‘We’re trying to keep our heads above water’: U.S. healthcare workers fight shortages – and fear

By Kristina Cooke, Gabriella Borter and Joseph Ax

LOS ANGELES/NEW YORK (Reuters) – U.S. nurses and doctors on the front lines of the battle against the new coronavirus that has infected tens of thousands of Americans and killed hundreds are shellshocked by the damage that the virus wreaks – on patients, their families and themselves.

Nurses and doctors describe their frustration at equipment shortages, fears of infecting their families, and their moments of tearful despair.

These are some of their stories:

NEW YORK CONFIRMED CASES: 53,324. DEATHS: 773

Dr. Arabia Mollette, an emergency medicine physician, has started praying during the cab ride to work in the morning. She needs those few minutes of peace – and some lighthearted banter with the cafeteria staff at Brookdale University Hospital Medical Center in Brooklyn at 6:45 a.m. – to ground her before she enters what she describes as a “medical warzone.” At the end of her shift, which often runs much longer than the scheduled 12 hours, she sometimes cannot hold back tears.

“We’re trying to keep our heads above water without drowning. We are scared. We’re trying to fight for everyone else’s life, but we also fight for our lives as well,” Mollette said.

The hospitals where she works, Brookdale and St. Barnabas Hospital in the Bronx, are short of oxygen tanks, ventilators and physical space. Seeing the patients suffer and knowing she might not have the resources to help them feels personal for Mollette, who grew up in the South Bronx and has family there and in Brooklyn.

“Every patient that comes in, they remind me of my own family,” she said.

At least one emergency nurse at a Northwell Health hospital in the New York City area is wondering how much longer she can take the strain.

After days of seeing patients deteriorate and healthcare workers and family members sob, she and her husband, who have a young son, are discussing whether she should leave the job she has done for more than a decade.

The emergency room, always a hotbed of frenetic activity, is now dominated by coronavirus cases. There are beds all over the waiting room. The nurse, who spoke on condition of anonymity, said she sees family members dropping off sick relatives and saying goodbye.

“You can’t really tell them they might be saying goodbye for the last time,” she said.

On Thursday, some nurses and doctors were brought to tears after days of physical and emotional fatigue.

“People were just breaking down,” she said. “Everyone is pretty much terrified of being infected … I feel like a lot of staff are feeling defeated.”

At first, she was not too worried about her safety since the coronavirus appeared to be deadliest among the elderly and those with underlying health conditions.

That confidence dissolved after seeing more and more younger patients in serious condition.

“At the beginning, my mentality was, ‘Even if I catch it, I’ll get a cold or a fever for a couple of days,'” she said. “Now the possibility of dying or being intubated makes it harder to go to work.”

There is no official data on the number of healthcare workers who have contracted the virus, but one New York doctor told Reuters that he knew of at least 20.

WASHINGTON STATE CONFIRMED CASES: 4,310. DEATHS: 189

A Seattle nurse has started screening patients for coronavirus at the door of her hospital, a different job from her usual work on various specialty procedures.

She doesn’t talk about her new job at home, because she doesn’t want to worry her school-aged children, she said. Her husband does not understand her work and tells her to decline tasks that could put her at risk.

“I’m like, ‘Well it’s already unsafe in my opinion,'” she said.

But she is nervous about having to separate from her family if she contracts the virus.

“I’ll live in my car if I have to. I’m not getting my family sick,” she said.

The nurse spoke on condition of anonymity because she is not allowed to speak to the media.

During her last shift, she was told to give symptomatic patients napkins to cover their faces instead of masks – and not to wear a mask herself. She ignored that and wore a surgical mask, but she worries less experienced staff heeded the guidance.

“We get right in their faces to take their temperatures because we do not have six-feet-away infrared thermometers,” she said. “The recommendations seem to change based on how many masks we have.”

Her hospital has put a box outside for the community to donate masks because they are so short of supplies.

She blames the government for not doing more to prepare and coordinate: “People should not have to die because of poor planning.”

MICHIGAN CONFIRMED CASES: 4,650. DEATHS: 111

Nurse Angela, 49, says the emergency room at her hospital near Flint, Michigan, is eerily quiet. “We’ve all been saying this is the calm before storm,” said Angela, who asked that only her first name be used.

The patients who trickle in are “very sick” with the COVID-19 respiratory illness, she said, “and they just decline really quickly.”

