Doctors battling Covid-19: a view from the front line
By Maja Beckstrom
Shortly after Dr. Jonathan Kirsch discharged his first COVID-19 patient from Bethesda Hospital a song played through the hallways—“Here Comes the Sun.”
At first Kirsch, as a volunteer, thought it was someone’s mobile ringtone. Then he realized the Beatles tune was played on hospital loudspeakers to celebrate each victory over coronavirus. With so many ill people admitted to St. Paul’s designated coronavirus facility last spring during the height of the pandemic, every recovery got a sendoff.
Kirsch, a St. Anthony Park resident, is an internal medicine doctor at the University of Minnesota Medical Center and like many health care workers in the neighborhood, he cared for COVID-19 patients over the past year.
America’s ambitious vaccination program may soon control the virus and better treatments are helping more people survive serious cases. But health workers remember those uncertain early days.
“That was when (COVID-19) tests took five to seven days to come back with results,” Kirsch recalls. He and colleagues cared for suspected coronavirus patients with inadequate masks and protection. They didn’t know yet what treatments might save lives.
“We were figuring things out and trying to apply new knowledge as we could,” he says.
When Bethesda Hospital, just north of the State Capitol, was staffed for the expected surge of COVID-19, Kirsch volunteered to work there. Some of his patients came in on ventilators and left to Beatles music. Others got worse quickly and ended up in intensive care.
“And sometimes people died without any family around, which was pretty awful,” he says. “It was emotional. But the feeling of camaraderie was also incredible there. People looked out for each other. We all had a similar mission.”
Dr. Brian Isaacson, also a St. Anthony Park resident, recalls a similar mission where he works in the emergency room at Fairview Ridges Hospital in Burnsville. For months, no visitors were allowed and patients arrived at the ER alone and often frightened. Reassuring people became an even bigger part of Isaacson’s job and he had to get creative to get information.
“If the patient is feeling very unwell and struggling to breathe and needing oxygen, you can’t get much history from them,” he says. “So we’d be talking to the family by phone to learn what’s going on.”
The emergency room organized zones to sequester suspected COVID-19 patients. But he says that worked less well than anticipated because so many people with the virus don’t show typical symptoms.
“You basically learned to not ever let your guard down,” says Isaacson, who would wear a surgical mask on top of an N95 mask, along with a face shield, gown, gloves and cap.
Even so, Isaacson worried that regular contact with COVID-19 would end up making him sick, especially before the effectiveness of masks and other precautions became clear. He recalled an otherwise healthy doctor in Seattle, a friend of a medical school classmate, who almost died of complications from coronavirus.
“It was hard not to think of this person and wonder if that could happen to me or one of my colleagues,” he says. “I’ve felt vulnerable in a way I think that I never really have before.”
In the end, few colleagues contracted the virus and none fell seriously ill. Still he felt “huge relief” when he got his vaccine early this year as part of the first wave of frontline health workers. “It was a game changer in terms of confidence,” he says.
Vaccines “a game changer”
Vaccines have also been a game changer in the delivery room, says Katie Pfaff, a certified nurse midwife at Hennepin Healthcare, and another St. Anthony Park resident. The number of pregnant women testing positive for COVID-19 has gone down in her practice. At the same time, some women are hesitant to get vaccinated because they worry about the effect on an unborn child.
“We think it’s safe in pregnancy,” says Pfaff. “But we can’t say that for sure, although we do know there are thousands of health care workers who have received it and are fine.”
Just recently Pfaff cared for a woman who came to the hospital vomiting and feeling sick. The woman thought she was in labor. It turned out she had coronavirus, though not a serious enough case to require hospitalization.
“We feel like we’re over the hump of the pandemic,” said Pfaff. “But this was a sobering reminder we are still dealing with this.”
One of the biggest changes over the past year has been the enforced separation from family and friends. Women in her care could only bring one person to be with them during the birth.
“There were sad stories about grandparents who didn’t meet their grandchildren for months,” she says.
But while some new families struggled with isolation after the birth others found an oasis.
“Sometimes the bubble was a bit of a blessing,” Pfaff says. “After you have a new baby it can be a time when you want to go to a quiet protective place. And people were able to do that.”
Kirsch says he also has seen a small, unexpected upside to the pandemic. The higher rates of COVID-19 among people of color and people in poverty have brought attention to longstanding health disparities and prompted the Otto Bremer Trust to give $1 million to the University of Minnesota to purchase and equip a mobile health clinic.
The new clinic on wheels builds on a summer course Kirsch teaches to U of M medical students and residents in providing health care to migrant workers.
The new van holds two tiny exam rooms and a lab and will hit the road in May, bringing blood pressure screening, hepatitis tests, and yes, COVID-19 vaccines, to community events year-round hosted by local organizations and faith groups throughout southern Minnesota.
“The need is enormous,” says Kirsch. “And now we’re on less of shoestring budget and have more resources to provide this care.”
Maja Beckstrom lives in St. Anthony Park and is a journalist and writer who is a frequent freelance contributor to the Bugle.