This story was originally published through ProPublica, a nonprofit newsroom that investigates abuses of power. Subscribe to ProPublica’s Big Story newsletter to get stories like this in your inbox as soon as they’re published.
When police discovered the woman, she had been dead in her home for at least 12 hours, alone unless it was for her 4-year-old daughter. Initial reports only indicated that he was 42 years old, was a mammogram technique 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, while browsing the news on her phone, was distraught. “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 at the end of March, the reports nevertheless provided one: Diedre Wilkes. And almost unknowingly, Rezba started counting.
The next name on her list was world-famous, at least in medical circles: James Goodrich, a pediatric neurosurgeon in New York City and a pioneer in the separation of twins conjoined at the head. One of his best-known successes happened in 2016, when he led a team of 40 people in a 27-hour procedure to divide the skulls and detach the brains of 13-month-old brothers. Rezba, who’d participated in two conjoined-twins cases during her residency, had been riveted by that saga. Goodrich’s death on March 30 was a gut-punch; “it just felt personal.” Clearly, the coronavirus was coming for health care professionals, from the legends like Goodrich to the ones like Wilkes who toiled out of the spotlight and, Rezba knew, would die there.
At first, look at your obituaries for a way to involve 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 long periods of time to worry. 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 through her loved ones. “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 count of physical care personnel lost by COVID-19: 27 deaths. At the time, Rezba’s list included several times that number: nurses, addiction remedy counselors, medical assistants, nurses, emergency users, physiotherapists, paramedics. “It was disturbing, ” said Rezba. “I mean, I’m, like, a user who uses Google and had already counted more than two hundred people and they say 27. That’s a big breach.”
Rezba’s training in mental self-protection has become a genuine mission. Soon he moved in a few hours a day to search the Internet for the newcomers; he saddened her, and then angered her at how difficult it was to find them, how temporarily the other people who gave their lives to the service of others seemed to have been forgotten. The more I searched, the more convinced she was that this invisibility was not an accident: “I felt that many of those hospitals and nursing homes were trying to hide what was going on.
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 being learned from these deaths, Rezba discovered instead men and women who had two or three jobs but were unsure; groups of contagion in families; so many young parents, I wanted to scream. Most of them were black or brown. Many were immigrants. None of them had to die.
At least you can force the government and the public to see them. “I feel like they had to look at their faces and read the stories, if they knew how many there are; if they continued to move and read, they might understand.
It’s been clear since the beginning of the pandemic that health care workers faced unique, sometimes extreme risks from COVID-19. Five months later, the reality is worse than most Americans know. Through the end of July, nearly 120,000 doctors, nurses and other medical personnel had contracted the virus in the U.S., the CDC reported; at least 587 had died.
Even those figures are almost in fact “a blatant understatement,” said Kent Sepkowitz, an infectious disease specialist at Memorial Sloan Kettering Cancer Center in New York, who has studied the deaths of medical personnel due to HIV, tuberculosis, hepatitis and influenza. Based on state data and beyond the epidemic, 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 the paintings “the most damaging task in America,” said a Washington Post editorial. National Nurses United, a union with more than 150,000 members nationwide, accounted for 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 illnesses of healthcare 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 have unnecessarily exhausted our equipment while we have to prevent him from disease and deaths on a large 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 fitness care staff have a maximum 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 those in poor health and the dead deserves to be a national priority, whether it’s protecting the workforce and improving care during the pandemic and beyond, said Patricia Davidson, dean of the Johns Hopkins School of Nursing. “This is incredibly important,” he said. “This deserves to be done in real time.”
But knowledge gathering and transparency were among the most serious weaknesses in the response to the U.S. pandemic, from blind spots in understanding the COVID-19 pregnancy’s public fitness formula 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 stealing control of coronavirus knowledge in hospitals 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 information about infections from fitness personnel is the popular form of two-page coronavirus case report, primarily through local fitness services. The form does not require many details; for example, it does not ask for the names of employers. The form arrives late or incomplete; the company is unaware of the working scenario of approximately 80% of those infected.
Data on infections and deaths among nursing home staff is stronger, thanks to a rule that came into force in April that requires establishments to report directly to THE CDC. The firm told Kaiser Health News that it is “also conducting an examination at 14 state hospitals and other infection surveillance methods” to monitor the deaths of fitness workers.
Another federal agency, the U.S. Occupational Health and Safety Administration, investigates infections and staff deaths based on court cases and has prioritized COVID-like instances in the fitness care industry. 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 members and 3 Ohio care centers that violated respiratory coverage standards. Of the more than 4,500 court cases that OSHA won related to COVID-19-like execution situations in the medical industry, nearly 3,200 were closed, according to an investigation through ProPublica.
