When Erika Roño was in nursing school, they were taught to always prepare for situations where there were mass casualties or patients. Reality though can be frightening.
Roño is among the 200-plus front liners dealing with COVID-19 at Johns Hopkins Hospital in Baltimore, Maryland, one of the premier hospitals in the United States and in the world (it was ranked the best in the US for 21 consecutive years from 1991-2011, a feat no other American hospital has matched).
And yet, even while working there these past five years, she wonders if this is the calm before the storm.
From one ward dedicated to COVID-19 patients there are now three at Johns Hopkins. “If this reaches levels like what we are seeing in New York where patients are already being treated in hallways, then I don’t know what to think,” said the 32-year old nurse via a video call early morning of March 27 (evening in the US March 26).
“Before I go to work, I have to prepare myself mentally,” she disclosed. “We all do. It sounds simple – we go in, stabilize patients, get them ready for the ICU, and help them live. We move on to the next patient. We aren’t informed of previous patients because we cannot afford to get caught up or emotional or else we lose our focus. But thankfully, some of our patients are getting better. We haven’t lost anyone... yet (although a couple of hospital staff are now quarantined). We have a peer hotline, where we can call our fellow staff just to talk if we are stressed out.”
Roño works 12 to 16 hour shifts at the main emergency room where she attends to patients with full blown cases to mild ones. “Right now, it’s manageable. What I am worried about – and I hope I am wrong – is this is, for lack of a better term, the calm before the storm,” she added with a hint of nervousness. “We are treating this like other previous diseases because we do not fully know yet what we are dealing with. It’s like shooting in the dark.”
Reports from Johns Hopkins are regular, on a daily basis. Everyone has to read the latest bulletins and adjust to any procedural changes on the virus, treatment, and staying safe to avoid exposure.
With the United States, like most other countries, short on personal protective equipment (PPEs), Johns Hopkins management made each and every one of the frontliners individual face shields (based on the sizes of their faces) with their reused n95s and powered air-purifying respirators (PAPR).
“We (Johns Hopkins) are doing better than other hospitals that are providing only surgical masks and limiting PPE usage,” noted Roño of the support.
One time, she spent an extended amount of time with an intubated patient. “You get worried, but as long as you follow procedures, you’re relatively safe,” she added. “Before you go the ER, or a room, you grab everything you need and it is disinfected. If you forget something, you have to go out, change your gown and everything and have to go through the entire disinfecting procedure again. And you cannot take anything for granted because the virus is highly transmissible.”
After every shift, they are sprayed on, they shower twice, with colleagues also helping out in disinfecting one another. Everything from their hair to the clothes and personal belongings are disinfected.
“My big fear too is bringing the virus home (to her husband, Allan who is a pre-school teacher),” bared Roño. “Allan and I have talked about a lot of scenarios including what we should do if one of us, or I, pick up the virus. We have this pre-arranged plan.”
Allan is a pre-school teacher, who like most everyone else, does his work from the relative safety of their home. After he picks her up, he goes through another routine of disinfecting her clothes and gear.
“At this point, the risk to my wife is great so I have to do my part in making sure she is safe,” he said.
Pausing for effect, Allan added, “She is my superhero.”