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When police discovered the woman, she had been dead in her home for at least 12 hours, alone, unless her 4-year-old daughter. Initial reports only indicated that he was 42 years old, a technical mammogram at a hospital southwest of Atlanta and almost in fact a coVID-19 victim. Was your identity hidden to protect your family’s privacy? Your employer’s reputation? Anaesthetist Claire Rezba, browsing the news on her phone, was horrified. “I had the feeling that her sacrifice was wonderful and that her son’s sacrifice was wonderful, and it was just this nameless woman, you know? He seemed very mundane. For days, Rezba clicked on Google, looking for a name, until the end of March, the reports, however, provided one: Diedre Wilkes. And almost unknowingly, Rezba began to count.
The next call on his list was world-famous, at least in medical circles: James Goodrich, a pediatric neurosurgeon in New York and a pioneer in the separation of accumulated duals in his head. One of his best-known successes came in 2016, when he led a team of 40 other people in a 27-hour procedure to split skulls and separate the brains of the 13-month-old brothers. Rezba, who had been concerned in two Siamese instances about his residence, had been fascinated by the saga. Goodrich’s death on March 30 was a blow; “It was just personal.” Obviously, the coronavirus came here for health care professionals, from legends like Goodrich to legends like Wilkes who worked outside the highlights and, as Rezba knew, would die there.
At first, the search for your obituaries is a way of involving one’s own fear. At Rezba Hospital in Richmond, Virginia, as in fitness services in the United States, elective surgeries were canceled and schedules reorganized, meaning he had to worry about long periods of time. Her husband is also a doctor, an orthopedic surgeon in another hospital. Your sister is a nurse practitioner. Testifying to the lives and deaths of others I did not know deviated it from the risks she faced. “It’s a way of dealing with my feelings,” he admitted on a recent afternoon. “He’s helping to bring order to some of those anxieties.”
On April 14, the Centers for Disease Control and Prevention published its first resteth of physical care personnel who lost to COVID-19: 27 deaths. At the time, Rezba’s list included several times that number: nurses, addiction remedy counselors, medical assistants, caregivers, emergency users, physical therapists, paramedics. “It was annoying, ” said Rezba. “I mean, I’m, like, a user who uses Google and had already counted more than two hundred people and say 27? That’s a big breach.”
Rezba’s training in mental self-protection has become a real mission. Soon he moved a few hours a day to search the Internet for the newcomers; saddened her, and then angered her at how difficult they were to find, how temporarily the other people who gave their lives to the service of others seemed forgotten. The more I searched, the more convinced she was that this invisibility was not an accident: “I felt that many of these hospitals and nursing homes were trying to hide what was happening.”
And instead of acting as guard dogs, public fitness and government officials have remained largely silent. While seeking knowledge and studies, any sign that classes were learned from these deaths, Rezba discovered instead men and women who worked in two or three jobs but were unsure; groups of contagion in families; so many young parents that she was looking to scream. Most of them were black or brown. Many were immigrants. None of them had to die.
The least she could do was force the government, and the public, to see them. “I feel like if they had to look at the faces, and read the stories, if they realized how many there are; if they had to keep scrolling and reading, maybe they would understand.”
It has been transparent since the onset of the pandemic that fitness personnel face unique and extreme hazards related to COVID-19. Five months later, the truth is worse than Americans know. By the end of July, only about 120,000 doctors, nurses, and other medical staff had contracted the virus in the United States, the CDC reported; at least 587 had died.
Even those numbers are “a braided understatement,” said Kent Sepkowitz, an infectious disease specialist at The Memorial Sloan Kettering Cancer Center in New York, who studied the death of medical staff from HIV, tuberculosis, hepatitis and flu. Based on data on state epidemics and beyond, Sepkowitz said he would expect physical care personnel to account for between 5% and 15% of all coronavirus infections in the United States, raising the number of staff who contracted the virus to more than 200,000, and in all likelihood much higher. “At the beginning of any epidemic or pandemic, no one knows what it is,” Sepkowitz said. “And you don’t take the proper precautions. That’s what we saw with COVID-19.”
Meanwhile, the Centers for Medicaid and Medicaid Services reports at least 767 deaths among nursing home staff, making this task “the most damaging task in the United States,” an editorial said in The Washington Post. National Nurses United, a union with more than 150,000 members nationwide, counted at least 1,289 deaths among all categories of fitness professionals, adding 169 nurses.
