Miracle Work

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Doctors and nurses have made the ultimate sacrifice. They tell stories from

on the ground of extraordinary recoveries and gains in combatting COVID-19.

Incredible Healing

At just 24, Nick Hunter has faced death and beaten the odds — twice. On the first day of his sophomore spring semester at Kent State University, Hunter received a phone call that changed the trajectory of his life — a new set of lungs was waiting for him at Cleveland Clinic. He was born with cystic fibrosis, and his lungs were not functioning well. The new lungs he got in an eight-hour double lung transplant gave him another chance at life.

Hunter was immunocompromised when the coronavirus pandemic began during the last semester of his journalism degree. He immediately made adjustments, leaving his job at Tree City Coffee and staying home.

“It was mostly fear that it was gonna spread quicker than I could account for,” Hunter says. “That’s exactly what happened.”

Near the end of March, his older brother visited before knowing his roommate was sick. Within the week, Hunter came down with cold-like symptoms, including headaches and a cough. Without a high-grade fever, he couldn’t get a coronavirus test. After a week of quarantining and continued symptoms, he was admitted to Cleveland Clinic Akron General with pneumonia and COVID-19.

“Having pneumonia and COVID together was absolutely terrifying,” he says.

Within 24 hours, Hunter’s oxygen dropped to dangerous levels. He was put on a ventilator for seven days. His intensive care unit team consulted with Marie Budev, a Cleveland Clinic doctor who has treated Hunter for more than six years, about how to keep his transplanted lungs protected.

He awoke a week later in the ICU during the middle of the night. “I just sat there for hours,” he says. “The first thought was, I can’t believe I’m alive, because it got so bad so fast.”

Soon after, he FaceTimed his mom since the hospital restricted visitors. “It was one of the most emotional experiences I’ve had,” he says. “If it weren’t for my family, if it weren’t for the incredible nurses at Akron General, I wouldn’t be here.”

He went home four days later when his lung function returned to baseline. Hunter was one of the first people with a lung transplant to survive COVID-19, Budev says.

“This sort of infection can cause a great deal of destruction in other organs besides the lungs. You can end up on dialysis. You can have heart problems. You can get blood clots,” she says. “He had none of those. We were very fortunate — a miraculous recovery with great medical care.”

All Together

As each local hospital enacts its disaster protocols, members of the Northeast Central Ohio chapter of the Emergency Management Agency meet to coordinate the regional COVID-19 response. “We set up incident command. It’s changed the way you do everything,” says Dr. John Crow, Akron Children’s Hospital associate chief medical director. Grace Wakulchik, Akron Children’s president and CEO, and NECO president, leads weekly meetings of 13 counties’ hospital leaders who prepare for surges by planning for temporary hospitals and more hospital beds, testing sites and personal protective equipment. Crow speaks to us about our regional response.

What has been most surprising about working on the regional plan?

JC: A very good thing that happened … was how all the hospitals that have normally competed in the region came together. We set up communication hubs. It was like, This is a national problem. We got to do our best and help our people in our region. It was heartwarming.

How does collaborating with other hospitals make a difference?

JC: The fact that we communicate means the visitation policies at all the hospitals are similar or the same. All those things for the public are more standardized across the region.

How does planning for a surge work?

JC: Hospitals every day submit their current occupancy and capacity. …[Wakulchik] communicated daily with the CEOs and hospitals, and then all the support staff, EMA people. We looked at sites for testing. We looked at setting up what we would call level three surge at the Covelli Centre in Youngstown or at a Kent State University dorm. These are on hold during the current surge due to staffing. ... We just started another subgroup on vaccination distribution. When vaccines come out, there’ll be a limited supply at first, so we want the people most at risk to get them.

What is the next step in dealing with the pandemic?

JC: We’re really worried. We’re surging. Most hospitals have expanded to make more room for COVID patients. ... The acute concern is the next months. Most people are compliant but some … want to go back to normal life and ignore that we’re in this together. The biggest challenge is the balance of Can we all keep working? Can we all wear a mask and do the simple things that need to happen? We’re in a lot better place than we were in April … because we have treatments. The percentage that goes on ventilators is lower. However — we’re kind of at a tipping point.

Care Advocate

By the last week in March, emergency department charge nurse Travis McDonald had faced COVID-19 while caring for patients at University Hospitals Portage Medical Center. By April 7, his concerned wife rushed him to his hospital — as a patient.

“The next day my breathing got worse,” recalls the 36-year-old. “It felt like in a matter of minutes we were going to the ICU to be intubated.”

Just a week or so earlier, McDonald quarantined after his temperature spiked, and he got a drive-thru coronavirus test. Despite a negative result, days later he kept running a fever, coughing and straining to catch his breath while talking and walking. His wife checked his oxygen saturation at home, and his levels were low.

He rapidly went from being admitted for monitoring of his oxygen levels after chest X-rays showed signs of COVID to going on a ventilator. On his way to the intensive care unit, his assistant manager passed him a phone, and he told his wife he loved her.

“I was scared,” he says. “I felt like I couldn’t go much longer working that hard just to breathe.”

When he came off the machine four days later, he couldn’t speak. He communicated with his wife and three kids via a whiteboard and iPad daily and was grateful his co-workers kept his family informed, too.

Following a harrowing eight-day fight, his oxygen levels improved, and his co-workers clapped as his wife wheeled him out of his hospital.

