One I.C.U., Five Patients: A Different View of the Virus’s Toll

One I.C.U., Five Patients: A Different View of the Virus’s Toll

Times Insider explains who we are and what we do, and delivers behind-the-scenes insights into how our journalism comes together.A hospital is an invaluable vantage point from which to understand an epidemic. It provides a glimpse of the severity of an illness in a geographic area, a sense of whether cases are going up or down, insights on which segments of the population are most affected and clues to how well the health care infrastructure is holding up.Soon after coronavirus cases began emerging in the United States, my editor, Rebecca Corbett, suggested reporting from within a hospital, to bring to bear my training as a physician and my prior work as a reporter on infectious disease outbreaks. After focusing initially on the crisis in New York City hospitals, I went this summer to report on a surge of cases in Texas at Houston Methodist Hospital, having spent time there in the aftermath of Hurricane Harvey in 2017. Officials there had agreed to give me, as well as my colleagues from the photography and video departments, exclusive access in the hospital, working with us to seek permission from patients we sought to interview.We also came to know many staff members. Near the end of one reporting day, Lluvialy Faz, a nurse in a coronavirus intensive care unit, talked about having been assigned only Hispanic patients for weeks.“They look like my aunt, they look like my sister, they look like my mom,” said Ms. Faz, who is Mexican-American.For Emily Rhyne, a Times cinematographer, that comment, and the fact that a majority of patients in that unit were Hispanic, “set off a light bulb” that led to our multimedia project on the impact of the virus on Houston’s Latino communities, told through the stories of five patients along a single hallway in the I.C.U. Instead of producing narrated videos, which we had been doing, for this story we would integrate video, photos, words and graphics built around the voices of patients, families and medical providers. “There is no sugarcoating the toll that this disease can take on the body, and I wanted to juxtapose this intensity with the softness with which their loved ones described them,” Ms. Rhyne wrote when I asked her to describe her vision for the project. “Some of the visuals aren’t easy to look at, and they shouldn’t be. Capturing this reality while retaining the person’s dignity was imperative. Photographer Erin Schaff and I were constantly discussing this.”One of my favorite parts of both working at The Times and reading The Times is the way that stories are now told across a range of modalities — words, photographs, videos, audio and graphics — each with its own strengths in conveying the realities of our world. Our team in Houston comprised me, the word person; Ms. Schaff, a staff photographer who had been my partner in reporting on the public hospital system in New York City; and Ms. Rhyne, who had done compelling work covering another New York hospital. Our perspectives, and those of numerous editors, producers and members of our video, photography, investigations, graphics and art departments (Sameen Amin, Solana Pyne, Emma Cott, Lanie Shapiro, Beth Flynn, Gray Beltran, Rumsey Taylor and Juliette Love, among others), came together to shape the project.We knew the statistics — Hispanic communities had been disproportionately affected by the health crisis. But standing in that I.C.U. hallway with the patients around us in room after room, their lives in the balance, made it much more real.The Coronavirus Outbreak ›Frequently Asked QuestionsUpdated August 12, 2020Can I travel within the United States?Many states have travel restrictions, and lots of them are taking active measures to enforce those restrictions, like issuing fines or asking visitors to quarantine for 14 days. Here’s an ever-updating list of statewide restrictions. In general, travel does increase your chance of getting and spreading the virus, as you are bound to encounter more people than if you remained at your house in your own “pod.” “Staying home is the best way to protect yourself and others from Covid-19,” the C.D.C. says. If you do travel, though, take precautions. If you can, drive. If you have to fly, be careful about picking your airline. But know that airlines are taking real steps to keep planes clean and limit your risk.I have antibodies. Am I now immune?As of right now, that seems likely, for at least several months. There have been frightening accounts of people suffering what seems to be a second bout of Covid-19. But experts say these patients may have a drawn-out course of infection, with the virus taking a slow toll weeks to months after initial exposure. People infected with the coronavirus typically produce immune molecules called antibodies, which are protective proteins made in response to an infection. These antibodies may last in the body only two to three months, which may seem worrisome, but that’s perfectly normal after an acute infection subsides, said Dr. Michael Mina, an immunologist at Harvard University. It may be possible to get the coronavirus again, but it’s highly unlikely that it would be possible in a short window of time from initial infection or make people sicker the second time.I’m a small-business owner. Can I get relief?The stimulus bills enacted in March offer help for the millions of American small businesses. Those eligible for aid are businesses and nonprofit organizations with fewer than 500 workers, including sole proprietorships, independent contractors and freelancers. Some larger companies in some industries are also eligible. The help being offered, which is being managed by the Small Business Administration, includes the Paycheck Protection Program and the Economic Injury Disaster Loan program. But lots of folks have not yet seen payouts. Even those who have received help are confused: The rules are draconian, and some are stuck sitting on money they don’t know how to use. Many small-business owners are getting less than they expected or not hearing anything at all.What are my rights if I am worried about going back to work?What is school going to look like in September?It is unlikely that many schools will return to a normal schedule this fall, requiring the grind of online learning, makeshift child care and stunted workdays to continue. California’s two largest public school districts — Los Angeles and San Diego — said on July 13, that instruction will be remote-only in the fall, citing concerns that surging coronavirus infections in their areas pose too dire a risk for students and teachers. Together, the two districts enroll some 825,000 students. They are the largest in the country so far to abandon plans for even a partial physical return to classrooms when they reopen in August. For other districts, the solution won’t be an all-or-nothing approach. Many systems, including the nation’s largest, New York City, are devising hybrid plans that involve spending some days in classrooms and other days online. There’s no national policy on this yet, so check with your municipal school system regularly to see what is happening in your community.Ms. Rhyne and Ms. Schaff spent long days filming and photographing the patients, families and members of the hospital’s staff. Ms. Cott, a senior video journalist, spoke with some of the families remotely. And I also spent days reporting in the I.C.U., visited with some of the families, worked with the hospital’s data specialists and stayed in touch with the medical teams and patients after we left to keep up with their conditions. Although we were in Houston for over three weeks as we reported this and other stories, it took many more weeks to assemble all the pieces.It was striking “how crushingly hard and scary it is for families not to be able to be with their loved ones in the hospital” because of coronavirus restrictions, Ms. Schaff reflected. She added that it was especially meaningful to document the moments when one patient, Ana Flores, had a video call with her husband, Domingo, and her daughters for the first time after she came off a ventilator. Our team had been present for similar virtual visits when she was unconscious and her outcome was unclear.One thing that will stick with me is the bravery of I.C.U. staff members. They treated more severely ill patients at the same time than they ever had in their careers, all while putting their own safety on the line. They still showed up to work every day with hope and determination, even if they sometimes shed tears.For Ms. Rhyne, the entire reporting process “moved me at my core,” she wrote. “A brother pleading to God to save his brother, an indomitable grandmother fighting for her life.” Speaking with families, she said, “painted a fuller picture of what we stood to lose from the virus.”

Via Source link