For a variety of reasons, even faced with the staggering figures – more than 280,000 people dead from COVID-19 and 200,000 more infected daily as the nation approaches 15 million cases since the pandemic started – many seem unconcerned.
Misinformation, lack of a coherent national response, refusal to believe the warnings of experts and downright arrogance have resulted in people refusing to wear face coverings, crowding bars and restaurants and going about their lives without regard for the health of themselves or others.
It bewilders Brookfield resident Melissa Litwin, who since March has seen a procession of the doomed wheeled through the doors of the intensive care unit at MacNeal Hospital in Berwyn, where she has worked as a nurse for the past 22 years.
“I feel betrayed by society,” Litwin said in a recent interview with the Landmark. “I feel people’s biggest concern is what restaurants are staying open that they can go eat in. It’s so frustrating. They just don’t get it.”
MacNeal Hospital’s intensive care unit has 17 beds. During her years working there, Litwin has seen the full spectrum of patients, many of them seriously ill.
Death is a fact of life in intensive care units across the county, but now the ICU at MacNeal is often at capacity, almost exclusively with people suffering desperately from COVID-19.
“By the time you get to me in the ICU, we’re the end of the line,” Litwin said. “I’ve never seen so much death. I know in the ICU there is a lot of death, but not like there has been. This isn’t normal. Our patients do recover, they do live.
“Every patient, it feels futile.”
Litwin, a single mother of a 12-year-old daughter, started working at MacNeal Hospital in 1992 as a medical assistant in a pediatric physician’s office. While a nursing student at Morton College, she transferred into the hospital proper as a patient care tech in the nursery of the mother/baby unit.
Upon earning her RN in 1998, Litwin moved into the ICU. Since then, she’s received her bachelor’s degree in nursing and recently was licensed as a nurse practitioner.
“Pre-2020 I loved working in the ICU,” Litwin said. “We had a variety of patients, a variety of illnesses. We even did open heart surgery, took care of post-op open heart patients and just regular ICU patients. Critical, but not as critical as they are now.”
Making matters more challenging, particularly during the first weeks of the pandemic, was a sudden and large scale turnover in ICU nursing staff. Some nurses left because they feared the danger of working directly with COVID-19 patients, while others left because ICU nurses suddenly were in critical demand.
“People took the opportunity to take agency travel assignments and make a lot of money and crisis pay that you generally can’t get as a staff nurse,” Litwin said.
All but one of the night shift nurses left, according to Litwin, while just a handful of her day shift colleagues remained. Many hospitals around the nation faced the same situation, she said, and responded by pulling nurses from other departments and by moving to a team system, which had mixed results.
“I would have four patients and a team of other nurses to help me,” Litwin said. “But these other nurses were pulled from other parts of the hospital. They weren’t ICU nurses, so they were scared. That’s when we lost a lot of nurses.”
While medical professionals have learned much more about COVID-19 and how to treat it, the recent spike in cases has meant ICU beds are at a premium. Litwin said that those who believe COVID-19 is primarily a disease that impacts the very elderly or those with underlying health problems are just wrong.
“I’ve taken care of so many patients who have had absolutely no risk factors,” Litwin said during a phone interview on Nov. 24. “I took care of a 30-year-old woman two weeks ago – I just can’t get her out of my head.
“We had to intubate her and she was begging, ‘Please don’t intubate me,’ so she knew. She had some knowledge that once you’re on that ventilator, your chances of survival are very low.
“And she kept saying, ‘I have three children.’ She just broke my heart. … When I met this woman in the morning she was just on oxygen with no IVs going in. By 6 p.m. at night she had 10 IV bags hanging. As of Nov. 24, the woman was still on a ventilator.
Because family members can’t visit those suffering from COVID-19, nurses have had to step in, providing comfort as well as care while also serving as the patient’s conduit to loved ones.
“We have iPads and we FaceTime with the family or Skype or Zoom and we have family in the room on FaceTime so they can see their loved one and what we were doing, hoping they would see we were doing everything we could do and the outcome is going to be the same no matter what,” Litwin said.
She described talking via FaceTime with the family of a patient who’d gone into cardiac arrest and was revived twice before the family decided to instruct staff to not intervene again.
“We stopped and he didn’t die right away, so I stayed there with him and held his hand and stroked his face and told the family, ‘I’m here with him, he’s not going to be alone,'” Litwin said. “And I have to hear the heart-wrenching, ‘Daddy, daddy we love you.’ It’s hard to not get emotional too. You try to separate yourself, but it’s so hard. We’re all exhausted, overwhelmed, frustrated.”
COVID-19 has also taken a close colleague, 48-year-old Neuman Kiamco, a nurse at MacNeal who contracted the disease and died after suffering more than a month.
Kiamco had come to work in June, saying he didn’t feel good but chalked it up to allergies. He never made it through the shift. After co-workers encouraged Kiamco to visit the emergency room, they learned his oxygen saturation level was about 70 percent.
“People come in walking and talking, and they’re oxygen level is so low and they don’t even know it,” Litwin said.
Kiamco died Aug. 30. Litwin and 100 others remembered him during a candlelight vigil held outside the hospital in September.
Litwin said hospital staff wear masks at all times inside the hospital and have stopped eating lunch together. Dressed for hours in full PPE, Litwin says she can feel where her respirator mask cuts into her skin days later.
“I go in the bathroom just to take breaks, because some of the transmission amongst employees has been through employees,” Litwin said. “Now, nobody takes their masks off ever [and] we’re eating lunch alone, because we just don’t want to give it to each other. Some people have been totally asymptomatic and have tested positive, and those are your superspreaders. So we’re extra cautious.”
Being exposed to COVID-19 patients constantly has taken a mental toll on her and her daughter, Litwin said. She goes very few places outside of work and the grocery store, where the sight of people wearing face coverings incorrectly is aggravating.
“I wear an N-95 when I go to the store, because I just don’t trust people,” she said. “There are too many people with their masks down below their noses. I’m not going to start fights with people in the grocery store about it, so I just protect myself.”
Sometimes the stress manifests itself suddenly and unexpectedly.
“Some days I think I’m going to have a good day, and as soon as I pull up to the street where the hospital is, there’s times where I just start crying,” Litwin said. “I can’t even help it and I didn’t even start my shift yet.
“When you’re done you just sit in your car and reflect, ‘What the hell just happened? What did I just experience?’ I’ve been an ICU nurse for 22 years, and I always think I’ve seen it all and it’s unbelievable.”