As they go from room to room, the nurses discuss how many things they are contaminating due to their limited protective equipment.

“You’d have to walk around with someone with Clorox wipes all night walking behind you,” she said. “The contamination is just so scary for me.”

She accepts that she and most of her colleagues may be infected. But she is worried about her daughter and her sister, who are both nurses, and she worries about infecting her 58-year-old husband.

Angela’s daughter has sent her three children, including an 18-month-old who suffers from asthma, to stay with their father to avoid possibly infecting them.

“I normally see my grandchildren twice a week and I haven’t seen them. It’s hard. I just cannot fathom what my daughter’s going through,” Angela said.

Many of her co-workers have done the same, packing off children to live with relatives because they are terrified, not so much of contracting the disease, but of passing it on.

Some of them are talking about quitting because they feel unprotected.

Angela would not judge them, she said, but she told a friend recently, “You have to remember, what if your kid gets sick or your mom gets sick, who’s going to take care of them when you take them to the hospital if all of us just leave?”

(Reporting by Gabriella Borter, Kristina Cooke and Joey Ax; Editing by Ross Colvin and Daniel Wallis)

Coronavirus rages on, putting strain on U.S. doctors, nurses

By Gabriella Borter and Nick Brown

NEW YORK (Reuters) – U.S. doctors and nurses on the front lines of the coronavirus outbreak came under increasing stress on Friday as the number of cases skyrocketed and hospital staff were forced to ration care for an overwhelming number of patients.

The United States surpassed two grim milestones on Thursday. The death toll soared past 1,000, reaching 1,261 by the end of the day, and the total number of infections topped 85,000, exceeding the national totals of China and Italy to make the United States the world leader in confirmed cases.

Worldwide, confirmed cases rose above 550,000 and deaths 25,000, the Johns Hopkins University & Medicine Coronavirus Resource Center reported on Friday.

“This is past a movie plot. Nobody could ever think of this, or be totally prepared for this. You’re going to have to wing it on the fly,” said Eric Neibart, infectious disease specialist and clinical assistant professor at Mount Sinai Hospital in New York. “The scale is unbelievable.”

After days of wrangling, the U.S. Congress may soon respond with a $2.2 trillion relief package, reinforcing an extraordinary array of economic measures that the U.S. Federal Reserve rolled out on Monday.

Leaders of the U.S. House of Representatives said they expected to pass the measure on Friday, sending the bill to President Donald Trump, who has promised to sign it.

In addition to aiding hospitals in hot spots such as New York and New Orleans, the package will bring welcome relief to businesses and unemployed workers. With much of the country on lockdown, a record 3.3 million Americans filed jobless claims last week, nearly five times the previous record set during the recession of 1982.

The counties surrounding Chicago and Detroit were also emerging as areas of concern, said Deborah Birx, coordinator of the White House Coronavirus Task Force.

One emergency room doctor in Michigan said he was using one paper face mask for an entire shift due to a shortage and that his hospital would soon run out of ventilators, the machines needed by sufferers of COVID-19, the respiratory disease caused by the virus, to help them breathe.

The doctor, Rob Davidson, urged Trump to use his executive authority to procure more test kits and ventilators.

“We have hospital systems here in the Detroit area in Michigan who are getting to the end of their supply of ventilators and have to start telling families that they can’t save their loved ones because they don’t have enough equipment,” Davidson said in a video he posted on Twitter.

New York Governor Andrew Cuomo has said any realistic scenario about the unfolding outbreak would overwhelm the healthcare system. His state, which has become the epicenter of the U.S. outbreak with more than 37,000 cases and 385 deaths, is scrambling to create more sick beds.

It is looking to convert hotel rooms, office space and other venues into healthcare centers, while setting up a convention center as a temporary hospital. Some hospitals are scrambling to convert cafeterias and atriums into hospital rooms to house intensive care patients.

Mount Sinai hospital had 215 inpatients with COVID-19 as of Thursday.

“The fear is next week we’ll have 400,” Neibart said, expecting a shortage of doctors and nurses.

In lighter moments, Neibart said he and his colleagues joke about claiming their own makeshift spots, for when they inevitably fall ill with the virus, although he said they routinely check on one another’s well being.

COVID-19 claimed the life of Kious Kelly, a Mount Sinai nurse manager whose death has led to an outpouring of remembrances from former colleagues.

