Phil Drake, Great Falls Tribune Published 10:21 a.m. MT May 16, 2020 | Updated 11:34 a.m. MT May 16, 2020
Yellowstone County has reported two new COVID-19 cases, bringing the states total to 468, officials said Saturday.
The new cases involve a woman in her 70s and a male under 19, according to the states covid19.mt.gov website.
Coronavirus.(Photo: Claudia Saveedra and Getty Images)
The state reports that 431 of confirmed reports have recovered and 21 remain active. Three peopleremain hospitalized out of 63 hospitalizations. The state has reported 16 deaths from the respiratory illness.
The state said it has completed 26,091 tests, which is 673 more than Friday.
The state reported Saturday that Montana has had 468 confirmed cases of COVID-19. Of those, 431 have recovered and 21 are active.(Photo: COVID19.MT.GOV)
Cascade County, which at one time had 17 confirmed reports and two deaths, has one active case. Toole County, which has had 29 reports and six deaths, now has two active cases, the state reported.
Yellowstone County now has five active cases, Big Horn County has six active cases.
Four confirmed cases of COVID-19 were reported Friday in Big Horn County. The Crow Tribe Incident Response Center posted on its Facebook page early Friday that seven of 44 COVID-19 tests by Indian Health Service have been positive, with one case pending.They note there havebeen eight confirmed cases in Big Horn County.
The Crow Indian Reservationhas extended its stay-at-home order, which was to expire May 14, until June 15 to curtail the spread of COVID-19 and has received more than $25 million in coronavirus relief aid.
Also on Friday, Gov. Steve Bullock visited a drive-thru testing site at the Fort Belknap Agency. That testing was to continue Saturday.
Elsewhere in the state, gyms, movie theaters and museums reopened Friday under Bullocksphased plan.Like restaurants and other businesses that were previously allowed to open under the phased reopening, gyms, theaters and museums will have to limit capacity, enforce social distancing and adhere to sanitation requirements.
Bullock on Wednesday said it was premature to make budget cuts and described Montanas fiscal condition as historically strong heading into the COVID-19 pandemic. He said the state entered into Fiscal Year 2020 with an unobligated general fund ending balance of more than $360 million.
The Budget Office will know more about the budget picture when income tax revenues are received in July, he said.
Bullocksaid the state is not in a position to make unnecessary, across-the-board cuts to essential services ones that Montanans are relying on more than ever during this pandemic.
Bullocksaid Montana, like other states, is starting to see revenue declines and that the Budget Office and state agencies are taking steps to save on expenditures and offset revenue reductions.
The state Legislative Revenue Interim Committee, made up of six Republicans and six Democrats, is expected to review aproposed letterto the governor at its May 20 meeting. The draft askshim to reduce current state spending, saying it could ward off significant budget cuts in the 2021 legislative session.
Bullock saidhe is managing our state budget on the basis of data, informed projections and fact, not politics.
In terms of other help, the state website covidrelief.mt.govfeatures nine programs and $123 million inCoronavirus Aid, Relief, and Economic Security (CARES)Act funds to help Montanans with recovery.
Also, $10 million in CARES Act funding is now available to Montana child care providers to continue serving families with essential workers and helpwith efforts to reopen after closing due to COVID-19.
For more information, go tobestbeginnings.mt.gov.
Other than covid19.mt.gov, people can also visitwww.dphhs.mt.govfor updated health information.
For mental health support, the Warmline is available at 877-688-3377 ormontanawarmline.org.
Reporter Phil Drake is our eye on the state capitol. For tips, suggestions or comment, he can be reached at 406-231-9021 or pdrake@greatfallstribune.com. To support his work, subscribe today and get a special offer.
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Everlywell was one of the first startups to announce that it was working on a self-administered, at-home COVID-19 diagnostic kit, but it initially sought out to ship kits before regulators made clear that this was not in line with its guidelines. Everlywell then became intent on working with the FDA to secure a proper Emergency Use Authorization for its kits before sending any to consumers, and that approach has paid off with the U.S. drug regulator issuing an EUA for Everlywells tech today.