Data disorders are not just a federal problem; many states have failed to collect or speak data on 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 warned how devastating the numbers can be: 37,500 nursing home employees, or about a quarter of the workforce in the state’s retirement homes, were inflamed with coronavirus from March to early. June.Array Other states, in addition to Florida, Michigan and New Jersey, provide knowledge about long-term facility staff, but not on fitness care staff in general. “We do not collect information about fitness employee infections and/or the death of fitness personnel 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 initiated legal action to force the government to investigate the shortage of non-public protective equipment in the national fitness service and “social protection” services such as retirement. Homes. 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 cases worldwide involve fitnessArray. “We are largely tracking those cases through our global networks,” said one spokesman.
“The fact that governments do not systematically collect this information” has been “outrageous,” said board chief executive Howard Catton, and “means we don’t have the knowledge that would be loaded into science that can just be infection prevention and control measures. and save the lives of other fitness care workers. Array.. If they keep closing their eyes, the message is sent that [these] lives don’t count.”
So regular people, like Rezba, have stepped up with their makeshift databases.
Rezba, 40, first sought 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 other people 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 his residency at VCU, his first rotation took place in the neonatal intensive care unit. “There was a baby I helped care for for for 3 weeks. And on the last day of this rotation, his parents withdrew from care … He was the first small user I declared dead. I went and cried on the stairs. after that. His next rotation in the burn unit and then in the emergency department. “It looked like death all over the post,” Rezba said. Witnessing this “is something very different from the rest of your life experiences. People look at others when they die. It’s not like television. They don’t seem to be sleeping. CPR is pretty brutal. The codes are pretty brutal. »»
He began to carry a list to deal with the pain. “At the residence, you record everything: the records of your case, the procedures you perform. It’s kind of a moment of nature to sign their names. Every time a patient died, she would make some other access in her wallet and then ” I persevered in a way”- rumiated — “in their names.” At the end of the year, he 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 he hit coVID-19. Infectious disease fans once became obsessed with leaking videos outside China: fitness staff groups in full protective clothing, makeshift rooms in tents, emergencies in chaos: “I knew from the beginning it was going to be a big problem.” In his work, Rezba was called to perform intubations. “The option of not having enough PPE caused her a lot of anxiety,” said her husband, Texas Patel, whom she met at medical school. “I would be the only one, if we get to this point in New York, that could potentially be in danger and bring it home for the children.
It turned out that the 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 were first-line heroes, he decided, his role was to look for the trenches for the bodies left behind.
Rezba is the first to admit that it is not only correct in technology; he rarely uses a computer 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 shots of, you know, those strangers. He recalled how, at the time of the students, Rezba had insisted on humanizing the corpse in his anatomy lab: “She was disappointed that it was this unnamed person. Knowing her birthday and little things like that would make her feel better. Patel thought the shots were part of a similar adaptation strategy. “It wasn’t until long after I found out she posted 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 a person’s profession and the cause of her death invariably takes her to Facebook, where she follows the trail of parents and co-workers, holiday slideshows and videos of the elderly serenading their grandchildren with the guitar. Every few days, check goFundMe, where you were recently surprised by the number of other people who stay for weeks or months before you die. He still finds deaths in April and May. Anyone under the age of 60 is subject to a special exam. “If the obituary says, “They died surrounded through their families, ” I don’t bother looking any more, because those other people don’t have COVID. Most people with COVID die alone.”
Doctors and nurses are the easiest to find. “If someone painted at the nursing home laundry branch, the family circle wouldn’t wear it,” Rebza said. However, it is non-medical personnel who feel a special legal responsibility to warn: hospitality coordinators and home technicians, food service managers 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 at a nursing home or specific rehabilitation center have died, not to mention their names, and Rezba feels that rabies begins to bubble. “These are other people who earn $12 an hour. And they are treated as 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 searching 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 between 30 and 40 who seem to have the virus yet and who die suddenly. . Center for attacks or strokes 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 are read as poetry; sometimes, like a howl.
He liked to dance at home with Bruno Mars, the movements became wilder as his circle of relatives laughed.
When I was a kid, she wrapped her clothes with Dove soap to make them smell like America.
