Originally published 14/09/20-------------------------------------
It's 5:30 AM in the paediatric emergency department of a Washington Metropolitan Area hospital. All is quiet. No patients are being seen. A mother pushes her stroller into the waiting room. Her infant son sits with his eyes closed and his body rigid. In broken English, the mother says he’s been like this for over an hour. The nurse moves to check him. His heartbeat is uneven and his respiration ragged. The realisation hits. The child is having a seizure.
The nurse grabs the child and bolts, yelling loudly ‘I need a doctor!’ Time stands still as the medical team swarms, checking vitals and preparing the equipment. The baby needs an IV access, but they struggle to find the vein. They find it. Next they need blood, to know whether or not they should administer antibiotics. Again, they struggle. Children’s veins are notoriously tricky to find; let alone on a seizing patient.
The baby’s core temperature spikes at around 107.8 degrees (42 Celsius). They insert ice water into the baby’s G-tube –a leftover entry point into the digestive tract from the child’s pre-existing medical issues. It’s not enough. They need more. The IV cart – which only moments ago was fully stocked– now runs desperately short. They dash to grab ice packs.
The baby isn’t getting enough air; a non-rebreather mask is placed over its mouth. Tensions rise. Oxygen circulates throughout the densely crowded room. Whatever pathogens the child may carry have become airborne. Thoughts of Covid-19 flash into the minds of the medical staff, who have not had a chance to prepare any protection for themselves. But they brush off the thought. The child’s life comes first, and nobody dares step out of the room. It takes the team over an hour and a half to stabilise the child but in the end, the battle is won.
Annika, a 26-year-old American-Latina clinical technician, steps out of the ER and breathes a sigh of relief. Annika has been working in the hospital for over a year. Known in most hospitals as CNAs, clinical technicians work alongside nurses and doctors on the front lines of the health sector. They were among the key work force in the Covid-19 health crisis, which swept across the United States to devastating effect in early 2020.
When the virus hit hard, she and other staff members were needed in the overburdened adult trauma centre, where new cases of Covid-19 were appearing daily. They were cross-trained and sent into the danger zone with a questionable stock of protective gear. Annika says she feels fortunate to have been working in a larger hospital throughout the crisis, as she believes they were better able to cope with greater support for staff and patients. Unlike smaller hospitals, Annika and her colleagues were entitled to the Emergency Time Off fund (ETO) which allowed staff who caught the virus to take paid time off from work.
But Annika still struggled. The nature of the medical system in the US is horrifically unsuited to the demand placed on it by the effects of the virus. The costs of medical advice and assistance are so extortionate that people are either afraid to seek it or go into crippling debt to try and afford it. With single ambulance rides starting at $1000, and helicopters upwards of $10K, many patients are at a loss. Without insurance this can be a death sentence of its own. When patients explain to medical staff that they do not have insurance, the hospital may come up with a range of alternative payment options or help the patient access government resources that can help pay the bill. But with this, Annika indicates she has observed a certain level of willful separation between the medical staff and the financial side of patients’ care, possibly in an attempt to avoid potential ‘humanitarian conflict’.
Annika may be one voice among many, but hers is the voice of a soldier in the field of a new kind of war. She provides a much-needed reality check that is often lacking from the dicta of politicians, scientists, and leaders. And when you get sick one day, will it be them in that room with you by your side risking their own life for yours?
Or will it be her?