Everlywells COVID-19 Test Home Collection Kit is the first standalone sample collection kit to be granted a proper EUA by the FDA. Other kits have been in use through physician-prescribed and directed collection, and others still have been authorized specifically for use with one test (where provider of both kit and test are the same). This approval is unique because Everlywell is offering its sample kit independent of any specific testing lab, and can work with a variety of labs to potentially provide a broader testing footprint.
The test kits are then sent to one of two labs currently authorized under separate EUAs for COVID-19 testing, and the administration notes that this could expand to other test providers in future should they file for an EUA and provide the requisite data that goes along with the verification required for that emergency approval. The FDA cites Everlywells work in collecting and presenting data from studies including those supported by the Bill and Melinda Gates Foundation to show that samples collected at home using its nasal swab collection method remain stable during shipping.
That data is also now available to others looking to provide similar test kit offerings, the FDA notes, which should reduce the burden of proof on anyone looking to gain authorization for a competing product. That could potentially open up testing even further, reducing a bottleneck that many public health professionals see as one of the key drivers of a successful recovery.
The authorization of a COVID-19 at-home collection kit that can be used with multiple tests at multiple labs not only provides increased patient access to tests, but also protects others from potential exposure, said Jeffrey Shuren, M.D., J.D., director of the FDAs Center for Devices and Radiological Health in a statement provided to TechCrunch. Todays action is also another great example of public-private partnerships in which data from a privately funded study was used by industry to support an EUA request, saving precious time as we continue our fight against this pandemic.
A nurse at the Veterans Affairs Medical Center in Manhattan holds a cellphone last month so a COVID-19 patient can see and listen to his family. Robert Nickelsberg/Getty Images hide caption
A nurse at the Veterans Affairs Medical Center in Manhattan holds a cellphone last month so a COVID-19 patient can see and listen to his family.
COVID-19 has given ventilators an undeservedly bad reputation, says Dr. Colin Cooke, an associate professor of medicine in the division of pulmonary and critical care at the University of Michigan.
"It's always disheartening to know that some people are out there saying if you end up on a ventilator it's a death sentence, which is not what we are experiencing and I don't think it's what the data are showing," Cooke says.
Early reports from China, the United Kingdom and Seattle found mortality rates as high as 90% among patients on ventilators. And more recently, a study of some New York hospitals seemed to show a mortality rate of 88%.
But Cooke and others say the New York figure was misleading because the analysis included only patients who had either died or been discharged. "So folks who were actually in the midst of fighting their illness were not being included in the statistic of patients who were still alive," he says.
Those patients made up more than half of all the people in the study.
And Cooke suspects that many of them will survive.
"We think that mortality for folks that end up on the ventilator with [COVID-19] is going to end up being somewhere between probably 25% up to maybe 50%," Cooke says.
Scary, but hardly a death sentence.
There's also some encouraging news from a New York health system that cares for people with risk factors that make them much more likely to die from COVID-19
Montefiore Health System in the Bronx serves a low-income population with high rates of diabetes, obesity and other health problems. And in April, it faced an onslaught of sick people with COVID-19.
"The number of patients with critical care needs was more than triple the normal levels," says Dr. Michelle Ng Gong, chief of critical care medicine at Montefiore and a professor at the Albert Einstein College of Medicine.
To cope, regular hospital wards became intensive care units, critical care teams worked extra shifts, and heart doctors found themselves caring for lung patients.
Weeks later, it's still too soon to calculate mortality rates precisely, Gong says. "We still have a large number of patients on mechanical ventilation in our intensive care unit," she says. "So the outcomes of those patients is still uncertain."
But Gong adds that when it comes to COVID-19 patients on ventilators, "We win more than we lose."
That's especially good news coming from a city where hospitals faced so many challenges, says Dr. Todd Rice, who directs the medical intensive care unit at Vanderbilt University Medical Center in Nashville, Tenn.
