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The Easter surge

This piece in the Daily Beast about COVID on the front lines in this fourth surge is just chilling. It’s not over and the people who are dying at this point are tragic victims of bad timing, ignorant obstinacy or people who think the pandemic is over and are wantonly spreading it around:

As he drove past reopened churches on Sunday, critical-care nurse John Haacke figured Easter will prove to be yet another holiday followed by a surge in COVID-19.

“It’s not like a guessing game,” Haacke told The Daily Beast on Sunday night. “We told you it’d go up after Halloween. We told you it’d go up after Thanksgiving. We told you it’d go up after Christmas. We told you it’d go up after New Year’s. And it’s going to go up after Easter.”

COVID-19 cases were already on the rise in recent days at the hospital in Eastern Maryland where he works in the ICU.

“Things are picking up again. It seems like it won’t stop.” he said. “I have two sets of husbands and wives that died in the last week and a half, right in beds next to each other. I think in both families, the children infected them.”

None of the patients had been vaccinated. They either had not yet been able to get a shot or they had declined the opportunity. One clerical worker in her 50s had been given the chance but refused and ended up in the ICU with COVID-19.

The woman’s chest X-ray looked like a white sheet of paper, something increasingly common among recent patients.

“The worst chest X-rays I’ve ever seen in my life,” Haacke said. “Some of these X-rays, with an untrained eye you wouldn’t know there’s a lung that exists in there.”

The ICU team decided the woman’s best chance was extracorporeal membrane oxygenation (ECMO), where a machine pumps and oxygenates the blood outside the body.

“We tried to send her out Friday to put her on ECMO, but they didn’t have any beds available,” Haacke said. “It’s been that way.”

On Monday afternoon, the woman took a turn from bad to worse. Haacke and his team spent two hours doing everything they could. Her husband and daughter arrived and were able to say their goodbyes. Then it was over for the woman as it was over for 270 Americans the day before, as it has been over for more than 550,000 of us since the pandemic began.

“The daughter was carried out, physically lifted and carried out because she was so hysterical,” Haacke reported. “Jesus Christ, this is awful.”

Other patients with white-out X-rays include a patient in his mid-thirties.

“He’s expected to not do well,” Haacke said.

Even if such a patient does survive, his lungs may be hopelessly scarred and damaged.

“At that point, you’re looking at a lung transplant,” Haacke said.

In general, Haacke noted, the new patients are “younger and sicker.”

He suspects one or more variants are responsible.

“I’m convinced there’s something going on,” he said. “We just don’t have the data to prove it right now.”

But even if they had proof, it would not change much.

“We can’t do anything differently anyway,” Haacke said.

What could change everything in the COVID-19 fight would be if we all did things differently in our everyday lives. Anti-mask Republican governors such as Kristi Noem of South Dakota have been rightly condemned for placing politics over science while thousands died. But an increasing number of governors who started out heeding science are now putting politics first, reopening everything from restaurants to sports arenas to gyms despite warnings from medical experts. They include Democrats Andrew Cuomo of New York, where cases are up 41 percent in the last two weeks, and Phil Murphy of New Jersey, where cases are up 20 percent in the same period. There is also relatively moderate Republican Larry Hogan of Maryland, where cases have jumped 41 percent in two weeks.

Even so, no matter what state you live in, nobody is forcing you to go out for dinner or attend a game or take a fitness class. We all know what the CDC says, and it is our individual responsibility to do our part to curb the virus.

“I am not the front line,” Haacke declared. “You are the front line. We are your last defense.”

Haacke believes that when hope finally arrived in the form of the vaccines, too many people began acting as if the fight were already over.

“Everybody decided they were done with it,” he said. “[COVID-19] is not done. It’s certainly not done.”

The virus gave a particularly wrenching demonstration of that last week with a man in Haacke’s ICU. The man was determined not to be put on a ventilator.

“You just watch people try so hard to not get intubated,”Haacke said.

Despite the discomfort, the man remained face down to facilitate his breathing. Haacke would remember him making clear that he was willing to do anything he was asked and was grateful for whatever was being done for him.

“Thank you. Anything you guys tell me, I’m going to do it. Anything you want. Thank you. Thank you. Thank you.”

The man’s wife was on a ventilator in a room 25 feet away, but he was in constant need of what Haacke terms “as much oxygen you can possibly give a human being without putting a plastic tube down your throat.” Haacke could not interrupt it for even a few brief moments.

“I couldn’t get him physically 25 feet to see her,” Haacke said.

Even with the uninterrupted maximum supply, the man’s blood oxygen level suddenly dropped.

‘He didn’t want to be intubated and he died,” Haacke said. “His neighbor and best friend was admitted the day he died and [the neighbor] is not looking good, either.”“Mix it up on Easter. See you in 5-14 days in the ICU.”

The man had at least been able to see his children and grandkids. He never did see his wife, who at last report remained in the ICU on a ventilator.

“She’s still there,” Haacke said.

Meanwhile, Haacke awaits a surge that he feels is coming as a result of reopened churches and holiday family gatherings.

“Mix it up on Easter,” Haacke said. “See you in 5-14 days in the ICU.”

He figures the surge may continue up to June.

“Until the vaccine is much more widely available,” he said. “There’s just not enough people out there yet who have been vaccinated.”

The clerical worker who died on Monday afternoon was not the only person Haacke has encountered who refused the vaccine. Another was someone who declined even though he routinely injects himself with a substance laced with any number of contaminants.

“I had a heroin addict [who] told me he wasn’t going to take it,” Haacke said. “He said it with a straight face.”

sigh…

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