“I remember him running crazy, checking on us and making sure we were OK,” Diana Torres, a nurse at Mount Sinai, told Reuters. “He would deliver our messages to administration if we weren’t happy. He wanted good things for us.”

Torres and other colleagues have also infused their tributes with angry messages about the shortage of personal protective equipment (PPE).

“It seems like we are fighting the government, (the hospital) administration and the virus,” Torres said. “We can tackle one, but not all at once.”

The New York Police Department also announced the first coronavirus death among its ranks on Thursday. Custodial Assistant Dennis Dickson was a 14-year veteran, NYPD said.

The Department of Veterans Affairs may be asked to help in New York, even as it struggles to provide enough staffing and equipment for armed forces veterans.

Maria Lobifaro, a New York intensive care unit (ICU) nurse treating veterans with COVID-19, said staff normally change masks after every patient interaction. Now, they are getting one N95 mask to use for an entire 12-hour shift.

The ratio of patients to nurses in the ICU is usually two-to-one. As of Monday it was four-to-one, she said.

“Right now we can barely handle the veterans that we have,” Lobifaro said.

(Reporting by Gabriella Borter, Nick Brown and Maria Caspani in New York and Doina Chiacu in Washington; Writing by Daniel Trotta)

‘I lived alongside death and didn’t die’: a Syrian frontline breathes again

Muhammad al-Masri, 75, gestures at his house in Jobar, eastern Ghouta, in Damascus, Syria April 17, 2018. Picture taken April 17, 2018. REUTERS/Ali Hashisho

By Laila Bassam

JOBAR, SYRIA (Reuters) – Muhammad al-Masri spent the Syrian war in a house the 75-year-old described as being on the frontline with death.

In his partly roofless, cobweb-filled house on a government frontline with the formerly rebel-held eastern Ghouta district of Jobar, al-Masri stayed put through years of conflict.

“Many said I was crazy … Everyone fled.”

But since the fighting ended three weeks ago, a trickle of life has returned to the war-ravaged, deserted streets around him.

The Syrian government, backed by Russia and Iran, regained eastern Ghouta, an area of farms and towns just outside Damascus, in early April in a ferocious assault.

The army offensive to capture it, heralded by one of the heaviest bombardments in the seven-year war, killed more than 1,600 people, said the Syrian Observatory for Human Rights, a war monitor.

Today the boom of mortars around al-Masri has been replaced with voices.

“Listen!” he says, as the sound of girls singing a traditional Syrian song reached him. “Life has returned to the neighborhood!”

Former residents are starting to come back, hoping to see what years of grinding warfare have done to their homes.

Near al-Masri’s house, soldiers yell at children and teenagers to stop exploring the barricades, trenches and war debris which had previously been off limits to them.

Most of the Jobar district is still uninhabited. Classified as a security zone by the Syrian army, the streets are strewn with destroyed buildings, bullets and explosives.

Underground, the army is still discovering a network of tunnels used by eastern Ghouta’s fighters and smugglers during years of siege.

Al-Masri’s house was the last inhabited position in his neighborhood before a bank of earth marked Damascus’s frontline with Jobar.

The house, shared at times with his son and daughter-in-law, was shelled three times. Shrapnel injured his son on one occasion.

“The mortars fell while I was inside. I didn’t leave. We cleaned up and sat back down,” he said.

“I lived here alongside death and didn’t die.”

His house was surrounded by Syrian government security forces who would bring him his food. He spent his days sweeping war debris from streets around him, watching television and telephoning family.

In the early days of the conflict he was scared and unsure of what might happen.

“For more than a month I slept with my shoes on, on full alert.”

Jobar adjoins government-held central Damascus. Parts of Jobar are just 500 meters from one of Damascus’s most famous public spaces: Abbasid Square.

Although Damascus has remained largely peaceful during the seven-year conflict, the proximity of formerly rebel-held areas like Jobar to the capital means rockets sometimes killed and injured people in the city.

“I didn’t take a single step from here. Not at night, not during the day. There was just 10 meters between me and the tanks. I was the only one in this area, no other buildings, no nothing. Me and the army were like brothers,” he said.

(Reporting by Laila Bassam and Firas Makdesi; Writing by Lisa Barrington; Editing by Alexandra Hudson)