"They were having to care for patients in makeshift ICUs [with] doctors who weren't their normal ICU doctors," Rice says. "That probably results in some worse outcomes."
So far, Vanderbilt has been able to keep COVID-19 patients on ventilators in existing ICUs with experienced intensive care teams, Rice says. And the mortality rate "is in the mid-to-high 20% range," he says.
That's only a bit higher than the death rate for patients placed on ventilators with severe lung infections unrelated to the coronavirus.
And, like many other intensive care specialists, Rice says he thinks COVID-19 will turn out to be less deadly than the early numbers suggested.
"I think overall these mortality rates are going to be higher than we're used to seeing but not dramatically higher," he says.
Preliminary data from Emory University in Atlanta support that prediction.
The mortality rate among 165 COVID-19 patients placed on a ventilator at Emory was just under 30%. And unlike the New York study, only a few patients were still on a ventilator when the data were collected.
Factors that may have kept death rates low include careful planning and no shortages of equipment or personnel, says Dr. Craig Coopersmith, who directs the critical care center at Emory. But the care largely followed existing protocols for patients with life-threatening lung infections, he says.
"There is no secret magic that can't be replicated in other places," Coopersmith says. "And I do believe that we will see a global trend toward better outcomes on the ventilator and in the intensive care unit."
Also, intensive care doctors say ICU teams are becoming more skilled at treating COVID-19 patients as they gain experience with the disease. For example, they are doing more to prevent dangerous blood clots from forming.
That means COVID-19 mortality rates in ICUs are likely to decrease over time, Coopersmith says.
"It's still going to be a devastating disease," he says, "but a more manageable devastating disease."
Monday was a day of triumph for Prime Minister Jacinda Ardern. Thanks to the efforts of the entire nation, she said, New Zealand had been largely successful in meeting its ambitious goal of eradicating, rather than just controlling, outbreaks of Covid-19. The lockdown she had put in place on March 25 could now end.
Ms. Arderns success is the latest data point in a widely noticed trend: Countries led by women seem to be particularly successful in fighting the coronavirus.
Germany, led by Angela Merkel, has had a far lower death rate than Britain, France, Italy or Spain. Finland, where Prime minister Sanna Marin, 34, governs with a coalition of four female-led parties, has had fewer than 10 percent as many deaths as nearby Sweden. And Tsai Ing-wen, the president of Taiwan, has presided over one of the most successful efforts in the world at containing the virus, using testing, contact tracing and isolation measures to control infections without a full national lockdown.
We should resist drawing conclusions about women leaders from a few exceptional individuals acting in exceptional circumstances. But experts say that the womens success may still offer valuable lessons about what can help countries weather not just this crisis, but others in the future.
The rock band Van Halen famously included a clause in its tour rider that required venue managers to place bowls of M&Ms in their dressing room. But WARNING it said in underlined capital letters, ABSOLUTELY NO BROWN ONES.
The clauses true purpose had nothing to do with chocolate. Rather, it was an easy-to-spot signal of whether the venues managers had taken care to read and follow the entire set of instructions in the rider including the safety guidelines for the bands extremely complex sets and equipment.
Just as the absence of brown M&Ms signaled a careful, safe venue, the presence of a female leader may be a signal that a country has more inclusive political institutions and values.
Varied information sources, and leaders with the humility to listen to outside voices, are crucial for successful pandemic response, Devi Sridhar, the Chair of Global Health at the University of Edinburgh Medical School, wrote in an op-ed in the British Medical Journal. The only way to avoid groupthink and blind spots is to ensure representatives with diverse backgrounds and expertise are at the table when major decisions are made, she wrote.
Having a female leader is one signal that people of diverse backgrounds and thus, hopefully, diverse perspectives on how to combat crises are able to win seats at that table. In Germany, for instance, Ms. Merkels government considered a variety of different information sources in developing its coronavirus policy, including epidemiological models; data from medical providers; and evidence from South Koreas successful program of testing and isolation. As a result, the country has achieved a coronavirus death rate that is dramatically lower than those of other Western European countries.