The loss of so many committed and deeply experienced professionals in such a pressing crisis is “unsurpassed,” said Christopher Friese, a professor at the University of Michigan School of Nursing, whose examination spaces include injuries and ailments of physical care employees. “Every employee we’ve lost this year is one less user who has to take care of the ones we enjoy. In addition to the tragic loss of this user, we unnecessarily depleted our equipment while we had at our disposal ‘to save him sickness and death. on a giant scale.
Largely, it lacks one of the potentially toughest equipment to combat COVID-19 in the staff’s medical body, he said: reliable knowledge about infections and deaths. “We don’t see where physical care staff are most at risk,” Friese said. “We had to rebuild it. And the fact that we’re rebuilding it in 2020 is pretty disturbing.”
The CDC and the Department of Health and Human Services responded to ProPublica’s questions for this story.
Learning from the poor and health deserves to be a national priority, whether it’s protecting the workforce and improving pandemic care and beyond, said Patricia Davidson, dean of Johns Hopkins School of Nursing. “This is incredibly important,” he said. “This deserves real-time.”
But knowledge gathering and transparency were among the most flagrant weaknesses in the U.S. pandemic response, from blind spots in understanding the public fitness formula of COVID-19 pregnancy to the sudden withdrawal of knowledge of hospital capacity from the CDC website, which was then restored after a public protest. The Trump administration’s sudden announcement in mid-July that it was ripping out control of the hospital’s coronavirus knowledge at the CDC has only heightened concerns.
“We would be the first to agree that CDC has been poor” in their knowledge collection and deployment,” said Jean Ross, president of National Nurses United. “But it is still the top federal company to do this, with transparent experience in the infectious disease response table.”
The CDC’s fundamental mechanism for collecting inshaperation in fitness personnel infections is the popular two-page coronavirus case report form, primarily terminated through local fitness services. The form does not require many details; for example, it does not ask for the names of employers. Insufflation is delayed or incomplete; The company does not know the employment scenario of approximately 80% of those infected.
Data on infections and deaths among staff in nursing homes are stronger, thanks to a rule that took effect in April that requires establishments to report directly to THE CDC. The firm told Kaiser Health News that it “is also conducting a hospital examination in 14 states and other infection surveillance methods” to monitor the deaths of fitness workers.
Another federal agency, the U.S. Occupational Safety and Health Administration, investigates infections and staff deaths based on court cases and has prioritized COVID-like cases in the physical care sector. But he advised that top employers would face no sanctions and issued only 4 pre-orders similar to the outbreak, to a Georgia nursing home that reported the hospitalization of six and 3 Ohio gymnasiums that violated respiratory coverage standards. Of the more than 4,500 court cases OSHA won in connection with similar COVID-19 situations in the medical industry, it closed only about 3,200, according to an investigation through ProPublica.
Data disorders are not just a federal problem; many states have been unable to gather and speak data about fitness personnel. Arizona, where instances have increased, told ProPublica, “Lately we do not report knowledge through the profession.” The same is true for New York State, a report in early July advised how devastating the numbers can be: 37,500 senior homes, or about a quarter of the workforce in the state’s retirement homes, were inflamed with coronavirus from March to early June. I fix other states, adding Florida, Michigan, and New Jersey, provide knowledge about the facilities staff in the long term, but not about the physical care staff in general. “We don’t gather knowledge about fitness employee infections and/or deaths due to COVID-19,” a Michigan Department of Health spokesman said in an email.
This challenge is global. Amnesty International, in a July report, pointed to widespread knowledge gaps as a component of a broader erasure of data and rights that it has left in many countries “exposed, silenced and] attacked.” In Britain, where more than 540 doctors died in the pandemic, the medical advocacy organisation Association UK has filed legal action to force the government to investigate the shortage of non-public protective devices in the national fitness service and “social protection” services such as retirement. Houses. And in May, more than 3 months after the death of the first known medical worker, the International Council of Nurses called on governments around the world to begin maintaining accurate knowledge of such cases and to have centralized records through the World Health Organization. WHO estimates that about 10% of COVID-19 instances worldwide involve fitnessArray “We are largely tracking these instances across our global networks,” said a spokesman.
“The fact that governments have not consistently collected this data” has been “outrageous,” the board CEO Howard Catton said, and “means we don’t have the knowledge that could carry into science that could only control infections and prevention measures.” and save the lives of other physical health workers. Matrix… If they keep closing their eyes, the message is sent that [these] lives don’t count.”
So people, like Rezba, have stepped up their wealth databases.
