygen, you can tell right away. The person is panicked, sweating, can’t speak in full sentences, has a high heart rate. When COVID-19 patients began coming into the hospital, Claudia said, a woman in her late 30s came in.
“I’m just thinking someone who is short of breath obviously looks short of breath. I’m thinking, ‘She looks fine.’”
The woman got off the stretcher, walked into a room in the ER, and set herself on the bed.
“I put her on the monitor and her oxygen is at 70%. A normal oxygen saturation is 95-100. You want it above 90 ideally. She didn’t look like she was struggling to breathe, but when you stop and you look at her, you realize she’s breathing at 45 breaths a minute,” Claudia said, noting that 1218 breaths per minute is a normal range. “We’ve had to learn a different way. They just don’t look like someone that is very sick off the bat, and they’re the sickest patients we have.”
The woman died in the ICU.
Treatment & Recovery
To make sure their patients are getting enough oxygen to their organs, hospital professionals often intubate them to support their breathing. They’ve found that in certain cases of COVID-19, early intubation may not be necessary.
Instead, Claudia said, they’ve been giving them as much supplemental oxygen as possible. They’ll give patients who can breathe on their own a nasal cannula—a breathing tube with extensions that go in the nostrils—and a non-rebreather facemask and flip them on their stomachs.
Kukreja said that after initially intubating most COVID patients whose oxygenation was deteriorating, they started to trial a different approach. “We started saying, ‘Wait a minute, we’re accumulating a lot of intubated patients really fast.’ It actually got to the point where we were testing our ventilator supply,” he said. “Then we started asking patients to prone themselves before resorting to ventilation because the reason it works, it would still work even if you weren’t on a ventilator. A lot of patients who did that were able to avoid intubation. It’s unclear if the prone positioning helped. This strategy needs to be appropriately studied, but it didn’t seem to hurt.”
Continue reading your story on the app
Continue reading your story in the magazine
THE WAY OF WATER
XRI’s sustainable water solutions are revolutionizing the water midstream industry.
FROM NICHE TO NEED IT TODAY
Once viewed as ‘nice to haves,’ amenities like online ordering and curbside pickup are redefining the grocery shopping experience.
Hospice Industry INFLUENCERS
Attending to a person in their hour of death is one of the most honorable and sacred things we can do for one another. Through state-of-the-art technology, education, and a deep devotion to compassionate care Maxwell Healthcare Associates aims to forever change the way we live our final days.
Clean up your act
RENEWABLE ENERGY IS GREAT, BUT RENEWABLE WASTE OIS A REAL PR BLEM. HERE’S WHAT CAN BE DONE ABOUT IT.
THE FUTURE OF FOOD LOGISTICS
HOW THE FOOD SUPPLY CHAIN IS CHANGING IN THE WAKE OF COVID-19
UNDER THE WEATHER
THE FACTORS THAT CAUSE CLIMATE CHANGE ALSO MAKE US SICK.FIGHTING IT CAN SAVE MILLIONS OF LIVES
WALK THE LINE
THERE’S A LOT TO LIKE ABOUT SAUDI ARABIA’S PROPOSED SUSTAINABLE CITY. BUT IT’S ALSOE 105 MILES LONG, AND THAT’S JUST BEGINNING OF OUR PUZZLEMENT.
TO BOLDLY GO
An astoundin mission to bring the internet to everyone on the planet is changing the way we think about mass production and procurement. Airbus Oneweb Satellites is shattering earthly bonds and long-held expectations about the linits of possibility.
5 REASONS FINANCE TEAMS SHOULDN’T RETURN TO BUSINESS AS USUAL
A year of COVID
MY OH MY, HOW THINGS HAVE CHANGED
Merriment in the Mudroom
A stylist gives us her tips on bringing festive charm to an otherwise forgotten zone.
Easy Outdoor Gatherings
It’s time to take it outside! By rethinking your garden spaces and having a few simple staples on standby, you can gather outdoors in a pinch for some safe and simple social distancing.
Claudia Rankine's Quest for Racial Dialogue
Is her focus on the personal out of step with the racial politics of our moment?
Pennsylvania Researchers Join Florida in Examining Industry With $500,000 Grant
GLOBAL LUXURY GOODS SALES TO SLIDE UP TO 35% - STUDY
The global luxury goods sector is heading for a stunning collapse of up to 35% this year due to coronavirus lockdowns, according to a new study by the Bain consultancy published Thursday.
Create an outdoor-dining tablescape as the centerpiece of your summer soirees.
How to finance and save for senior care.
Make The Leap – You Really Can Do It!
A new year is the perfect time to make a life-changing decision. Here’s how to go about it – and how to stick to it
Happy N.Y.E (New Year Energy)
How to feel perkier than a crateful of V
Comfort & Joy
This Newport Beach homeowner transforms her coastal chic home for the holiday season with greenery, glitz and glam.