Georgia hospital fights intense coronavirus epidemic

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Before Mandy Hall stood in line to take her temperature, put on a surgical mask and walk through the glass doors of the hospital, she recited a line from the Old Testament.

This may be the moment for which you were created.

It was not yet 7 am and the small emergency room was already crowded with dozens of COVID-19 patients who were having difficulty breathing.

Ambulances parked in the emergency bay as the front-line nurse and director of emergency services at Phoebe Putney Memorial Hospital, 47, donned freshly washed Caribbean blue scrubs, put an N95 mask under her surgical mask and gathered with staff to prepare for the coming assault.

Soon, his unit would run out of beds and begin aligning critical patients in gutters along a rear hallway.

Phoebe Putney Memorial Hospital in Albany, Georgia.

A hallway at Phoebe Putney Memorial Hospital in Albany, Ga.

((Andres Rengifo)

“What if patients keep coming?” She said as the paramedics delivered a man on a stretcher. “What if at some point we don’t have room to adapt them? I don’t think it’s a question of whether it happens. It’s a question of when. “

Far from the major coastal centers of Seattle, Los Angeles and New York, this hospital in the remote southwest Georgia city of Albany – more than 35 miles from an interstate highway and 180 miles from a major airport international – is struggling to treat an afflicted community with one of the nation’s most intense rates of coronavirus.

With 973 cases in Dougherty County, approximately one in 90 residents of this predominantly black poor community tested positive for COVID-19 – much more than that in 1,450 residents of Los Angeles County. Already, 56 people have died, 75% of whom are African-American, according to county county coroner Michael Fowler.

The deadly virus arrived in Albany earlier than in other pockets of the Great South and has taken a heavy toll on black residents of this city of 75,000, many of whom already suffer from chronic medical conditions that compromise their immune symptoms: diabetes , lung disease, high blood pressure, hypertension and heart disease.

Phoebe Putney Memorial Hospital in Albany, Georgia

Hospital staff inside Phoebe Putney Memorial Hospital in Albany, Ga.

((Andres Rengifo)

“Sometimes you wonder if it was planned by a villain to cause maximum damage,” said Demetrius Young, a commissioner for the town of Albany who represents the predominantly black neighborhoods south of the city center.

While nearly a third of the inhabitants of Albany live below the poverty line, he estimates that this number is more than 50% in his district, where the residents have only one grocery store which sells fresh products. and limited access to adequate health care. Georgia, he noted, is one of 14 Republican-led states that have not extended Medicaid to cover low-income adults.

In the past week, Phoebe Putney rushed to open a fourth COVID-19 intensive care unit, expand her intensive care beds from 38 to 49 and dedicate a total of 176 beds to COVID-19 patients. But it’s not enough. With insufficient ventilators, intensive care beds, and critical care nurses and doctors, the hospital was forced to transfer more than 100 patients to hospitals across Georgia and Alabama.

“There is no room at the hostel,” said Evelyn Olenick, senior vice president and chief nurse of the hospital.

As doctors and nurses fell ill – some ended up in the emergency room – Governor Brian Kemp dispatched the National Guard to reinforce the staff of Phoebe Putney.

However, Hall and his colleagues work 12 to 18 hours a day.

Mandy Hall is a front-line nurse and director of emergency services at Phoebe Putney Memorial Hospital in Albany, Georgia

Mandy Hall, right, is director of emergency services at the Phoebe Putney Memorial Hospital in Albany, Georgia.

(Ben Roberts)

One afternoon last week, paramedics rushed into a rush of seven critical patients in an hour and a half. All were out of breath and required immediate intubation.

With only two doctors, 13 nurses and a respiratory therapist on duty, the emergency team quickly gathered additional staff and supplies to accomplish the complicated task of putting patients on respirators – over and over again.

“Is the ball falling? Hall wondered, rushing to take care of a 60-year-old woman with high blood pressure whose oxygen was dangerously low even with an oxygen mask. “Is this where it gets really bad and stays really bad?” “

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No one suspected COVID-19 when a man from the Atlanta area arrived at the emergency room of Phoebe Putney on February 29 to complain of shortness of breath.

The 67-year-old man suffered from chronic lung disease and had not traveled to China or the West Coast.

He had come to Albany to attend the funeral of Andrew Jerome Mitchell, a retired janitor. After more than 100 people gathered at the Martin Luther King Memorial Chapel in Albany for service, many crowded into Mitchell’s three-bedroom cottage for a potluck meal of fried chicken, green vegetables and corn bread.

“We hugged, we talked, we cried together,” said Alice Wise Bell, daughter of longtime partner Emell Murray. “We didn’t think about it. “

Before going to bed, Murray started to feel chills. The next day, Bell rushed his diabetic and hypertensive mother to the hospital with a fever of 103. Staff told him that she suspected a urinary tract infection.

