Marching Off to War Against Unseen Enemies by Kraig Klein

  • April 27, 2020
Marching Off to War Against Unseen Enemies by Kraig Klein

STONY BROOK, NY, April 19, 2020 —Dr. Anthony Schramm was one of 122 Stony Brook Medicine students who received a diploma on April 7, when Stony Brook University’s Renaissance School of Medicine graduated them early so they could start fighting against the coronavirus.

“Thanks to the current staff, faculty, and the 49 new physicians who are on the front lines, we have a lot of providers assisting in the fight,” Dr. Schramm wrote in an email.

Dr. Schramm has joined a months-long fight against COVID-19, the virus that has ravaged most of the countries in the world since the beginning of 2020. As of April 18, more than 720,000 United States citizens have been infected, and almost 35,000 have died. Over 2.2 million cases have been confirmed worldwide, and over 150,000 people have died internationally.

Stony Brook Medicine graduates and practitioners like Dr. Schramm have willingly put themselves at great risk to treat patients infected with the coronavirus. Dr. Schramm is working specifically at Stony Brook University Hospital (SBUH), a stone’s throw away from the university he graduated from. Communicating digitally, he explained the hospital’s general battle plan to fight the virus.

“Most of us are working on floors consisting of all COVID positive patients, and some of us are assigned to non-COVID inpatient units. The average workday is like most hospital shifts, consisting of a day team and a night team alternating every 12 hours,” Dr. Schramm wrote. “We are currently working 5 days on and 5 days off. To minimize the exposure of healthcare workers, many institutions, including SBUH, are virtually speaking with patients when a physical exam is not required.”

Medical practitioners have to balance treating COVID-19 patients with treating uninfected patients. The influx of COVID-19 cases, however, has put a strain on hospitals’ abilities to accommodate so many patients. The Federal Emergency Management Agency (FEMA) has already constructed a field hospital outside SBUH, where one thousand beds have been reserved for patients coming in from all over Long Island.

Dr. Danielle O’Hara, another freshly graduated medical student, gave more information on how hospitals’ procedures have been changed by the spread of the coronavirus.

“Elective procedures have been cancelled, which frees up some space. Many floors have been converted to general medicine, ICR [Interventional Cardiology Review], or ICU floors dedicated to COVID-positive patients,” she explained in an email. “Since we just opened the [Medical and Research Translation building], more space is available to treat patients.”

The virus has also posed another challenge to doctors and nurses: obtaining enough medical supplies in order to safely treat the massive influx of cases. Public demand for surgical masks and ventilators has surged, causing shortages of both supplies and taxing factories unable to satiate the unending flood of requests.

“Stony Brook recognized the need for personal protective equipment early in the pandemic and responded quickly to ensure personal protective equipment (PPE) is available and will be maintained throughout the pandemic,” Dr. Schramm wrote. “I also want to acknowledge that the public’s social distancing measures are also key in the fight for PPE. As we flatten the curve, we can try to decrease the demand for PPE and medical equipment—such as ventilators—required on any given day.”

Although SBUH is allegedly prepared to assist its employees as much as it can, Dr. Schramm still fears the possibility that medical staff will be infected and thus unable to continue the war on the virus.

“I cannot comment with any certainty of providers becoming infected,” he wrote. “We record our daily temperatures, screening for any subclinical evidence of illness. [SBUH is] doing their best to protect our health and making early adjustments to scheduling if anyone begins to feel ill.”

Dr. O’Hara also fears the possibility of nurses being infected.

“It’s certainly possible that practitioners have been infected, but some of them may be entirely asymptomatic and be unaware of their positive status,” she wrote. “Others may have a mild course that keeps them at home for a couple of days, but once a fever is resolved, they are permitted to return to work.”

COVID-19’s origins have not yet been definitively determined. Most scientists point to a live animal market in Wuhan, China, arguing that the virus originated from an animal species—most likely bats—and was transmitted to humans at the market. The current theory is that bats’ highly active immune systems caused the virus to proliferate rapidly in an attempt to overwhelm the immune systems. Then, when the bats came into contact with other animals, the extremely responsive and quickly spreading virus jumped to other animals, in turn spreading to animals at the market and then spreading to humans. The science community’s insistence that the coronavirus originated from animals hasn’t stopped conspiracy theorists from arguing that COVID-19 is a leaked bioweapon or is caused by 5G wireless communication technology. (That latter theory has resulted in United Kingdom citizens burning more than thirty 5G cell towers as of April 10.)

As the debate over the coronavirus’ origins wages on and the search for a potential vaccine continues, the virus continues to spread rapidly. Dr. Janet Galiczewski, a Stony Brook Medicine certified nurse and clinical associate professor at Stony Brook University’s School of Medicine, has devoted most of her time to slowing COVID-19’s spread.

“I have been a critical care nurse in the Medical ICU at Long Island Jewish Medical Center (LIJ) Northwell Health for the past 32 years,” she wrote in an email. “I usually work one 12-hour shift per week, as I am also a full time clinical associate professor at [the] School of Nursing. I am now working 45 hours per week, all weekends and off shifts, so I can do both jobs.”

Dr. Galiczewski explained that her usual workday begins with her putting on medical equipment—an N95 model surgical mask behind a face shield, with the rest of her body covered in scrubs and a surgical cap and gown. Before going to the critical care unit, which houses the patients most susceptible to the coronavirus, she stops and prays for guidance and fortune.

“A big part of my day is trying to do one special task for my patients that helps remind me during all the chaos that I am caring for someone’s mom, dad, son or daughter,” she explained. “It may be something so simple as giving them a bath, providing mouth care or placing a warm shampoo cap on their head and combing their hair. It sounds silly but it helps humanize the situation. It helps me forget about the machines, alarms and sadness.”

Dr. Galiczewski explained that many of the critically ill patients—who are often middle aged and are otherwise “in the prime of their lives”—do not survive. More than 150 beds have been added to the Intensive Care Unit to accommodate more and more severely sick patients. Long Island Jewish Medical Center tries to comfort them by hanging up photographs of their relatives and playing their favorite songs. “Here Comes the Sun” is frequently played in a despairing attempt to improve morale among the medical staff. It hasn’t truly worked. Dwindling medical supplies haven’t helped either.

“I never thought in my career I would see such hopelessness and horror,” she wrote. “Sometimes I don’t think I can go back for another shift, but I do because the patients need us…they need us to help them get better or they need us to help them die with dignity.”

Many people die in the Intensive Care Unit almost every day. The standard procedure is to use Face Time to allow the dying patient’s family to bid farewell to the patient. The doctor assigned to the patient then holds the patient’s hand as they are taken off life support. Face Time is used again to let the family see the body, and medical staff wrap the body and store it. The process is repeated almost instantly, and Dr. Galiczewski is at her wit’s end.

“We are physically, emotionally and mentally exhausted. I am forever changed. I am not the same person or nurse I was 4 weeks ago,” she wrote.

The only positive element that Dr. Galiczewski could recall was the fact that seven nurses who had been infected recovered and immediately went back to work. Otherwise, she feels surrounded by misery and sorrow.

The recently graduated Dr. Schramm and Dr. O’Hara are more optimistic about working in the same environment that has depressed the experienced Dr. Galiczewski. Dr. Schramm in particular believes Stony Brook Medicine will fully support him and his recently graduated colleagues.

“Stony Brook Medicine is extremely kind and helpful to its providers on the front lines,” he wrote.

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