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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. Had his identity been hidden to protect his family’s privacy? Your employer’s reputation? Anaesthetist Claire Rezba, browsing the news on her phone, was horrified. “I felt that her sacrifice was wonderful and her son’s sacrifice was wonderful, and she was just that nameless woman, you know? He seemed very mundane. For days, Rezba clicked on Google, searching for a name, until late 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 here in 2016, when he led a team of 40 other people through 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 physical care 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, nursing assistants, emergency users, physiotherapists, paramedics. “It was annoying, ” said Rezba. “I mean, I’m just a user who uses Google and I’ve already counted over two hundred people and they say 27? It’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 you can do is 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.”
Since the onset of the pandemic, it has been transparent that physical care personnel face unique and extreme dangers 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 the numbers are almost a “blatant understatement,” said Kent Sepkowitz, an infectious disease specialist at The Memorial Sloan Kettering Cancer Center in New York, who has 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 Medicare 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, 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 illnesses of healthcare employees. . “Every employee we’ve lost this year is one less user than we have to take care of the ones we enjoy. In addition to the tragic loss of this user, we unnecessarily depleted our workforce while we had equipment at our disposal” due to illness or 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 know 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 remains the highest federal company to do so, in 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 professional prestige of almost 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.
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, “We haven’t talking about knowledge through the profession lately.” 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 fitness staff 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 introduced legal action to force a government investigation into 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.
“Governments’ inability to collect this data consistently” has been “outrageous,” the board’s 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 care workers… 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 his residency at VCU, his first rotation took a position in the neonatal intensive care unit. “There’s a little baby who helped me care for 3 weeks. And on the last day of this rotation, his parents withdrew care. Array… He was the first small user to declare dead. I went to cry on the stairs after this.” His next rotation in the burn unit and then in the emergency department. “It looked like death all over the post,” Rezba said. Testifying 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.”
She began to keep a list to deal with the pain. “At the residence, you record everything: the records of your case, the procedures you perform. It’s just a kind of natural moment signing their names.” Every time a patient died, she would make another access in her pocket and then “persevere somehow” – ruminating – “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 let him go.”
A decade later, Rezba was working full time as an anesthesiologist and raising three small children, her list-compiling days long past her, she thought. Then COVID-19 hit. The onetime infectious disease geek became obsessed with the videos leaking out of China — the teams of health care workers in full protective gear, the makeshift wards in tents, the ERs in chaos: “I knew early on that this was going to be a big problem.” In her job, Rezba was often called upon to do intubations. “The possibility of not having enough PPE caused a lot of anxiety for her,” said her husband, Tejas Patel, whom she met in medical school. “She would be the one, if we did hit that level of New York, who could potentially be at risk and bring it home to the kids.”
As it turned out, Rezba’s hospital wasn’t inundated, nor did it experience the PPE shortages that plagued many health care facilities. But her anxiety didn’t disappear; it just took a new shape. If health care workers were front-line heroes, she decided, her role was to search the trenches for the bodies left behind.
Rezba is the first to admit that he is not smart 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 discovered that I 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 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 further, because they didn’t have COVID. Most 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 a special legal responsibility to note: hospitality coordinators and home technicians, food service personnel 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 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 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 photos 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 would wrap her clothes around Dove soap so they would 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 results: running in a room designated for COVID-19 did not put staff at greater risk 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 protect their workers.
Imagine all of the opportunities it would present if everyone could see the full landscape, said Ivan Oransky, vice president for editorial content at Medscape, where a memorial page to honor global front liners has been one of the site’s best-read features. “You could be doing some real great shoe-leather epidemiology. … You could go: ‘Wait a second. That hospital has 12 fatalities among health care workers. The hospital across town has none. That can’t be pure coincidence. What did this one, frankly, do wrong, and what’s the other one 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 of a disproportionate drop in certain categories of staff, for example, registered doctors versus nurses versus nursing assistants, in certain types of facilities or in certain parts of the country? Are providers who serve low-income communities more likely to get sick?
“If we don’t pay attention to those disorders, it puts everyone 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 in this business for 23 years. I had never realized that so many health care personnel had been 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 resolution managers recognize that the PPE is still insufficient and that they want to redouble their efforts… People keep doing MacGyvers and open up. If we reuse N95 respirators, we won’t have solved the problem. And until that happens, we’ll continue to see the tragic effects we’re actually 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 Azar told those gathered: “Health workers … they don’t get inflamed because they take the right 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.”
Piercing that sense of invulnerability — making the enormity of the COVID-19 disaster seem real — isn’t only Rezba’s mission. From The New York Times’ iconic front page marking the first 100,000 American deaths to the Guardian/Kaiser Health News project “Lost on the Frontline,” news organizations and social media activists have grappled with how to convey the scale of the tragedy when people are distracted by multiple world-shattering crises and the normal rituals for processing grief are largely unavailable.
“The moment that 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 him an image of his child or pay attention to someone telling him who his mother or father was. There were no consequences. political decisions have been different if [the other people who make them] would 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.” 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 searching online, “I couldn’t locate any data. I started to be really frustrated by the lack of misremeas. Arrangement… And then I started thinking, well, what happens if I die here? Nobody knows? “
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. Array”
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 like-minded and trustworthy.” 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.” is a colleague you care about and you know him as a user you’ve traveled with Array… 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 said. “When someone says, “Oh, other people don’t die, they’re not so [young], “you can temporarily come back with genuine names, genuine articles. It’s more powerful. You have your 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 recklessness of politicians who underestimate health care personnel for lack of leadership, refusal to recognize the severity of this crisis, and 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 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.
Ryann Grochowski Jones and Hannah Fresques contributed to the report.
ProPublica © 2020
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