Shortly thereafter, a cascade of patients – including Bell’s aunt and cousin – rushed to the emergency room.

It was not until March 10, after the man from the Atlanta area was transferred to a hospital in Marietta, Georgia, that the staff of Phoebe Putney discovered that he had tested positive for COVID- 19. He died two days later.

By the time the hospital and local authorities realized that the deadly virus was in the community, it had already spread from the funeral home to churches, the county courthouse, and the hospital.

Sheriff’s assistants, teachers and caregivers were among those who tested positive for the virus, with more than 60 hospital workers.

At one point, Phoebe Putney was so understaffed that employees were advised to continue coming to work even if they were positive and asymptomatic.

After consulting the Georgian Department of Public Health and the Centers for Diseases Control and Prevention, the hospital now invites all employees who test positive to self-quarantine for seven days.

Administrators began preparing for a possible COVID-19 outbreak in December, said Scott Steiner, president and CEO of Phoebe Putney Health System. But after storing what would usually cost six months of personal protective equipment, when the epidemic escalated, the hospital burned its supplies in seven days.

Officials then turned to the black market, paying more than three times the normal price for a shipment of 200,000 protective gowns from Mexico – only to discover that they were not made of the right material and did not not protect personnel from liquids.

Faced with an urgent need for masks and face masks, administrators rushed to convert the offices into makeshift factories, mobilizing around 100 people to sew tens of thousands of fabric masks and build plastic, foam and face masks. elastic bands.

Meanwhile, patients continue to go to the emergency room, their lungs clogged with mucus so thick that even with ventilators they have trouble getting enough oxygen.

“He strikes so fast,” said Hall. “As soon as they walk through the door, we have to make a life-changing decision. “

After waking up one morning barely able to breathe, Melita Nichols, a 48-year-old manager at a center for the elderly with diabetes and Crohn’s disease, called an ambulance to take her to Phoebe Putney.

The following day, her 27-year-old daughter, Qunia Roberts, was admitted to the hospital. The next day, his brother.

Nichols returned home last week with an oxygen tank, but Qunia remains in intensive care on a ventilator.

“She was never a sick child,” said Nichols. “The only thing is that she had severe allergies. When the pollen comes out, she’s like a hissing puppy, but she doesn’t have any underlying medical conditions. She’s just a 27 year old free fantasy girl! “

Several former childhood friends of Nichols and fellow congregants at the Gethsemane Worship Center are now dead, as well as the owner of a downtown art cafe, a probate judge, and the pastor who delivered the speech. Mitchell’s funeral praise.

“It’s like something from a very, very scary movie,” said Young, who has diabetes and started isolating himself at home with his 17-year-old daughter in mid-March, a week before Dougherty County officials do not order residents to take shelter. in place.

“I felt like the guy who saw the monster coming in and being grounded and tried to warn the people who were going on with their daily activities, not really understanding what was going on there. “

After working as a nurse for 20 years, Hall calls emergency medicine his first love. But COVID-19 posed unprecedented challenges – not only to juggle large numbers of critically ill patients, but also how to treat those who have been struck by the relatively unknown new virus and how to protect staff.

“We know that when we treat a heart attack, we follow the proper medical guidelines and we know that when we treat a trauma, we follow the trauma protocol,” she said. “With the coronavirus, we know so little about it. We feel completely helpless. “

At the end of last month, the emergency secretary, Shawndel, a woman in her 40s who used to glue their service, entered the emergency room. X-rays showed so much mucus that filled her lungs that doctors didn’t think she would ever come off a ventilator.

The doctor cried while intubating him. The nurses shook hands with him through nitrile gloves and told him that they loved him.

On Monday, everyone lined up in the halls to cheer and cheer as Shawndel was released from the hospital. She had an oxygen tank at her side, but she had gotten to the point where doctors were convinced she was going to recover fully.

When Hall returns home after long days of intubating patients who cannot breathe – taking care to take off his clothes and shoes in the garage, spraying his shoes with Lysol and throwing his clothes in the laundry room – she is shocked to scroll through Facebook and see photos of casual family reunions.

“It is very frustrating,” she said. “The community as a whole does not understand the gravity of the situation and how drastic it is to stay at home. “

Over the past week, local city and county officials have been begging the public not to congregate on basketball courts, organize great restaurants, and snack on groceries and hardware stores. They also threatened to distribute quotes.

While home support orders have ended daily activities in a large part of the country, cellphone location data show that residents of the Southeast, including Dougherty County, do not have as much. practiced social distance as residents of most other parts of the country.

Hall lived apart from his own son Charlie, 12, for three weeks.

After sending him to live with his father because she did not want to risk exposing him to the virus, their only contact is via Facetime.

“We don’t know much about this virus yet, but the sensitive population are people we visit every day – our grandparents, our mother, our father,” she said. “We really have to quarantine ourselves and stay away.”



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