This deficient baby has his mom 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 policy makers could be informed of if they had a more complete knowledge of fitness personnel in the United States. cities, where more than 10,000 doctors, matrix 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 monitor 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 the reports of others 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 just do a very clever epidemiology of leather shoes … You can just say, “Wait a second. This hospital has 12 deaths among physical health workers. The hospital on the other side of town doesn’t have it. 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 attention? Does the disproportionate decline in certain categories of staff – for example, registered doctors versus nurses versus nursing assistants – have an effect on certain types of facilities, or in certain parts of the country? communities of color income more likely to get sick?
“If we don’t pay attention to those problems, everyone will be at a disadvantage,” Wingfield said. “It’s hard to identify disorders or find answers without the data.” The answers are mainly found in black and Latino communities with the highest rates of illness and death, and where fitness personnel 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 near-term consequences have also been enormous. The lack of public data about health care workers and deaths may have contributed to a dangerous complacency as infections have surged in the South and West, Friese said—for example, the idea that COVID-19 is no more dangerous than other common respiratory viruses. “I’ve been at this for 23 years. I’ve never seen so many health care workers stricken in my career. This whole idea that it’s just like the flu probably set us back quite a way.”
He sees similar misconceptions about the PPE: “If we had a greater understanding of the number of inflamed fitness workers, it could help our resolution managers recognize that the PPE remains insufficient and that they want to redouble their efforts. People keep getting into the trash bags. If we reuse N95 respirators, we won’t have solved the problem. And until we figure it out, we’ll continue to see the tragic effects we’re seeing.”
The misconceptions appeared to stretch to the highest reaches of the federal government, even as infections and deaths started surging again. At a White Houseevent in July focused on reopening schools in the fall, HHS secretary Alex Azar told the people gathered, “health care workers…don’t get infected because they take appropriate precautions.”
Even some medical staff members continued to refuse. 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. Until the Guardian/Kaiser Health News task “Lost on the Frontline,” news organizations and social media activists have wondered how to convey the scale of the tragedy when others are distracted through multiple crises that are causing the global and the general rituals of pain remedy are 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 who needs to show you an image of his son or pay attention to someone telling you who his mother or father was. There were no consequences. Have our political decisions seemed as if [the other people 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, and her respiratory symptoms persist for more than six weeks. She lived alone and chose not to go to the hospital, in component because she was afraid to infect others. “At this point [of the epidemic], I would have been piped, given hydroxychloroquine and azithromycin and probably killed.” As he continued his recovery, he wondered how the other doctors were like: “I couldn’t. He was the only doctor I knew who was sick.” But while searching online, “I didn’t discover any data. I just started to get really frustrated by the lack of data and the wrong data… And then I started thinking, well, what if I died here? ?
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 temporarily began publishing memorials on the page; As he became more than 4,800 members, Bial asked him to help him moderate it. Among the things shared by the two women is a determination to stick to the facts. “I didn’t need politics and I didn’t need it,” Bial said. “(Rezba) one hundred percent of the same opinion and trust”. She is also someone with whom Bial simply communicates, doctor in doctor, while recovering. “Not only were there 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 the New York-Presthroughterian hospital system, fighting the virus while wrapping Washington Heights. “It’s just … damning,” he recalls. “We intubate 20 patients a day. We had corridors full of COVID patients; there was nowhere to put them. In the area of a few brutal days at the end of April, three of Gilman’s colleagues, one of them by suicide, died.” he’s a colleague you care about and you know him as someone you’ve traveled with… man, it’s hard.”
While much of the media has focused on the dangers to elderly patients, Gilman has been surprised by the number of other seriously ill people in their twenties, thirties and forties. In mid-April, his own 27-year-old cousin, a gymnastics instructor at a charter school in New Jersey, died suddenly; He went to the emergency room twice with chest pains, but 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 vitally important 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 into the kind of gallery he knew with an emotional blow. Then he went further, making photographs and obituaries, more than 1,000 other people, sorted by 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 most openly political assignments is Marked through COVID, modeled through Kristin Urquiza after her father, Mark, after her “honest obituary” of him 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’s been going on lately with COVID are just mind-boggling [in terms] of 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 come forward and share their stories” and the COVID-19 edition of the anti-AIDS organization Act Up.
They also increase GoFundMe’s budget 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 is preventable; 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 stack of dozens of articles to publish, and the death toll continued to rise.
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You just sent an amazing message: that quality journalism doesn’t have to respond to advertisers, billionaires or hedge funds; that the editors can basically thank the generosity of their readers. It is very powerful Especially in what has been called a “media extinction event”, when those seeking to benefit from the news withdraw, the Mother Jones network intervenes.
The months and years to come won’t be easy. Away from there. But there is no one with whom we would rather face the wonderful and demanding situations that you, our committed and passionate readers, and our team of intrepid hounds who come forward every day.
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