72 y/o female with h/o hypertension presents to the ED complaining of a sore throat and diarrhea. She has no known allergies, lives alone, and enjoys cooking for her family. She is diagnosed with COVID-19 (Day #1). She is asked to stay overnight in the hospital for observation and IV fluid replacement. Overnight, her O2 saturations drop and pt is placed on 2L BNC. The next day she is unable to walk to the bathroom and becomes extremely SOB on exertion. O2 is increased to 4L BNC and is placed on steroid therapy. The pt continues to decline and is now looking at rehab placement at discharge. The following night, the pt is placed on a nonrebreather plus Optiflow HFNC and is transferred to Critical Care where she will be intubated. The nurse arranges a FaceTime call with the family because they are unable to come see their grandmother/mother and the pt is declining quickly. The pt passes away that night.
Scenarios such as this happen every day in the hospital. As cases continue to rise, people continue to disregard the pandemic, refuse to wear a mask, and bet on the election to halt the so-called pandemic.
Previously healthy individuals are dying. Patients with comorbidities are dying. Elective procedures are being canceled. Jobs are being furloughed/eliminated. OB nurses and forced to work critical care. Healthcare workers are isolating from family and working overtime, while the community praises the “heroes” and can’t even wear a mask when in public.
COVID inpatients spend between 3-20+ days in the hospital. Disease progression has been seen to peak around day #7 in which the patient will make a turn for the better or a turn for the worse. Symptomatic treatment plus steroid therapy and Remdesivir has been shown to be effective for treatment. Isolation precautions are extended to 20-21 days for those being hospitalized.
Why is a pandemic and the importance of wearing a mask political? COVID continues to place a strain on the healthcare system as the frontline staff face burnout, hospitals are accepting higher acuity/patient loads, and the overall stress levels are not healthy to sustain.
The CDC explains how mask wearing helps with source control- You wear a mask to protect others and vice versa. Cloth and medical masks are not tight-fitting, therefore do little to protect the wearer. They are more effective in reducing transmission to others, expanding the importance of masking requirements for the public. N95 masks are the most effective to protect yourself and others as it filters 95% of small aerosolized particles and is fit-tested to the specific wearer.
The right to wear a mask is not a right to the individual. A majority of the people who do not wear a mask are not the people dying from the COVID-19. In order to protect the health of those around you, please wear a mask.. then everyone can be deemed a hero.
Until next shift,
Shania