The doctors, nurses and other health care professionals on the front lines of the battle against coronavirus on Long Island are struggling to keep up, struggling to protect their own health and struggling to even understand the enemy that they’re fighting.
“This COVID-19 crisis is very unique,” said respiratory therapist Andrew Florez, whose 13-hour shifts at Peconic Bay Medical Center in Riverhead are spent making sure the ventilators keeping COVID patients alive are working properly and closely monitoring the status of patients who are not on ventilators.
“It’s very difficult to predict outcomes, because it’s very new and very different,” said Florez, who has about a dozen years of experience in his field. “It’s acting in a way a lot of us have trouble understanding.” Patients’ conditions can change rapidly and unpredictably, he said.
Patients often deteriorate rapidly and when they do, “everything takes a hit,” Florez said. They often continue to deteriorate even after they are on ventilators, he said.
It’s confounding — even to a respiratory therapist whose job is to take care of people on ventilators. It’s a specialized field. Respiratory therapists maintain the sophisticated equipment that does the job of breathing for patients who can’t breathe on their own. They adjust the machines, monitor their performance and monitor the patients’ conditions.
But ultimately their function is to keep COViD patients alive with the machines in the hope that their bodies will rally to to fight the virus.
“Basically, we’re helpless with this virus,” said one physician at Stony Brook University Hospital, who spoke on the condition of anonymity. “All we can do is support you on oxygen and monitor you and, when you decompensate, stick a tube down your throat and try to keep you alive.”
Both the doctor and the respiratory therapist said they are seeing much greater variety in patient ages and conditions than is being discussed by officials.
“This is a different beast than what we’re being told,” the physician said. “This illness is very, very vicious. It is not just a disease of the old. The young are just as sick,” he said.
He estimated some 80% of the coronavirus patients at Stony Brook are Latino. “Almost exclusively, the Hispanic and Latino patients are of working age.” Often, they hold jobs that are both considered essential and do not have paid sick leave or personal days. They feel like they have no choice but to work, even when they feel sick, he said.
“We need to do a better job of messaging in Spanish — the basic things that must be communicated about social distancing, wearing face coverings, protecting yourself,” he said. Spanish-language communications started far too late, he said — and it’s showing in the disproportionate illness in the Spanish speaking population.
Areas that are predominantly Latino — such as Brentwood, Central Islip and Huntington Station — have the highest incidence of coronavirus infection in the county, with infection rates per 1,000 people double or even triple that of many predominantly white areas.
“This is a group that’s getting hit so hard,” he said.
“The entire hospital is pretty much all coronavirus patients now,” the Stony Brook doctor said. “Everyone who comes through our doors has coronavirus. We’re opening up new units for them every single day.” You’d be hard-pressed to find a non-COVID unit there now — there’s maybe one out of 15, he said.
“Everyone is a COVID doctor now. There are basically no other types of doctors at this point. It’s all hands on deck,” he said.
Florez said all of his patients on ventilators at PBMC are COVID patients. The hospital has filled one of its ICUs and is working on the second.
“An ICU is minute-by-minute,” Florez said. “Things can change very drastically very quickly.” Work in an ICU requires being able to handle stress very well, he said. “We’re always dealing with life and death.”
Fear and worry for one’s personal safety are part of a health care worker’s daily life in the age of coronavirus.
“I’d be lying if I said I’m not scared of catching it,” Florez said. “Like any virus it can land on your shoe and you can potentially bring it home.” Florez is the father of three young children and his risk of exposing them to the virus is on his mind constantly.
He sees first-hand on a daily basis the damage this unpredictable “ugly virus” causes, he said.
People need to take his seriously, Florez said. “Unfortunately, they’re not. People all thought it’s ‘just the flu’ but it’s not. This is not the flu. We don’t have a therapy. We don’t have a vaccine. In fact, it’s unlike anything we’ve ever seen,” he said. “People deteriorate rapidly, abruptly.” And there’s nothing health care providers can do.
“All we can do is give people a fighting chance,” Florez said. “But the reality is people are dying.”
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