Jean Joseph’s patient is struggling against him.
The respiratory therapist is in one of 19 small rooms ringing Roseland Community Hospital’s busy emergency department, each occupied by a COVID case, each room’s air negative-pressurized to keep droplets of infection from wafting back into the ER. Joseph is trying to draw blood from the man’s right wrist to get a reading of oxygen and carbon dioxide levels.
But the 79-year old twists and writhes.
“He was fighting with me,” said Joseph, coming out, peeling off a yellow plastic protective gown. “When you get COVID, you cannot function. The carbon dioxide makes you lethargic and confused.”
“Cannot function,” “lethargic” and “confused” are apt terms to describe our national response to COVID, a roiling, contradictory crisis: medical disaster intermixed with scientific triumph. The selfless, exhausted labors of skilled doctors and nurses here, butting up against selfish, stubborn public resistance and ignorance there. A roller coaster disaster of peaks and valleys, with no end in sight as our nation finishes its second year fighting COVID-19.
The first case in the United States of what the World Health Organization dubbed 2019-nCoV, for “2019 novel coronavirus” was diagnosed Jan. 20, 2020.
The arrival of vaccines one year ago offered the promise of getting the pandemic under control. Then last month, the highly contagious Omicron variant jammed hospitals coast to coast.
“It’s getting worse,” said Joseph, comparing the start of 2022 to last year’s peak. “Because we have more COVID now.”
Roseland Community Hospital is a reminder that not every hospital is a sprawling, flush medical center like Northwestern or Rush. At 125 beds, it is neither big nor wealthy. The Far South Side hospital’s facilities have been described as “no better than those in Third World countries” without argument from hospital administrators.
And while there has been improvement since then, put it this way: There is no self-playing grand piano in its lobby off West 111th Street — in fact, there’s no lobby at all; that was curtained off last year and given over to COVID testing and vaccine injection. Recently, the line to be tested stretched out the door, around the corner, down the block, all the way to Wentworth Avenue.
The building is 96 years old. On a Wednesday at mid-morning, the emergency room waiting area is filled with slumped figures, one whose head is covered in a sheet, like a ghost, another whose sweatpants are stained in blood.
In September, there were about 21 COVID patients at Roseland every day; now that’s up to an average of 70 — half of new admissions are infected with it. Masks are handed out, but not everyone complies.
“Pull your mask up, sir!” commanded Marcus Hines, a public safety staffer at Roseland standing point by the door.
Inside, the emergency department is crowded, hectic and occasionally loud.
“I wanna go home, I been here two days, I’m just sittin’ here,” Connie Edwards, 75, called out to no one in particular. She arrived at 7 p.m. the night before with a swollen leg due to complications from diabetes.
The rise in COVID cases means that often patients suffering from other ailments get crowded out. Now it’s nearly 11 a.m. She is one of eight patients who, with no open rooms to go to, are parked along the square central ER nursing station in hospital beds and wheelchairs. One is in an office chair.
“I wanna go home, I can’t get out of the hospital. I can’t get a cab,” Edwards complained.
It turns out, she has already been treated and checked out. A reminder that places such as Roseland, where 90% of the patients have no private health insurance, medical care is only the beginning, coupled with social service and a degree of gentle counseling. More than a third of the residents in the community surrounding Roseland live in poverty. A quarter are unemployed. Infant mortality here is 50% higher than Chicago overall.
Which only adds to layers of stress. Roseland, like most hospitals, has a hard time keeping its employees.
“We’re short-staffed,” said chief medical officer Dr. Khurram Khan. “People are exhausted.”
The problem isn’t just burnout but also those who seek the higher pay of temporary medical staffing agencies. Nurses can leave and double their salaries.
“Lots of staffers have left for greener pastures and more pay,” Khan said. “All our nurses are agency nurses; the state nurses, overnight, decided not to come.”
Agencies that charge $250 an hour to parachute nurses into a hospital, fees that slam a place like Roseland extra hard.
“There’s price-gouging going on statewide,” Khan said. Late last year, legislators and hospital association officials were urging the White House to investigate skyrocketing agency fees nationwide.
While staffing is the “key problem,” there also the need to have enough complicated equipment and keep it running, which Roseland could barely afford to do even before COVID-19. Now it is scrambling to retrofit the hospital to cope with a years-long contagious epidemic.
“The ICU is filled,” Khan said. The intensive care unit is also jury rigged — for instance, some bays COVID-19 patients are in lack doors, so barriers were set up using ZipWall, which is primarily used to contain construction dust. The plan is to eventually build actual walls.
It has been reported that the Omicron variant, while more easily spread, is milder. But that is deceptive in two ways. First, because patients don’t die as fast from Omicron, they don’t turn over their beds to new patients, which contributes to packed hospitals across the country.
“Not as many people dying as before,” said Shanta Craig, manager of Roseland’s emergency department. “People are coming in, getting IV antibiotics. In the beginning, when this was new, we all really didn’t know. Now we know what we’re fighting, and once you figure out what you’re fighting, you can hit the monster head on.”
And second, though milder, Omicron’s jacked up contagiousness means it is more widespread. Not so terrible for the vaccinated and boosted, though there is a risk.
“The majority initially were not vaccinated, with most of the variants and Delta,” Khan said. “Now, 10 to 15% of the patients that are admitted COVID positive are vaccinated ,with the booster. The virus has mutated. “
As it does so, it becomes less dangerous — for most people.
“The virus is mutating so fast it’s losing its pathogenicity — how sick it can get people,” Khan said.
That’s good. Except when it isn’t. Those patients showing up at hospitals are just as sick with Omicron as patients were with Delta last year.
“Honestly, once you get that sick you need to be hospitalized, there is no variance between Omicron and Delta,” Khan said. “It’s really the same symptoms: mainly lack of oxygen and high fevers.”
The best news is found in the lobby, where the testing and vaccinating take place.
“I was exposed to it; my husband was sick with it,” said Kendra Beard, waiting to get her nostrils swabbed by medical assistant Tyla Wilson. “I just wanted to make sure I was OK.”
“Busier than ever,” Wilson said. “The kids gotta go back to school.”
Speaking of which, nearby, Aliyah Flowers, 18, got her third vaccine before she starts classes at Southern Illinois University, where she is a sophomore studying communications.
“Extra protection,” said Flowers, explaining why she’s here, even though her classmates tend not to take COVID-19 seriously. “Mainly for the protection of myself.”
One undeniable benefit of Omicron is that it drove others who had put off being vaccinated to finally break down and get the shot.
“People watching these new variants come out, are being more inclined to get the vaccination,” agency nurse Soretta Miller said. “They want to do their own research. They’re not sure. They’re seeing people get sick.”
(That said, you don’t have to be in a red state to be hostile toward the vaccine. “I don’t want them to know I’m vaccinated,” explained one patient, declining to have her picture taken.)
Lori Gross is the manager of Roseland’s COVID-19 testing and vaccination efforts — they’ve organized remote testing and vaccine sites at more than 100 churches and community centers.
“We’ve seen a high increase of children being vaccinated. Teenagers are drug in by their moms,” said Gross, noting that more than one teen, even after being forced to come in, has still refused the jab. “People are coming back for their boosters. The public is taking the boosters seriously. You no longer need two doses; you need three doses.”
Three years ago, Gross was a dental hygienist. Now she’s gone through training and is looking at a career providing coronavirus testing and vaccines.
“When I see the lines getting longer I generally come down and will roll my sleeves up and vaccinate.”
And what will she do when COVID-19 ends?
“I don’t think COVID will ever leave,” Gross said. “We’ll have waves.”