Rezba, 40, was first looking for a career in public health. While completing his master’s degree at Emory University in Atlanta and for a few months later, he worked as a lab technician at the CDC, analyzing nasal samples to track cases of MRSA, the carnivorous bacteria. But he made the decision that he cared more about others than insects, so he went to Virginia Commonwealth University School of Medicine in Richmond, where he graduated in 2009 with the goal of specializing in the remedy of chronic pain.
During her residency at VCU, her first rotation was in the neonatal intensive care unit. “There was a little baby I helped take care of for three weeks. And the very last day of that rotation, his parents withdrew care. … He was the first little person I pronounced dead. I went and cried in the stairwell after that.” Her next rotation was in the burn unit, then the emergency department. “It seemed like death was just everywhere,” Rezba said. Witnessing it “is something very separate from the rest of your life experiences. People look different when they’re dying. It’s not like TV. They don’t look like they’re sleeping. CPR is pretty brutal. Codes are pretty brutal.”
She began to keep a list to deal with the pain. “At the residence, record everything: the records of your case, the procedures you perform. It’s just a natural moment to sign their names. Every time a patient dies, she makes another access in her pocket and then “I persevered a little” — ruminated — “in their names.” At the end of the year, she brought the paperback to the church.” I lit candles for them. Prayed. And then I gave up.
A decade later, Rezba worked full-time as an anesthesiologist and raised three young children, her days compiling lists after her, she thought. Then COVID-19 attacked. The infectious disease geek once became obsessed with the leaking videos of China: groups of fitness personnel in full protective clothing, makeshift rooms in tents, emergencies in chaos: “I knew from the beginning that this was going to be a big problem.” In his work, Rezba was called to do intubations. “The option of not having enough PPE caused her a lot of anxiety,” said her husband, Texas Patel, whom she met in medical school. “It would be the case, if we get to this point in New York, that could be in danger and take it to the children.”
It turned out that Rezba Hospital was not flooded and was not delighted by the shortage of PPE that has affected many fitness facilities. But his anxiety has not gone away; It just took a new form. If the physical care staff was a frontline hero, he decided, his role was to look for the trenches for the remaining bodies.
Rezba is the first to admit that it is not only correct in technology; she rarely uses a PC at home. Patel discovered what he was doing because his iPhone and iCloud accounts are linked. “Every time I record a photo on the phone, I can see it. And I saw a lot of pictures of those strangers. He recalled how, at the time of the students, Rezba had insisted on humanizing the corpse in his anatomy lab: “He was disappointed that it was only this unnamed person. Knowing her birthday and little things like that would make her feel better. Patel thought the shots were components of a similar adaptation strategy. “It wasn’t until long after I found out I was posting them on Twitter.”
Much of Rezba’s excavation occurs in the middle of the night, when he cannot sleep. Start by Google searching for local news; If you’re not tired yet, turn to the obituary site Legacy.com. The search for the profession and the cause of a person’s death invariably takes her to Facebook, where she follows the trail of parents and co-workers, holiday slideshows and videos of old men serenading their grandchildren on guitar. Every few days, check GoFundMe, where she was recently surprised by the number of other people who stay for weeks or months before she died. He still finds deaths in April and May. Anyone under the age of 60 is a subject of special examination. “If the obituary says, “They died surrounded by their families, ” I don’t bother looking any more, because those other people don’t have COVID. Most other people with COVID die alone.”
Doctors and nurses are the easiest to find. “If someone painted in the laundry room of the nursing home, the family circle wouldn’t wear it,” Rebza said. However, it is non-medical staff who feel the special legal responsibility to note: hospitality coordinators and home technicians, food service painters and concierges. “I mean, the hospital probably won’t paint if there’s no one to take out the trash.” Occasionally, a report mentions that several staff members in a nursing home or rehab facility have died, not to mention their names, and Rezba feels that anger is beginning to bubble. “These are other people who earn $12 an hour. And they’re treated as if they were disposable.”
If you can’t locate someone’s identity right away, or if the cause of death isn’t clear, you’ll wait a few days or weeks before looking again. Because you know them anyway, you have to stick to other categories of COVID-19 deaths, such as young people and pregnant women, as well as physical care personnel in their 30s and 40s who still do not appear to have the virus and who die suddenly. central attacks or blows or other mysterious reasons. “I have a lot of them,” she says.
Once you’re sure you’ve discovered it in your list, select one or two images and write some words in your honor. Sometimes they read like poetry; sometimes, like a howl.
He liked to dance at home with Bruno Mars, the movements became wilder as his circle of relatives laughed.
As a child, she wrapped her clothes around Dove soap to make them smell like America.
This deficient baby has his mother in his arms. Instead, he’s got it in an urn.
