The 80-year-old African-American man on a ventilator with coronavirus I told you about last week is still alive. He’s had a rough time of it, though, with a secondary bacterial infection. And I’d give him about a 50 percent chance of weaning off the machine.
His daughter is beside herself with guilt for having brought the virus back from Italy. It’s hard to reassure her over the phone. Relatives are now forbidden to visit. She shouldn’t blame herself, but she does. I almost added “of course.”
Coming into the hospital in the morning, we have our temperatures taken. If it’s normal, we get a wristband. As soon as we cross the threshold, we put on surgical masks, which we keep on at all times.
By the time you reach the I.C.U., everyone is in scrubs. Personalized N95 masks are no longer kept in brown paper bags. They are thrown away safely and incinerated. We are running out of N95 masks. A national shortage.
Coronavirus-pneumonia patients are on ventilators in 8 out of our 16 I.C.U. beds, and there are about 20 with the virus in the hospital altogether. This is nothing compared with what my sister, also a physician, calls “the carnage” down in New York City. But we are learning. This is not the flu.
What is the coronavirus? It is a scrap of ribonucleic acid in a protein coat with spikes sticking out of it. It is smaller than a wavelength of light. And yet it moves fast. From bats to pangolins, it is thought, to a human at a wet-meat market in Wuhan, China. It then hitched a ride on other humans, via plane, to the four corners of the earth. And Poughkeepsie.
We have come to understand earthquakes and tsunamis. Asteroids crashing into earth, we get it. But this? Smaller than a wavelength of light? Wouldn’t you rather wrestle with a feral cat?
Why does it seek to wreak such malevolence? Well, that’s just it; it doesn’t seek to wreak anything. It is simply a collection of molecules that know how to get into our cells, know how to replicate very efficiently once there, and know how to infect our fellow Homo sapiens.
But even that conception is also completely wrong. They don’t know anything. They simply act and interact in a certain albeit random and valueless way that nevertheless leads to our infection and, sometimes, death.
Do you see how difficult it is to talk about these little stinkers without projecting animal qualities onto them? I just did it again. They don’t even qualify as being alive.
His daughter is beside herself with guilt for having brought the virus back from Italy. She shouldn’t blame herself, but she does.
We lost our first patient to the virus. He had emigrated from Ireland at 16, and ran a restaurant in Kingston, New York, with his three sons. He was 48. He had not knowingly been in contact with an infected person and in fact hadn’t been out of the country in six years—or even to New York City. He had what’s known as a community-acquired infection. In other words, out of nowhere.
He had a particularly high fever from the start. “Cytokine storm,” said Janet the intensivist. “ARDS, acute-respiratory-distress syndrome. We gave him hydroxychloroquine, azithromycin, zinc, vitamin D, vitamin C. We gave him a broad spectrum of antibiotics for a probable superadded infection.”
She pauses, then returns to quizzing a couple of residents outside of a patient’s room on how to manage ventilated patients.
There are about 14 staff members in the unit; Stan the nurse and I are the only males. Betty the cleaner is swabbing out a recently emptied room. We call the ward clerk Rosie the Riveter.
The nurses go about their business with their customary effortless—or apparently effortless—heroism. “When I get home, I undress in the garage,” Nurse Mulligan says. “My husband leaves a dressing gown and some slippers for me. And when I come into the house, everyone else goes into the front room. We communicate by phone. I walk along the corridor to throw my clothes into the washing machine and turn it on. I walk upstairs. I shower. Oh, the shower! I love the shower! Then I dress. I bring the dressing gown back downstairs and throw it in the washing machine. And then—only then—the gin-and-tonic.”
So far none of our staff has acquired the illness. Asymptomatic infection is another question.
Janet is on the phone again. “Two? You have two P.U.I.’s in the E.R.?” A P.U.I. is a Person Under Investigation for the coronavirus. “I’m coming down to take a look at them.”
John Froude is the author of the forthcoming book Ten Plagues