Infectious disease outbreaks are always a concern in hospitals.
They have exercises.
Protocols are in place.
There is a plan.
But preparing for a pandemic is difficult.
“I wouldn’t be telling the truth if I said I imagined this,” said Dr. James Keller, chief medical officer at Advocate Lutheran General Hospital in Park Ridge. “We’ve all been prepared for infectious disease outbreaks, and those were in place in terms of isolation and everything we do for transmitted respiratory viruses, but in terms of frustration and uncertainty, I don’t think not that many of us have considered that.”
Like many others, suburban doctors watched in late 2019 as a wave of disease swept the world, starting in China, then spreading across continents and countries until it landed in the United States in January 2020, killing 36,494 people in Illinois alone since then. Worldwide, more than 6.8 million people have died.
“I don’t think I personally understood how bad it would be until I saw what was happening in Italy and how devastating it was and how it took them by surprise,” said Dr Jonathan Pinsky , Medical Director of Infection Control and Prevention at Edward Hospital in Naperville. “So I knew it was going to be bad.”
As they watched the rest of the world’s healthcare workers battle the disease, doctors, nurses and local hospital officials acknowledged the effect it would have on the country’s healthcare system upon their arrival, but few people could imagine how the pandemic would reshape how Americans received medical treatment. Also.
“We knew it was a marathon,” said Dr. Tom Oryszczak, executive vice president and chief medical officer of Northwest Community Healthcare in Arlington Heights. “It was very disheartening to see the level of disease and the scale of the suffering and destruction of people and their families, but along the way you learn how to provide better care, and we learned collectively as as a group of health professionals across the country and around the world.”
Bend the curve
In an effort to minimize the effect of COVID-19 on state health care resources, Governor JB Pritzker issued a “stay-at-home order” that went into effect three years ago on Tuesday. The order was intended to slow the spread of the virus so that hospitals are not overrun with infections.
But hospitals also faced another risk initially, as the number of sick people increased and accessibility to personal protective equipment such as gowns, masks and gloves decreased.
“We were lucky to have enough PPE and never run out, but there was also an outpouring of generosity from the community,” Pinsky recalls. “There was a seamstress in town who made hospital gowns for us. Luckily our worry about running out of PPE was short-lived.”
The state would spend millions of dollars at inflated costs to secure medical supplies for other hospitals and health care facilities during the first months of the pandemic.
The state also spent millions to redevelop Chicago’s McCormick Center as a makeshift hospital for less seriously ill COVID-19 patients, but it became largely useless and was dismantled a few months later.
Today, several suburban hospital officials are reporting that PPE supplies are more in excess now than before the pandemic, for fear of being shorthanded again.
“Equipment and supplies were used up at such a rapid and intense level in the beginning, and that’s what caused the shortage,” Keller recalls.
Store shelves and many households remain stocked with testing kits, masks and other items that were once essential for getting out at the height of the pandemic.
“There’s less stigma about wearing a mask to keep others safe,” Keller said. “I think it’s here to stay, where someone with a scratchy throat will mask up in public for the safety of others.”
At its peak during the initial wave, hospitals in Illinois were treating more than 5,000 COVID-19 patients a day by the end of April. Nearly a quarter of them are believed to be in intensive care beds requiring individual nursing care, according to Illinois Department of Public Health records.
Illinois recorded its first death from COVID-19 on March 17, 2020. In just one month, another 1,133 people statewide would die from the disease. As of mid-May, IDPH records show the state was averaging nearly 120 deaths a day from COVID-19.
weather the storm
Initially, there was not much to do for those who needed to be hospitalized due to COVID-19.
“A lot of the care we provided in those early months was supportive,” Keller said. “When the therapeutic was identified, it changed the course.”
Remdesivir was the first antiviral drug to be deployed in the fight against COVID-19 infection. The drug’s effectiveness is still somewhat disputed, but most frontline doctors believe it has benefited many patients.
“Remdesivir was a game changer,” Pinsky said.
