coronavirus New York

In the frontline against an invisible enemy

By Paul D Panakal

Registered Nurse and Director of Patient Care Services for Northwell Health.

The sizeable Malayalee healthcare community is visible in all healthcare facilities in the New York metro area as professional or ancillary staff. Here is an insider’s account of how they have contributed valiantly in the war against the deadly coronavirus.

As a Registered Nurse, Johnson went to bed last Saturday with mixed feelings of fear, anxiety and uncertainty.  He was aware that returning from work the previous evening, after seeing the sights in the hospital, was traumatic for him.  Johnson (name changed to protect identity) does not work with the critically ill patients in the ICU or patients arriving in the Emergency Room.  But he did witness his colleagues desperately trying to help men and women of all ages to breathe or to get some oxygen in their body system as the highly contagious coronavirus invades and disables the lungs. Some patients were conscious, some unconscious and some in conscious sedation. Their lives were in the hands of doctors and nurses, who, however, know they are not tooled or equipped to contain the killer virus.  Johnson saw his colleagues helplessly calling the doctors to see if they could still instill some beats in the patients’ still hearts. As many body bags were moved to the refrigerated trucks, the healthcare workers had no time for a sigh of grief, frustration, or sadness as more and more critically ill patients were being wheeled in.

Working with moderately or severely ill COVID-19 patients, Johnson feared that he might have contracted the virus himself despite using personal protective equipment (PPE). So, returning from work, he went directly to the basement, put all clothes in the washer and took a shower. He still maintained a physical distance from his wife and children and used the basement as his bedroom.  He lay tossing and turning for several hours in bed, thinking about his colleagues, the patients and their families. 

As he woke up from a brief nightmarish sleep, Johnson opened his social media pages on his mobile and learnt that four people he personally knew from the Malayalee community had died from the complications of COVID.  They died in the hospital after being put on ventilators; none of their loved ones was with them in their last moments. 

Next morning, Johnson was back to work on a 24-bed medical floor with three other RNs. Their nurse manager told him that the situation in the hospital had changed rapidly. Due to the influx of patients, additional hospital beds were laid out in the parking lot and even in the cafeteria. The same team will have to tend to the added capacity also. Johnson told the nurse manager, “I understand. It is that time. We are made for this. We will do it to the best of our ability. We will comfort our patients as best as we can”.  The nurse manager nodded with a painful smile. 

Most of the patients on the unit were receiving oxygen treatment, I V antibiotics and some were on medications under study to test their efficacy.  Most of the patients were elderly and needed assistance in getting out of their beds and to use bathrooms. Call bells sounded constantly. In some rooms IV fluid or IV medication ran out. The three nurses moved from room to room, to electronic medical records to electronic medication bins or to the utility rooms or attending phone calls.  They prioritized the severity of the needs and met critical needs while being vigilant of every patient and their medical conditions. The patient care associate relentlessly moved around, assisted patients, took vital signs, communicated with the nurse manager and Johnson. The unit clerk was on the phone dealing with anxious and desperate families, being careful not to violate privacy laws and transferring the lines to the RN or the MD for further assistance. 

Johnson later learned that the surge of COVID patients at his hospital was three times its capacity. (The condition in other hospitals was no different.) Even while emergently augmenting its resources including ventilators and PPE, his hospital was doing everything possible to save the lives of patients brought in.  During the day, doctors, nurses, patient care associates, respiratory therapists, unit clerk, and housekeepers lived amid pain and despair, grief and death, comfort and pleasant discharge.

Johnson is one of the hundreds of Kerala origin Registered Nurses in New York who have been proudly, painstakingly, and resiliently providing professional nursing care to thousands and thousands of COVID-19 patients.  Queens, the hardest hit epicenter in New York City, which in turn is the epicenter of COVID spread in the world, is also home to a large Indian community, a major group of which is Malayalees with a considerable number being healthcare professionals.   Thanks to the cultural, social and religious activities and initiatives, most of them share extensive social relationships among the community. Sadly,

Within a period of two weeks, the Malayalee community has lost 17 people to the complications of COVID-19.  They included an RN who was working in a city hospital.

Anni John, an ICU RN from Queens General Hospital, shared her experience: “It is still a challenge providing support to save lives while protecting myself from getting infected and from transmitting the virus to my family.”  She insisted that all healthcare professionals do everything humanly possible to save people’s lives. But, Anni sighed, “With COVID we do not know what would work to help patients suffering from its complications”.

CP, a physician working in ER was leading the team to intubate a patient at a time when the coronavirus was not yet a pandemic. When she learned later that the patient had COVID, “I immediately went in quarantine”.  On getting fever and flu symptoms, she asked for a test, but was told that she did not meet the criteria. She was relieved that her symptoms were not serious, so she is back in the Emergency Room doing her job.

Nisha John, another ICU RN from Lenox Hill Hospital, was also emphatic on her mission as a nurse. She has been self-quarantining and even after testing negative for the deadly virus, she avoids close contact with her children. Annie George, a nurse educator and administrator at HHC, was appreciative and impressed as to how quickly our strong healthcare system mobilized the resources to fight the invisible enemy.  She was proud to praise “the attributes of readiness and determination of the doctors, nurses, respiratory therapists, and the dietitians that came from the army reserve were like the frontline forces in a real war!” 

Among those the community lost was the 21-year-old son of a community leader.  The saddest part is families’ inability to cope with the shock and grief caused by the unanticipated, lonely death of a loved one. The families found it difficult to even get the bodies released to funeral homes, which were stretched beyond their capacity just like the hospitals.

“We can’t point fingers or find fault with what has been happening,” says Tara Shajan, a nurse administrator and President of Indian Nurses Association of New York. She is appreciative of how New York has managed the attack of the virus that came like wildfire. “We lost a lot of precious lives but considering the number of COVID positive cases, the death rate has been low. Most of the people who lost their life had had serious comorbidities. Our doctors, nurses and other healthcare workers have been helping to save thousands of precious lives”. 

Gisha Jose, a nurse manager who recovered from COVID, recalls that she was having the symptoms of seasonal allergy that she gets at this time of the year. “But when I lost my sense of smell, I decided to get tested. The result was positive, and it caused lot of anxiety. Having to quarantine myself away from my loved ones only made that worse.  I had to remind myself that it was the best thing to do for everyone”.

The sizeable Malayalee healthcare community is visible in all healthcare facilities as professional or ancillary staff throughout the New York metro area.  As reports emerged of the COVID outbreak, no one imagined that it would hit as rapidly as this crisis and overwhelm the emergency and critical resources including protective equipment, causing panic. While a majority of the COVID positive individuals remained home with symptoms that were not life threatening, cases that came to hospital emergency rooms were critical. Nervousness, anxiety and fear initially overwhelmed those who were called upon to respond to those fighting for life. As they provided care and comfort, many of them themselves became ill and recovered.  They became more resilient, proud and altruistic.

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