- Shortly before intubation and putting on a ventilator, one of Derrick Smith's coronavirus patients asked, "Who will pay for it?"
- It's "deeply sad that people may be worried about their finances in potentially dying moments," 33-year-old Smith told Business Insider.
- As an anesthetist in a New York hospital, Smith was placed in an "intensive care" role characterized by bottlenecks in personal protective equipment, long hours, and contagion concerns.
- Smith is disappointed with government containment measures and criticizes the failure to "protect and protect his citizens".
- You can find more stories on the Business Insider homepage.
According to Derrick Smith, the corona virus has turned the pox scars of the US healthcare system into glaring scars.
In one much shared Facebook post On April 3, he described the last words of a COVID-19 patient: "Who will pay for it?"
Shortly before intubation and putting on a ventilator, the person "wheezed" the question to their medical team between "laboring breaths" before they made the last call to their spouse, "as many patients do not, recover." Hose, "Smith wrote.
Smith, a Certified Registered Nurse Anesthetist in a New York hospital – whose name he wanted to withhold, wrote: "This situation is by far the worst I've seen in my 12 years of intensive care and anesthesia collective … This country is really a failed state, and it's so bad to be a first-hand witness, more obvious than ever. "
As Smith considered the experience, he told Business Insider that it was "deeply sad that people may be worried about their finances even in the process of dying." He declined to disclose more information about the patient, citing data protection laws.
People struggled to grasp the full extent of the corona virus as the government tried to downplay it
The 33-year-old Smith remembered the first hearing about the coronavirus in January when it raced through Wuhan, China, and admitted that "it was difficult at the time to determine the severity of the coronavirus".
The United States reported its first case on January 21. But a day later, President Donald Trump told CNBC's Joe Kernen that he was "not at all concerned".
"It is a person who comes from China and we have it under control. It will be fine," Trump said.
Given that the federal government "didn't seem to take it very seriously" and even compared the disease to the general flu to downplay it, Smith said he had only started to fully increase the extent of the devastation caused by the corona virus in late February detect.
He described that he would immediately be concerned about the impact that "any type of viral, contagious pandemic" that was rapidly advancing would have on the "already fragile health care system" in the United States.
And what an effect it had.
The United States has almost the largest registered COVID 19 outbreak in the world 400,000 confirmed cases and over 12,900 deaths. New York is the hardest hit state. More than 140,300 people test positive for the coronavirus and over 4,000 die. Hospitals are overcrowded, morgues are full, and medical professionals who lack adequate personal protective equipment (PPE) succumb to the disease.
The corona virus has changed Smith's medical work. An influx of COVID-19 patients has flooded the various medical facilities in which he works, with the exception of one surgical center that "no longer works" because it focuses on election procedures that are currently rare.
His role in the hospital has also changed. Before the pandemic, Smith's work was more predictable.
"Meet the patient first, do a full interview and physical exam, take him to the treatment area, sedate or have him anesthetized, and then take care of him until the postoperative period," he said of his routine.
Since the Coronavirus struck New York, the elective operations have been suspended, leaving Smith in a "rather critical role" that includes intensive care unit work (ICU) or responding to all types of emergency across the hospital.
"I reused the same N95 mask throughout my shift."
No two days or cases are the same, said Smith.
"There are some people coming in who are breathless and need to be intubated relatively soon," he said. "Or you have someone who is just very, very sick with classic flu symptoms and upper respiratory problems and doesn't have to be fully intubated yet, but definitely needs hospitalization, fluids or antibiotics for pneumonia."
After a 12-hour shift where he only had an N95 mask, Smith said the hospital's PSA coverage had improved, but there was still a lot to do to protect medical personnel.
"I reused the same N95 mask throughout my shift, just being careful not to remove it frequently," he said. This maintenance of PSA represents a dramatic shift from the pre-pandemic era, Smith added when N95 was used as the disposable mask for which it was developed.
Smith also believes that his team's shifts are getting longer. The hospital "welcomes more and more patients" and thus increases the workload.
When asked if he and his colleagues were concerned about the coronavirus infection, Smith simply replied, "Yes."
The corona virus affects people in different ways. Some are asymptomatic carriers, while others have symptoms so severe that they need to be intubated in the intensive care unit, Smith said.
For example, like his friends and colleagues, Smith "just tries to stay as healthy as possible with diet, routine at home, exercise, and enough sleep to strengthen his immunity," so that he can ward off a severe reaction if he does the disease catches virus, he said. It would also be helpful if people followed social distance guidelines to smooth the curve.
However, the corona virus takes a toll on Smith.
"I'm no stranger to death, illness, and the American health system because I've been in it for over a decade," he said, "but I've never seen what I've seen lately with the speed and intensity and spread of the virus itself and its effects on patients and the hospital system.
"It takes a toll, but there is currently no other option," he added.
The government is failing people instead of protecting their health, Smith said
Smith said his frustration with the "sad" state of the health care system "peaked" on the day he was on Facebook.
His interaction with the patient emphasized how concern about medical care "prevents people from getting treatment at all," he said. This is "inherently problematic" in the context of a pandemic because, according to Smith, "patients are a greater burden on the system if they become so acutely ill".
"(A) Tertiary care, where people with or without insurance come to the emergency room … in my opinion is anything but the best way to do it," he said. "Primary prevention, public health and also solvency (health care) should be emphasized regardless of your social or class status."
Smith said, denouncing federal and state responses to the crisis, that thousands of people a year would not die or be forced to fund their treatment in "one of the richest industrialized nations in the world" due to lack of access to medical care .
He called on Trump not to do enough with the Defense Production Act to actually "lift the parts of this mess" and leave it up to state officials to put together a "patchwork" of containment measures. He also criticized the Wisconsin authorities for holding elections during a pandemic and forcing people to choose between their welfare and democracy, and for the CDC to change its guidelines on which face masks to use safely.
"I think the main purpose of a government is to protect and protect its citizens, and I feel that this is clearly not the case," he said.