COVID-19 Update – Who else dies?

The day after my open heart surgery,  just back from the ICU, the nurse came and provided a heparin shot.   This thinned my blood to prevent clots.  However, too much heparin and I would bleed out.  My new graphs would leak and my heart would fail from the pressure build up.  Yet, an hour later a new nurse came in determined to give me another heparin shot, doubling the proper dose.  Had it not been for family members fighting tooth and nail,  I would have gotten that second shot and met my demise.  What you ask,  does this have to do with COVID-19?    Read on.

Melonie could barely sit up as she waited in the waiting area at Grandview Medical.  She leaned against her boyfriend and when she talked 70% of what she said had no connection to reality.   The pneumonia had advanced to the point her kidneys were shutting down with every breath a rale.  This was pneumonia, a secondary lung infection after a bacterial infection had settled in her lungs.  Without oxygen or a respirator Melonie would have died.

Unable to communicate effectively, Melonie’s boyfriend, and medical proxy had to communicate for her.   He could do what she could not while she was impaired by sickness.  Had he been banned from the ER the results of Melonie’s situation may not have been as successful.

This crisis is banning patient advocates.

The events above are real, though Melonie is not her real name.  The subsequent hospital stay was 16 days, the first 4 of which were touch and go, not knowing whether she would survive the ordeal.  Pneumonia is how COVID-19 kills the vulnerable. It is how lung infections kill those who are infected, by filling the lungs with so much fluid that infected person can’t breathe.

The fact that many, particularly young people contact this disease but have next to no symptoms is misleading.    They are the typhoid Marys of COVID-19, carrying this disease to their parents and grandparents who by virtue of age or prior bad health are far more susceptible to getting the high fever, cough and subsequent breathing crisis.   As of this moment, the US has 22,708 confirmed cases with 279 deaths and 64 seriously critical patients.  Many of the latter will die.   In the US 1.2% of those infected die.  The scary thing is that because testing has been delayed in the US, the total number of cases will grow tremendously in the next couple of weeks.

In Italy and now New York, hospitals are being overwhelmed.   With the cancellation of elective surgeries and the governments urging all but the most seriously sick to avoid emergency rooms, there are other tragedies occurring.  These receive little media attention and yet create fatalities that are not reported.   The beds are filled with COVID-19 patients, so the lady with COPD  comes in needing a respirator.  It is not available, the bed is not available.  The man having a heart attack is delayed while the hospital is in all out COVID-19 war mode.  He dies.  The lady with the flu and subsequent pneumonia is sent home because the hospital does not want her to get COVID-19 as well.   The most effective patient advocates are banned in the interest of preventing spread.

The resources of our medical community are being marshaled full on to take care of COVID-19 cases.  Yet, while those cases are receiving as much help as possible there is a silent set of deaths happening.   No one reports on these.  No one reports on the other life threatening infections whose treatment is delayed while COVID-19 sweeps across the US.  Many of our hospitals were swamped before this pandemic.  Those patients still need care but many are being sent away, delayed or denied the care they need.

The banning of family members from hospital rooms and care facilities will dramatically increase the number of medical mistakes.  Ginger, recovering from foot surgery, developed a MRSA infection in her arm.  Even though the nurses bandaged it, they did not chart it.  Her husband had to keep asking about treating this even after her arm had swollen to twice its normal size.  It took 4 days of constant asking to get the antibiotics ordered that eventually cleared up the infection in her arm.   Had the husband not been there Ginger would have lost the arm or her life.  This is the role of the patient advocate.  COVID-19 has banned patient advocates from the ER and from the hospital room.  How many extra deaths will this cause?

Further,  anyone that has had the experience of staying with a seriously ill loved one in the hospital knows how many small errands they run in order to take care the sick.  From getting blankets, pillows or drinks to helping with a bath the family member adds tremendously to the patient’s comfort. Now without the family member there, the nurse or aid has to perform these tasks adding to the work load of already overworked staff.

I firmly believe that we have to defeat this virus, but we have to do so without causing ancillary damage.   I am sure that no hospital would admit that having family at the beside saves lives.  Yet, seriously ill patients’ ability to communicate and to advocate on their own behalf is compromised.  Often they are completely unable to communicate.  This is one area of the COVID-19 response that needs to be rethought.   I would urge that medical facilities allow at least one family member in with the sick patient.  It will prevent countless unnecessary deaths.  For God’s sake, give the member a mask to protect them from COVID-19 and to protect the hospital staff from infection, but don’t put patients at greater risk because the policies are not thought through.

If you agree with this, I urge you to pass it on.

 

 

 

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