What’s worse than fighting for your life against COVID-19 in a hospital?
Fighting that battle at home.
With the infection curve finally flattening, for now, and what attention is being paid to the sick concentrated on those in hospitals, it’s easy to forget: people with no insurance, or who are undocumented and fear entering the system, or just don’t know to seek care, are sick at home.
Not many, relatively. According to the Illinois Department of Public Health, only 4 percent of COVID-19 deaths in the state occur in private homes. Still, that’s some 200 deaths since February. Thousands more are being cared for, not by trained professionals, but family members.
They can’t be counted, but they can be helped.
For them, Francisca Garcia, a critical care nurse who heads the COVID unit at Holy Cross Hospital, has an important piece of advice: lay on your stomach.
“For the patients who are awake and alert and able to follow directions, we ask them to lay on their stomach,” she said. “Laying on their stomach helps with lung capacity, increases oxygenation. It’s almost a little mini-miracle when we have patients prone.”
She said this has become widespread practice.
“In the ICU, we’ve been doing this for many, many years. Patients with acute respiratory distress syndrome, an acute phase patients’ lungs go into when they’re very sick. We’ve been doing this for 25 years. With COVID, nurses and doctors and hospitals all over have started trying it.”
Also, she said, drink lots of water.
Garcia grew up in Little Village, and said immigrant communities can be both fertile ground for the pandemic to spread, and a population reluctant to seek professional medical care once it does.
“It’s a combination of living conditions, lack of health care, not cooperating with social distancing,” she said. “There are gatherings, and if one person has it, that’s it. Everybody can spread it. Hispanics have large families, so if one sibling visits an aunt, and one sibling is sick, it’s spreading it to the next family and the next family and the next family. Plus there are a lot of essential workers and cops.”
Rev. Gary Graf, pastor of San José Luis Sánchez del Río Parish, has dedicated most of his priestly vocation to migrant ministry. He agrees with Garcia, noting a bias against going to the hospital in some Latino communities.
“A lot of communication is: don’t go to hospitals. You’re going to go in, you’re not going to come out,” he said. “I’ve served the last 36 years, and for the undocumented, there’s a general ignorance what [they] have access to.”
Immigrants from Mexico and Central America are often used to a corrupt, cash-first system.
“They assume they’re not going to get it, they can’t afford it, or that eventually a bill is going to come and they’re not going to be able to pay it,” he said.
And yet ...
“They all know, when the rubber hits the road, in a life or death situation, they know their lives will be saved,” said Rev. Graf. “They’re grateful for that, and it’s one reason they risk their lives to come here. That’s different from the countries they come from, [where] if you don’t have the money up front, they’re doomed. When I was in Mexico, you got a gunshot wound, you’ve got to come up with the money before you go to the hospital or you’re going to bleed to death in the waiting room. Very often, they wait literally until they’re close to death. Then they’ll show up in the emergency room.”
Social distancing has indeed flattened the curve, and the death rate has gone down. That’s the good news. The bad news: COVID-19 is still out there, waiting, and if society goes back to old habits too soon, the numbers will climb again.
“It is horrifying,” said Garcia. “I’ve been a nurse 20 years, most of my career in critical care. The COVID is something we’ve never experienced. This is a beast nobody can control. This is not your normal strand of virus, not the common flu. I’ve helped people with H1N1. This is something far more aggressive and far more dangerous than anything I’ve ever seen. It affects everyone differently. The same strand in a household can affect everyone differently. Right now the Little Village community is greatly affected. I’d like to have the opportunity to spread the word, help people at home.”
She would like people to be aware of the illness, and to know the measures needed to avoid it must be taken seriously. Among some, there’s a temptation to pretend everything is back to normal; that’s a luxury unavailable to nurses at Holy Cross.
“I am holding these patients’ hands while they’re taking their last breaths. It’s very disheartening to see how this virus is destroying so many lives,” she said. “It’s stressful and scary. We’re just taking it day-by-day, standing strong, being there for each other. With COVID it is so scary. One second a patient is stable, the next minute we’re calling Code Blue and the patient is having a cardiac arrest.”
It’s easy now to get tired of safeguards and to start cutting corners.
“Especially with the nice weather,” she said. “Summer’s coming. It’s sad. We don’t know what long-term effects this virus is going to cause, what it’s going to do to your immune system. It’s very scary.”