A Year Of COVID-19: Healthcare workers still fighting an unpredictable enemy

Nurses, doctors and hospital staff have been on the front lines in this battle with a new enemy, learning how to fight COVID-19 in real time and hoping to outlast the coronavirus until relief could arrive in the form of a vaccine.

“I think the sacrifice and the selflessness that I’ve seen from our staff is absolutely remarkable,” said Dr. George Narby, chief medical officer at Southeast Health. “To watch everybody that works here, through the months of this, go through this and come to work every day and not complain and put in very long hours has been amazing. And at the same time, you can see in some of their faces what they’ve actually gone through and experienced.”

Locally, those who work within Dothan’s two hospitals have learned a lot about themselves and the communities they serve.

“I think we’ve learned to, one, listen – listen to the experts; listen to the front-line staff; follow recommendations,” said Jeff Brannon, CEO of Flowers Hospital.

Even when things were at their worst and changing hour by hour, the staff kept moving forward, showing up every day with their hearts in the right place, Brannon said.

“Our patients needed us to do that,” Brannon said. “They needed us to be here. They needed us to not go on diversion. They needed us not to shut down a service line… The thing I’m most proud of is our team. Every time we ask them to climb a mountain, they climb the mountain.”

When Southeast Health recently became a mass vaccination site, the community as a whole came out to help. Firefighters, police, nursing students, medical students and nurses who work outside of Southeast Health volunteered their time.

“For me, that’s one of the biggest takeaway,” said Narby, named to his position last September. “To see this community, probably like countless of others, manage this pandemic and still stay together and really pull together has been amazing to see, to witness.”

As a doctor, Narby said he’s glad Alabama Gov. Kay Ivey leaned on public health advisers in implementing emergency orders to slow the spread of the virus even though such measures have been unpopular among many in the state.

“It’s very, very difficult to balance the scientific realities of this situation with the economic realities of it,” Narby said.

Flowers is not a mass vaccination site but has held a drive-thru vaccination clinic in recent weeks, vaccinating 400 people in three hours. The hospital will publicize any future clinics when vaccines are available, Brannon said.

“We’re going to continue to get vaccine and we’re going to continue to give it,” Brannon said. “We see that as another tool in the arsenal to help prevent COVID or to prevent the severity of the illness.”

And the hospital has also treated high-risk COVID patients with monoclonal antibody infusions. Since Dec. 3, Flowers has treated 714 patients with the infusions, which are done as outpatient only for people who have been recently diagnosed with COVID-19 and meet certain criteria. Of those patients receiving infusions, only 10 had to later be hospitalized because their illness progressed.

“We have no doubt that that’s kept people out of the hospital,” Brannon said.

Early in the pandemic, it was clear the coronavirus that causes COVID-19 was unlike any virus healthcare workers had seen.

In the early days and weeks, it was unclear if exposure could occur from surface contact or if simply by breathing in droplets carrying the virus. A year later, it’s been accepted that exposure from touching surfaces is not as likely. Initially, masks were thought unnecessary for non-healthcare workers but eventually became key tools to preventing the spread of the virus in a community. Now, two masks are better than one.

Even symptoms vary among patients. People had fever, body aches, difficulty breathing. Others had gastric symptoms. Still others had the new loss of taste or smell that became tell-tale signs of COVID-19.

It was impossible to guess how sick any given individual might become from COVID-19 and whether or not they could recover. Older people and those with underlying health conditions were identified as those most vulnerable for developing severe illness. But then seemingly healthy people also got very sick.

A year later, patients still develop widely different symptoms, and it’s still impossible to guess who will become severely ill and who won’t.

As the number of patients grew during the early weeks of the pandemic, keeping an adequate supply of personal protective equipment, or PPE – such as masks, gloves and gowns – became a crisis as the supply chains for such items shut down around the country. At one point, staff at Southeast Health used a conference room to make their own gowns. Hospitals received PPE donations. Local residents sewed masks for medical workers. A year later with supplies replenished and new manufacturing sources identified, the PPE supply is not an issue. But, Brannon of Flowers said, balancing infection control guidelines with cutting PPE waste has been a big lesson of the pandemic.

Both hospitals have loosened their visitation policies for non-COVID patients, allowing limited visitors for non-COVID patients.

“We feel like patients will get better, they will do better with family members with them,” Brannon said.

Everybody wants life to go back to normal.

But Brannon and Narby agree that getting back to normal is a process. Personally, Brannon said he will keep wearing a mask when he can’t social distance and he’s not sure he’ll see a day when he won’t have a mask nearby or won’t follow social distancing guidelines.

“People have to make their own choices,” Brannon said. “And I would say that I’m going to continue to use my God-given common sense.”

Healthcare is a limited resource, as it turns out. There are a limited number of nurses and a limited number of critical care beds for patients. COVID-19 tested both.

At this point, the biggest challenge in the fight against COVID-19 may just very well be time itself. It’s been a year. New strains have already emerged. Vaccinations are ongoing and the numbers of COVID-19 cases are going down along with the rate of hospitalizations. But people are tired and patience is waning. Alabama’s mask mandate expires April 9, and the governor has already indicated she won’t renew it. State legislators have made a push to stop businesses from being shut down under any future emergency orders as they were during the pandemic.

“I hope that everybody gains a healthier respect for infectious disease,” Narby said. “Pandemics are not to be trifled with. It is an unyielding, uncaring, inanimate enemy. It doesn’t care. In all the emotions we as people put into fighting something like this, a pandemic – it doesn’t care. It’s going to do what it’s going to do. There’s a few things we can do as people to impact the outcome. And one of them is continue to wear masks and vaccinate it as quickly as possible simply because the more people this virus is infecting, the greater the chance that it continues to evolve and mutate.”