“The main thing that was driving me was my family,” McDonald says. “I didn’t know how things would end up, so it was a big relief to see my family again.”

His battle continued at home. He pushed to regain strength by walking his dog daily. Mentally preparing to return to nursing was tough.

“When I left the hospital, I was nervous to go back,” he says. “But once I got home, I wanted to help. No one expects a pandemic, but I couldn’t think of doing anything else.”

McDonald’s case helped change UH Portage. Before he got sick, guidelines mandated staff wear masks within 6 feet of patients, but afterward, guidelines changed to wearing a mask within 6 feet of everyone and social distancing, and those are constantly updated. Upon returning to work in early May, McDonald became the first patient to share his story on a big local platform — Ohio Gov. Mike DeWine’s press conference. He wants people to know it’s much more dangerous than the flu.

To him, being a COVID-19 survivor means he can better explain the treatment process and advocate for patients’ needs as their symptoms fluctuate.

“It’s making sure they are aware this can be serious. At the same time, it could not be anything. It affects everyone differently,” he says. “Don’t hesitate to seek treatment if it doesn’t go away or gets worse.”

Help Arrives

Akron Children’s Hospital float nurse Hannah Sexton watched TV news reports of how the pandemic was straining New York hospitals and knew she needed to help. From April to mid-July, Sexton took a travel assignment in the Bergen New Bridge Medical Center’s adult COVID-19 intensive care unit in New Jersey just outside of New York City, and the surge was as bad as it looked on TV. “It was kind of warfare — everyone trying to do what they could and stay above water,” she says. Sexton continued to follow the need,  working in Good Samaritan Medical Center’s ICU in West Palm Beach, Florida, from late July to September and in a Texas hospital in November. She shares what it was like nursing in epicenters of the pandemic.

How did you feel before leaving for New Jersey?

HS: It wasn’t something you could prepare for. Not knowing if we’re going to have the proper protective equipment, how sick the patients are or what the environment is like was nerve-wracking.

The New York area has been described as deserted. What was it like being there?

HS: It was hard. You don’t have your friends. You don’t have your family. So you’re in a ghost town by yourself. Most of the nurses worked a lot because they had so much need day after day. I would take a day off here or there to sleep and then work another five, six, seven days in a row.

How did you feel about going back out for Florida?

HS: It was a little easier because I knew what to expect. I knew what we were doing for COVID patients in New Jersey, what worked and what kind of problems we would see. I was more confident going in. But treatments and everything is changing all the time, so it’s still nerve-wracking to catch on and learn all they’re doing to treat patients.

What does this experience mean to you?

HS: It was a horrible thing, but I feel like me going there was meant to be. I learned so much. … You feel like you were actually helping. Sometimes we feel like we’re just there. But in New Jersey, everyone was so grateful, and you felt like you were really making a difference in these patients’ and these families’ lives.

Long View

During March, our future looked bleak. But now, medical professionals are armed with more treatments, testing availability and scientific trials on COVID-19. The Food and Drug Administration approved the drug remdesivir for hospitalized COVID-19 patients. Vaccines are promising, and Aultman Hospital in Canton is set to distribute vaccines to front line workers soon, according to the Ohio Health Department. Dr. Shanu Agarwal, an infectious disease physician at Summa Health System’s Akron Campus and the chair of infection control for Summa, has seen progress firsthand. “I definitely would say we’ve made some headway in making sure we decrease length of stay for patients,” she says. “I’m inspired by ... seeing the results of how the patients are doing compared to where they were in March.” Agarwal talks about the ongoing fight against COVID-19.

How have the medical knowledge and treatments of COVID-19 changed since March?

SA: There’s a lot more trials with more patients. We go on NIH [ National Institutes of Health] recommendations … of different trials and what the outcomes were. We use a lot of their guidance to say, This is a medication that’s worth trying. We’ve seen some good outcomes. … Back in March, we didn’t have enough out there, and now in October, there are more treatment options shown to be beneficial.

What has been the most inspiring?

SA: What we heard in March was, If you’re in the ICU, if you’re on a ventilator, your chance of survival is very, very grim. As we’ve moved through this pandemic … I’ve seen people come into the ICU — we see young patients, we see older patients — but then they make it out of the ICU. They make it out walking.

Can you tell me about a special situation that you’ve experienced?

SA: There’s a lot of restrictions with visitors, and [patients] can be in the hospital anywhere from a couple of days to maybe a week or two weeks. … A lot of times, they’re frustrated they can’t see their loved ones. The loved ones are frustrated because they can’t see them. You have to be there for them. You form relationships when it’s a sensitive time for everybody.

What are your plans for the hospital moving forward?

SA: We need to not only continue what we’re doing on a week-to-week or day-to-day basis with COVID, but to make sure as we get into the colder months, how we factor in flu and other viral illnesses.

What have you taken away from this pandemic?

SA:  What I learned is you gotta … always keep in mind that there could be something that’s thrown at you that’s brand-new, and you just gotta work hard at keeping up with what is out there as far as the treatment options or what literature, what research is out there. … I think we’re all learning every single day from the fire.

What drives you to keep working?

SA: My children. When I go home, they’re like... Mom, my teachers ask how you were doing and thank you for everything. They saw you on the news. … That makes me wanna do more for everybody, and it really keeps my hopes up that ... we’re gonna get through this. All the appreciation and all the kind words I’ve heard from everybody makes me want to do more.