Keeping sight of the singular human being
We write a lot about statistics and illustrative examples here in our Public Health Rising blog, but we think about these issues in terms of people -- real people.
It’s so easy to lose sight of the singular person when we are inundated with so many statistics. Here in the U.S., 330,000+ dead; 19 million+ cases; over 100,000 hospitalized today. To put it starkly, just about 1 in 1,000 Americans have died of COVID-19 infection. It’s the holiday season and too many families and friends are missing their special people. This is especially true for Black and Brown communities. There is much sorrow and loss. And so many people are still suffering. We’re sharing some stories that we had the privilege of being a part of because it would be wrong to lose the individual within the tsunami of statistics. With this blog we often just talk about population health but we don’t want to lose sight that each of those data points is a human being. With their own story, and here are a few that keep us motivated to keep trying our best against this pandemic:
A colleague describing a video call for family to pay their last respects to their loved one who was dying. Telling any family that there is nothing more that can be done and that death is imminent is hard under any circumstance. But COVID-19 has added the additional trauma of so many dying alone because of safety concerns surrounding spread of disease as well as the need to conserve personal protective equipment (PPE). That trauma is indescribable and overwhelming to patients, families, and health care professionals.
A patient spoke of days alone in a hospital with COVID-19 infection while struggling to breathe, without their support network, not knowing if they would survive and their only sources of human touch from strangers and gloves. People enter your room as minimally as possible to conserve PPE and to limit exposure. You, as a patient, sometimes press buttons on your own IV pump to save the nurse a visit.
A young girl with trouble breathing likely had COVID pneumonia. She was all alone in the clinic room because her mom had been too tired to come in, and mom was found outside in the waiting room with significant shortness of breath. She couldn’t afford another co-pay and we don’t know what happened to this family after leaving the clinic.
There was an entire company of dozens of workers who came in to be tested because multiple staff had been recently diagnosed with COVID. So many of these workers refused to report the name of their company to ensure proper contact tracing because they were undocumented, and worried that company would be shut down and that they would be unemployed.
An elderly man walked into clinic gasping for air. Within 10 minutes of arriving, he was transferred to the emergency department (ED). During those few minutes, he learned how sick he was and he started praying out loud. You share a moment with patients when you realize that your face may be the last face that they ever see. That is not a look that you will forget. He was intubated within minutes of arrival to the ED and died 17 days later.
A young woman with COVID pneumonia was found to have low oxygen levels. We prepared her for hospitalization, but when beds are in short supply only the really critical get hospitalized. People who are hypoxic with risk factors for worsening illness would have been hospitalized in October. Now, if they are stable on supplemental oxygen (O2), they may be sent home with O2. If you do not have insurance, you must present a credit card to get home O2, at a cost about $120 per month. Imagine thinking about how to afford oxygen to breathe and survive.
A patient called a nurseline after being diagnosed with COVID-19 a few days earlier. He had been sent home on O2 and was feeling more short of breath. This patient was advised to put himself into prone position to help with breathing issues. Imagine getting phone advice on how to slow down the feeling of drowning. Telemedicine has increased significantly during this epidemic, including many people calling in to get advice on worsening symptoms, such as shortness of breath. The option to send an ambulance or advise someone to come into a health facility has changed significantly for overwhelmed health systems.
A man was dropped off for help because he wasn’t breathing. It was an overdose and he was able to be saved. Sadly, we have seen increasing numbers of drug overdoses during these last 9 months. Is it the increased stress of joblessness, poverty, loss, hopelessness, etc leading to this behavior? We don’t know for sure. Some overdoses appear to be intentional, not accidental: they are definitely not grateful for being “saved.”
Almost all of these patients are Black or Brown. And these stories are just a drop in the ocean of heartbreak that 2020 has been. The injustices of our healthcare system are further highlighted by the inability to afford a copay, and the struggle of affording life-saving medical oxygen.
As we get through this season and move into a new year that will hopefully be brighter, we’ll continue to share our perspective in this blog. We’re sure to continue to lean on numbers, statistics, and illustrative examples. Underneath, we’ll always keep our focus on the people that lived through what we’re talking about, without forgetting those who were lost.