A preprinted review conducted in Italy last week alluded to the kind of classes that researchers and policymakers could be informed of if they had a more complete understanding of fitness personnel in the United States. The examination gathered knowledge of occupational medicine centers in six Italian cities, where doctors, nurses and other providers underwent coronavirus testing from March to early May. In addition to the fundamental demographic information, knowledge included the task title, status quo, and the service where the worker worked, the type of PPE used, and the self-informed symptoms of COVID-19.
The maximum findings: Running in a room designated for COVID-19 did not disclose staff to a greater threat of infection, while dressed in a mask “seemed to be the most effective approach” to ensure their safety.
In the United States, many medical services control workers’ infections and deaths and adjust their policies accordingly. But for the most part, this data is not made public, so it is highly unlikely that the systems will be informed of each other’s reports to better protect their workers.
Imagine all the opportunities it would provide if everyone could see the entire landscape, said Ivan Oransky, vice pre-adaptive editorial content at Medscape, where a memorial page to honor the world’s first lines is one of the site’s most read features. “You can do a very clever epidemiology of leather shoes. Matrix… You can say, “Wait a second. This hospital has 12 deaths among physical care workers. The hospital in the other aspect of the city doesn’t have one. This can’t be a natural coincidence. Frankly, what has this done wrong and what is the other doing right? »»
For Adia Harvey Wingfield, a university of Washington sociologist and writer of “Flatlining: Race, Work, and Health Care in the New Economy,” some of the most pressing questions are about disparities: “Where does this virus affect our physical care? Is the staff the hardest? Does the effect have a disproportionate drop in certain categories of staff, such as registered doctors versus nurses versus nursing assistants, in certain types of facilities or in certain parts of the country? communities of the highest color income likely to get sick?
“If we don’t pay attention to those problems, they’re all at a disadvantage,” Wingfield said. “It’s hard to identify disorders or identify responses without data.” The answers relate mainly to black and Latino communities with the highest rates of illness and death, and where fitness workers are more likely to be other people of color. Without smart data to consult existing and long-term policy, he said, “we could address long-term catastrophic gaps in care and coverage.”
The short-term consequences were also enormous. Friese said the lack of public knowledge about fitness personnel and deaths would possibly have contributed to harmful complacency, as infections have increased in the south and west, for example, the concept that COVID-19 is no more harmful than other non-unusual respiratory viruses. “I’ve been running in this box for 23 years. I’ve never realized that health care personnel had been so affected in my career. This total concept that it’s like the flu is likely to push us back.”
He sees similar misconceptions about the PPE: “If we had a greater understanding of the number of inflamed fitness workers, it could help our decision makers recognize that the PPE remains inadequate and that they want to redouble their efforts. Array… People are getting MacGyver and packing themselves in garbage bags. If we reuse N95 respirators, we haven’t solved the problem. And until we figure it out, we’ll continue to see the tragic effects we’re seeing.”
Misconceptions to make the highest degrees of the federal government bigger, even as infections and deaths began to rise again. On one occasion at the White House in July aimed at reopening schools in the fall, HHS Secretary Alex Azartold, others met, “Health Care WorkersArray … they don’t get inflamed because they take proper precautions.
Even some medical staff members remained in denial. A few days before Azar spoke, Twitter was humming about an Alabama nurse who painted during the day on a hospital’s COVID-19 terrain and unbuttoned in crowded bars at night, where he passed without a mask. “I paint in the physical care sector,” he said, “so I feel like I probably wouldn’t make it if I hadn’t figured it out yet.”
Drilling this feeling of invulnerability, making the enormity of the COVID-19 crisis seem to be out there, is not just Rezba’s mission. Since the iconic New York Times cover marking the first 100,000 deaths in the U.S. Even Guardian/Kaiser Health News’s “Lost on the Frontline” project, news organizations and social media activists have wondered how to convey the scale of the tragedy when other people are distracted through multiple crises that are causing the rituals of global and general mourning remedy largely unavailable.
“The point where duty happens regularly is when our leaders have to count on the families they’ve lost, and that hasn’t happened,” said Alex Goldstein, Boston-area communications strater, the heartbreaking Twitter account @FacesOfCOVID, which has launched nearly 2,000 memorials since March. With COVID-19, “no one has had to look into the eyes of a crying father and needs to show him an image of his child or pay attention to someone telling him who his mother or father was. There were no consequences. our political decisions have been seen as if [those who make them] had to face this death and loss in a more visceral way?
