Coronavirus, or one version of it titled SARS-CoV-2, is wreaking havoc on the world. Some are terrified, feeling the world is coming to an end and believe it’s a religious indicator of the second coming or rapture. Other people think it is not that bad, overrated, a media blow-out, some kind of conspiracy and that we should resist restrictions and go out to play as we normally would. Most of us are helping neighbors or sheltering in place, hoping that is enough to keep ourselves and others out of harm’s way. And then there are those who are working on the front lines with the virus.
Maybe some of you have not been affected by the virus in any way, other than the inconvenience of stay-at-home orders and the inability to go to work so you can pay bills. Some of us, on the other hand, have people we love and care about who are affected in ways that we can only empathize with.
Personally, I have friends and family who are working in the front lines in the medical field. Probably the closest person is my sister’s husband. Jeffery Wesolowski is an RN at the University of Michigan Hospital (aka: Michigan Medicine). He has been working in the intensive care unit at Michigan Medicine since 2003. While working in the ICU over the years part of his responsibilities have included assisting with ventilator placements, administering medications for vented patients, working with respiratory therapists, critical care doctors, and others. His patients have typically been those with chronic liver and kidney diseases. Coronavirus patients started showing up in his unit the first week of March.
While Jeff says he’s not rattled by the disease, he says many on his nursing team are fearful. He is not rattled because a large number of people who get the virus do not get really sick, especially if they are in good health to begin with. Although he admits that people might have underlying health issues that they were not aware of until the virus hits them. These unknown conditions can put people at risk of a worse outcome with the virus. And that is when a seemingly healthy person will end up in the hospital.
Those who are showing up at the hospital are coming in with symptoms that are different from other viruses that cause pneumonia and that Jeff has worked with. He says that patients are not maintaining body functions as well as with other viruses. Usually our kidneys do not break down when we are fighting a virus. Our bodies will prevent that from happening unless there has been an extended period of low blood pressure or shock. However, with the new Coronavirus, kidney failure has been a complication that can happen even if the patient has normal or elevated blood pressure. He also says that more often Coronavirus patients do not respond to treatment as readily as with pneumonia from other causes.
This author is not a medical professional. However, deferring to the experts, it seems one possible reason for these renal failures could be linked to the patient being low on oxygen (a condition called hypoxia) for many days before arriving at the hospital. This article from the Saudi Journal of Kidney Diseases suggests that hypoxia contributes to kidney failure.
Jeff’s personal opinion is that nutrition is a key factor in warding off the virus. He believes people need to be seeking out and learning about anti-viral properties in food and that people need to cut back on processed foods. He shares that many of his Coronavirus patients are obese, and in fact, one of the listed risk factors for having a poor response to Covid-19 is obesity. Being overweight tends to cause sleep apnea which can weaken the heart and causes right ventricular hypertrophy. This condition is also commonly caused by lung disease. Overweight also causes diabetes which affects a patient’s autoimmunity.
“Get your diet in gear right now,” Jeff encourages, “because eating healthier will help you fight the virus, should you be exposed.” While fast food chains are open right now, he suggests abstaining. “The virus is showing us how bad our diet and health are. No one puts a gun to your head and tells you to eat at McDonald’s. When you go there you are not getting food with anti-viral properties.” It is important to educate yourself about nutrition; your life literally depends on it.
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Back at Michigan Medicine, Jeff watches over his patients. “Basically, the more oxygen support a person needs, the more sedation they will be placed under. If a person needs severe to deep ventilation, they will be placed in a deep comatose state. For people who are not on as much breathing assistance, they often can communicate by writing on their phone or on a pad of paper. Alert patients used to be more whiney when they came to our ICU before. Now they aren’t complaining as much. They are scared.”
When asked about personal protective equipment, Jeff responds that so far U of M hospital seems to have enough supplies but could use more as staff are wearing the same gear all day without refreshing them. Staying outfitted all day also assists in saving time removing the gown and re-gowning up each time medical staff enter the rooms where patients are located. When asked about masks Jeff says he wears a battery-operated Power Air Purifying Respirator (PAPR) which he wipes down at the end of each shift. Another reason that Jeff isn’t afraid of getting the virus is that he trusts his PPE.
Jeff told me that he believes that the U of M has enough ventilators at this time. He shared that typically hospitals will update equipment with newer models and sell old inventories. He said that U of M has several of these older ventilators in storage which were not resold, so they have extra if they are needed.
In Ann Arbor, where the University is located, there have not been as many Covid cases. However, many patients have been sent from Detroit, 45 minutes east of Ann Arbor for care at U of M. Jeff indicated that Toledo, Ohio, about an hour south of Detroit has not had a large uptick of cases but hospitals in Toledo are also receiving patients from the Detroit area.
Detroit has been deemed a Coronavirus hotspot where racial disparity and systemic racism has been recognized in the death toll from the virus. The city has a lack of adequate healthcare, rampant poverty, food deserts , all of which create large disparities in its poor communities of color. A very large population of Detroit and Flint residents lack water running to their houses. At a time when we need to be eating healthily and washing our hands often, lack of these basic human rights and commodities contribute to the quickly growing numbers of Covid patients in Detroit. Also consider that people in poverty often cannot afford to stop working because their jobs do not offer sick pay, or they are now considered “essential.” People in poverty also often live in small houses or apartments with many extended family members, making social distancing impossible. These desperate factors contribute to the disproportionate ratio of black community members being infected and dying.
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No one is immune to Covid-19. It is a “novel” coronavirus which means exactly that…no one is immune. This virus is scary in nature. You can carry it without knowing you have it and do not know whether or not you have an underlying condition which might make you succumb to a more serious dance with it. These are all reasons to take it seriously.
My sister has started sleeping on the couch to allow Jeff to sleep well in their bed. This also protects her from possible exposure. She has been sleeping on the couch since the Covid patients started arriving at the University of Michigan Hospital.
Other measures Jeff takes to protect his family is to wait to change until he gets to work, and he leaves the clothes he works in at work and does not bring them back to the house. He has started driving to and from work alone when for years he had participated in carpooling. He and his co-workers are completely covered from head to toe with PPE when they are working. And Jeff, who had a mustache for years, has shaved it off. It made breathing in the PAPR more difficult than it already was. He says “it’s annoying” to breathe in the mask all day long. My sister, a hairdresser, will cut Jeff’s hair shorter than he’s had it for a while. I was surprised that she would touch him at all. She replied, “Well, I’m not kissing him!”
Because of my sister’s profession, people have been calling her to ask for haircuts, since salons are closed. While she is legally not allowed to cut hair now, it is easy for her to tell them no. They are not interested in getting their hair cut once they learn that her husband is working directly with the Covid patients. Jeff and my sister have one adult daughter who still lives, and right now is working, at home. Their adult son moved to Denver last fall and lives near me.
Jeff believes the University of Michigan hospital is a “stellar” facility in part because of its ability to take patients who need ventilators. He states that smaller hospitals do not have the resources. They generally do not have the equipment or the personnel, since it is a specific skill to manage extremely sick ventilated patients.
So far at Michigan Medicine he hasn’t been required to pick up extra shifts. He doesn’t know if that will change but he has picked up an extra shift each week anyway, just because of his dedication to his work. Jeff said he doesn’t know when the peak will be in the Detroit area. He related that isolating people changes the peak and postpones it. He believes, “another round will happen in the fall. I hope the numbers will be smaller than the spring outbreak.”
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A related story about Michigan Medicine and Jeff’s coworkers appears here.
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