There are no beds left, warn doctors at the coalface

TALI FEINBERG

Rose, a doctor working at a state hospital, is just one of a number of people at the coalface of COVID-19 who have taken to social media to paint the real picture of the horror of the virus. They are doing so to warn people to stop taking risks.

In some cases, family members have written about what those closest to them are experiencing. In a post that has also gone viral, Aharon Chemel described how his wife Talya (Tali) Chemel, a Hatzolah dispatcher this past Saturday, 27 June, “spent her whole Shabbat dealing with emergencies and COVID-19 related issues”.

It’s clear that the virus has entered the homes of the community, and that emergency care is needed around the clock. “They are out there taking care of the elderly and the sick,” said Chemel. “They do it at 02:00, 03:00, 04:00, 05:00 while travelling around Joburg in the freezing cold. At 08:00, after no sleep, they continue. They spent their entire Shabbat treating patients and saving lives.

“Not to mention the endless hours they put in, every single day, phoning everyone in the community to make sure their fevers aren’t too high and their breaths aren’t too short.”

Meanwhile, in a post on 28 June that has also gone viral, Rabbi Yossi Chaikin described the heart wrenching moment of losing a congregant. “Last night, I cried. Right after Shabbat, when I heard the devastating news that Oxford [Shul] had lost a beloved congregant to COVID-19.

“There was the huge loss of a very dear person, a regular Shabbat congregant at the shul, and a personal friend. M. was regal, and she commanded the weekly brocha from her corner table like a queen. She is going to be so sorely missed.

“Until a week ago, COVID-19 seemed far away. Over the past week, I started hearing the names of people I knew, and at least one person I work with [remotely]. But it still felt remote and surreal. Nobody I knew of in my congregation had succumbed to the dreaded disease, or even tested positive. Last night, it hit at the heart of the Oxford synagogue community.”

Rose said that if any of these community members landed up in hospital, they might find that there isn’t be a bed, even if they are on medical aid.

“There are no ICU beds left. Medical aid payments don’t equate to a reserved bed for you or your dependents. There are NO beds left,” he wrote on 28 June.

“We have a waiting list for patients who qualify and need ICU care – there aren’t enough beds, or ICU trained staff [doctors or nursing staff] which means there are NO BEDS LEFT. People are DYING on our waiting list,” he wrote.

He said his message was from “a concerned healthcare worker who is literally begging you to minimise your risk of infection”.

He described what happens when a person gets the virus, and has to go to hospital. “You’ll be put on oxygen, [given] prescriptions for a whole bunch of vitamins, steroids, immune modulators, and anticoagulants, and we pray it starts to help. You are breathing at a rate of 35 to 40 breaths per minute, for days on end. The normal breathing rate is 12 to 20 [breaths per minute]. Patients are telling us that they are tired of breathing!

“It’s at this point where we scurry to intubate you [insert a tube into the trachea for ventilation]. High flow nasal oxygen forces in heated, humidified air at a rate of 60l/minute, like air being forced in at the rate of air coming out of your nose when you sneeze. All this while you are on your stomach to try and improve ventilation to the basal areas of your lungs.

“Now we prepare everything for the intubation, for the invasive lines, and basically to take control over every bodily function we can. We turn you on your back. Your effort of breathing becomes infinitely harder. We put up a central line and an arterial line, which is excruciating. Now we are ‘ready’ to intubate.

“We give a drug to sedate, followed immediately by a muscle relaxant. You are still somewhat aware [awake], and now we have paralysed you. We try to intubate and in the process, your saturations deteriorate to 40%, some even as low as single digits. The tube is in, and your heart slows down. Now we have to give you adrenaline to try and stop you from having an arrest because if you have a cardiac arrest, you will die.

“Let’s say you don’t crash, the adrenaline works, and you are now intubated. We ram air into your lungs at pressures so high it could cause a pneumothorax [collapsed lung]. We then place a tube in your nose and try and feed it into your stomach so we can feed you. Often it fails, we inadvertently cause trauma to your nasal passages, and we have to try the other nostril.

“Now we try and ventilate you while you are on your back. When that all fails, we prone you – six people have to disconnect everything but your ventilator, and turn you onto your stomach with pillows under your chest and pelvis and try to ventilate. Now on your stomach, you develop pressure sores. Your face and your eyes swell. And this is all in an attempt to save your life.

“We are not treating COVID-19. There is no treatment. We are at best modulating the immune response. We are literally supporting organs. We are trying to stop your body from attacking itself,” he said.

“These messages serve to inform you all of the possible outcome of infection, so that every choice you make from here on out is an informed one. We need you to help us, help your family. Because as it stands, we have no space to help, and this is only the beginning.”