Eventually, monoclonal antibodies were also developed to help combat the severity of symptoms of infection, while today a five-day course of the antiviral drug Paxlovid is widely used to ward off symptoms of COVID-19. .
A change in weather combined with state-mandated mitigation efforts also helped reduce patient numbers at hospitals across the state in the spring of 2020. Children were still locked out of school, while many sports and other extracurricular activities were also interrupted. Many workers who could work from home were still doing so before the summer.
Doctors have reported that patients who had postponed visits for other medical issues for fear of contracting COVID-19 were seeking help. To allay these concerns, most physicians have turned to telehealth. Virtual doctor visits by phone or computer have exploded.
“If there was a silver lining to all of this, it was the advancement of telehealth,” Keller said. “We had tried it and we kind of knew it could be important, how it would increase access to health care for certain populations and could speed up interventions. I think it’s something that will be with us for a long time. .”
And more help was on the way.
In November, a partnership between drugmakers Pfizer and BioNTech produced a COVID-19 vaccine that showed 95% efficacy. By mid-December, the vaccine was delivered to every state and deployed to those most at risk. Moderna and Johnson & Johnson have also produced vaccines.
This was less than a year after the virus was first detected in the United States.
“The speed at which these have been developed is unprecedented,” Oryszczak said. “It was really amazing.”
But it wasn’t early enough to avoid a second push.
In November, cases spiked again, with hospitals treating more than 6,000 COVID-19 patients a day across the state.
In December 2020 alone, 4,237 deaths from COVID-19 would be recorded in Illinois, the most of any month for the duration of the pandemic.
As mitigation measures eased and eventually ended, COVID-19 hospitalizations fluctuated through much of 2021.
People traveled hundreds of miles for vaccination appointments, but doctors said they saw the effects of those vaccinations in patients.
“Vaccines were day and night,” Pinsky said. “That’s when we saw a change. Bam.”
Most serious cases, he said, were in unvaccinated or immunocompromised middle-aged people.
COVID long-haul has entered the lexicon.
A significant portion of the infected population reported symptoms long after they stopped testing positive for the infection. Brain fog, loss of taste and smell, exhaustion and persistent cough were among the most common symptoms. But not all patients present the same, the doctors explained. And many have never been hospitalized because of the infection.
Northwestern Medicine has opened its Comprehensive COVID-19 Center to treat and study long-haul.
“I think what makes this a very, very difficult problem to solve is because your group is not uniform,” said Dr. Marc Sala, co-director of the center and assistant professor of pulmonology and critical care. . “What I see now is that even though the number of people who refer to our clinic is about the same, the reason why I see them has changed.”
A study conducted by the center showed that the majority of long-haul patients were women.
“There’s a lot of speculation about why women and women turn to people who have long COVID,” Sala said. “But when you look at most, but not all, autoimmune diseases, they tend to affect women more than men.”
More transmissible variants of the original strain also became a problem, first with delta and then omicron in 2022. Omicron also tended to dodge vaccine efficacy, and a specialized booster dose was created in the year last to combat new strains.
What these new versions of COVID-19 were not, however, was more dangerous.
“After the winter of 2021-2022, there was a sense of relief because we weren’t seeing such severe infections,” Pinsky reported.
In fact, IDPH figures show that while hospitalizations due to COVID-19 infections reached an all-time high of more than 7,300 per day in January 2022, only around 15% of those who needed care beds intensive at the height of the outbreak.
Health experts will note that the pandemic is not over and COVID-19 remains a threat. But thanks to vaccination or natural immunity, the virus is not causing the kind of havoc it had in previous years.
This winter, hospitalizations related to COVID-19 have never exceeded 2,000 patients. Currently, fewer than 900 are hospitalized statewide with COVID-19, and only 13% are in intensive care beds.
Most doctors agree that while the healthcare industry has been battered during the pandemic, there have also been significant triumphs.
“If you look at what healthcare workers and industry have done during the height of the pressures of the pandemic, there is something to be proud of for the work that has been done,” Oryszczak said. “I understand that I have a biased opinion on this, but I am very proud of the healthcare community and how we have adapted to the challenge of the pandemic.”