This is a fundamental factor for fitness professionals, who have seen, in the most visceral way possible, the worst coVID-19 can do. Erica Bial, a pain specialist in the breakdown of neurosurgery at a Boston-area hospital, became dangerously ill with COVID-19 in March, her respiratory symptoms persist for more than six weeks. She lived alone and decided not to go to the hospital, partly because she was afraid to infect others. “At that time [of the epidemic], I would have been piped, given hydroxychloroquine and azithromycin, and probably killed me.” As his recovery continued, he wondered how the other doctors were doing: “I couldn’t be the only doctor I knew who was sick.” But while I was searching online, “I didn’t discover data. I started to be really frustrated by the lack of misremeas. Array… And then I started thinking, well, what happens if I die here? Will anyone know?
Like Rezba, Bial has experience in public health; the Facebook page he created, COVID-19 Physicians Memorial, an attempt to build “a network where there is responsibility.” I’m not necessarily looking to create, you know, reverence or remembrance. I’m looking to sense the magnitude of the problem. »»
Rezba began temporarily publishing memorials on the page; As he grew up with more than 4,800 members, Bial asked him to help him moderate it. Among the things that the percentage of the two women is the willingness to stick to the facts. “I didn’t need politics and I didn’t need you,” Bial said. “(Rezba) one hundred percent of the same opinion and trust”. She is also someone with whom Bial can communicate, doctor doctor, while recovering. “It’s not just two other people obsessed with something morbid,” Bial said. “She’s a source of support.”
Emergency physician Cleavon Gilman also followed his Facebook posts, a newspaper about what he witnessed as an emergency room resident in New York’s Presthroughterian hospital system, fighting the virus while wrapping Washington Heights. “It’s just … damn it,” he recalls. “We intubate 20 patients a day. We had complete corridors of PATIENTS with COVID; there was nowhere to put them. In the area of a few brutal days at the end of April, 3 of Gilman’s colleagues died, one of them by suicide.” he’s a colleague you care about and you know him as someone you’ve traveled with… man, it’s hard.”
Although much of the media has focused on the dangers to elderly patients, Gilman has been affected by the number of seriously ill people, people over the age of 20, 30 and 40. In mid-April, his own 27-year-old cousin, a gym instructor at a charter school in New Jersey, died suddenly; He went to the emergency room twice with chest pains, but was diagnosed as worried and sent home, according to his relatives, only to collapse into his car in the look of the road.
As the crisis in New York slowed, Gilman may see disorders in other parts of the country, adding Yuma, Arizona, where a new job is about to begin. It is vital to help other young people perceive the dangers they face, and create for others, by not respecting physical distance or wearing masks, not to mention the dangers faced by fitness personnel due to persistent PSP shortages. Gilman then began collecting the memorials he saw on Twitter and Facebook, many of which were discovered through Rezba or @FacesOfCOVID, and organized the dead on his online page in the kind of gallery he knew it was an emotional blow. Then it went further, making images and obituaries, more than 1000 people, take care of themselves through age and profession.
“You’re starting to see a trend here,” he says. “When someone says, “Oh, other people don’t die, they’re not that young, ” they can temporarily come back with genuine names, genuine articles. It’s more powerful. He’s got his evidence there.
One of the overtly political maximal assignments is Marked through COVID, shaped through Kristin Urquiza in honor of her father, Mark, after her “honest obituary” went viral in early July. For Urquiza, who earned his master’s degree in public affairs from the University of California, Berkeley and works as an environmental advocate in the San Francisco area, “the parallels between the AIDS crisis and what is happening lately with COVID are simply mind-boggling [in terms] of the government and the inability to prioritize public health.” She and her partner, Christine Keeves, a longtime LGBTQ activist, hope that the assignment will be “a platform for others to introduce the story to others” and the COVID-19 edition of the anti-AIDS organization Act Up.
They also increase the budget on GoFundMe to help other families pay for obituaries; The right moment in place for a Texas breathing therapist named Isabelle Odette Hilton Papadimitriou: “His unworthy death is due to the negligence of politicians who underestimate health care personnel for lack of leadership, refusal to acknowledge the severity of this crisis, and their reluctance to give a transparent and decisive direction to minimize the dangers of coronavirus. Isabelle’s death can be prevented; their children channel their pain and anger so that fewer families can suffer from this nightmare.
This is an ending that Rezba is fully compatible. By the end of July, he had published some 900 names and faces of U.S. fitness staff. He had died as a result of COVID-19. She fantasized about what it would be like to leave the countdown. “It would be wonderful if I could stop. It would be wonderful if there was no one else to find. But it had a build-up of dozens of articles to publish, and the death toll kept increasing.