Assassin

Connecticut saw its COVID positivity rate jump to over 6% last Thursday.  Our seven day average remains 3% for now.  Cases, hospitalizations and deaths are all up.  The flat line we enjoyed this summer has turned decidedly up and threatens to go parabolic.

The last three shifts I have worked I have done cardiac arrests.  All have been elderly who were somewhat independent, but with many comorbid conditions.  They all felt ill in the recent days.  All were connected to areas where there were known COVID cases.  None were tested for COVID.  Could these be independent deaths or were they the work of the greatest serial assassin of the last 100 years?  Will they be counted eventually in the COVID numbers or will they just appear in the “excess deaths” category?  It has already been estimated that there have been 300,000 excess deaths in America this year, meaning 300,000 more people than would have been expected to die in a normal year, are gone from us.

Amid pandemic, U.S. has seen 300,000 ‘excess deaths,’ with highest rates among people of color

As we move into what is predicted to be a harsh and dark winter in terms of the COVID pandemic, I worry about my fellow health care workers.  The fatigue is taking its toll.  In early days, once we had the PPE, everyone dutifully put it on despite its difficulties.  Now, I am noticing some responders tend to forego the extra gear.  It is one thing to gown up in a hospital room, where fresh supplies are stacked outside the door, the room is well lit and temperature controlled and the patient is on well positioned hospital bed, it is another to climb four flights of stairs, carrying heavy gear and find a patient on the floor in a tight hot bathroom with no lighting, lying in diarrhea and vomit.  Your gowns rip, trying to see through a face shield is like trying to drive in the rain with a broken defroster, and a N95 with a surgical mask over it doesn’t always allow all the oxygen you need in a dusty, stinking apartment.

I am on my stomach intubating, staring down the throat of a still warm body, looking at the vocal chords.  COVID is invisible, but I imagine him there behind the folds, taunting me, giving me double barreled middle fingers, then unleashing a dragon’s breath torrent of viral load, a hot water cannon of death and sickness that fills the room and our every breath as we do our best with no success to bring back his latest victim.



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