By contrast, the male-led governments of Sweden and Britain both of which have high coronavirus death tolls appear to have relied primarily on epidemiological modeling by their own advisers, with few channels for dissent from outside experts.
However, a signal is not proof. And the surrounding political system can trump the different perspectives that a diverse group might bring to the issue.
When Ruth Carlitz, a political scientist at Tulane University, analyzed governors track records in the United States, she found that women were not quicker to impose lockdowns to fight the coronavirus. (Her analysis is recent and has not been peer-reviewed.)
That may be because any gender effect has been muffled by the all-consuming power of political partisanship. Dr. Carlitz found that Republican governors in the United States, male and female, took longer to impose stay-at-home orders than Democrats did.
After President Trump was criticized for failing to wear a mask during public appearances, David Marcus, a conservative journalist, argued in an article for the website The Federalist that Mr. Trump was projecting American strength. If Mr. Trump were to wear a mask, he wrote, that would signal that the United States is so powerless against this invisible enemy sprung from China that even its president must cower behind a mask.
Medical accessorizing is not usually seen as so crucial to great-power conflict. But Mr. Marcuss analysis is actually quite consistent with the traditional idea of a strong American leader: one who projects power, acts aggressively and above all shows no fear, thereby cowing the nations enemies into submission.
In other words, a strong leader is one who conforms to the swaggering ideals of masculinity.
That has often created difficulties for women in politics. There is an expectation that leaders should be aggressive and forward and domineering. But if women demonstrate those traits, then theyre seen as unfeminine, said Alice Evans, a sociologist at King's College London who studies how women gain power in public life. That makes it very difficult for women to thrive as leaders.
Ms. Arderns approach to fighting the pandemic could not be further from that traditional archetype. But on this new kind of crisis, her cautious leadership has proved successful. I would say that shutting down the economy early was a risk-averse strategy, Dr. Evans said. Because no one knew what was going to happen, so its the strategy to just protect life first.
After New Zealand began its lockdown on March 25, Ms. Ardern addressed the nation via a casual Facebook Live session she conducted on her phone after putting her toddler to bed. Dressed in a cozy-looking sweatshirt, she empathized with citizens anxieties and offered apologies to anyone who was startled or alarmed by the emergency alert that announced the lockdown order.
Theres no way to send out those emergency civil alerts on your phones with anything other than the loud honk that you heard, she said ruefully. That was actually something we all discussed: was there a way that we could send that message that wasnt so alarming?
By contrast, Mr. Trump has tried to anthropomorphize the virus into a foe he can rail against, calling it a brilliant enemy. But while that may have encouraged his base, it has not aided American efforts to contain the pandemic. The United States now has the highest coronavirus death toll in the world.
In Britain, Boris Johnson rose to power as a prominent Brexit backer, promising to play hardball to win the best deal in the countrys exit from the European Union. But the skills he used to battle Brussels bureaucrats turned out not to be useful in the fight against the pandemic. His government delayed lockdowns and other crucial protective measures like increasing testing capacity and ordering safety equipment for hospitals. Britains death toll is now the second-highest globally.
Male leaders can overcome gendered expectations, of course, and many have. But it may be less politically costly for women to do so because they do not have to violate perceived gender norms to adopt cautious, defensive policies.
That style of leadership may become increasingly valuable. As the consequences of climate change escalate, there will likely be more crises arising out of extreme weather and other natural disasters. Hurricanes and forest fires cannot be intimidated into surrender any more than the virus can. And neither can climate change itself.
Eventually that could change perceptions of what strong leadership looks like. What we learned with Covid is that, actually, a different kind of leader can be very beneficial, Dr. Evans said. Perhaps people will learn to recognize and value risk averse, caring and thoughtful leaders.
It is a risk; youre not going to be physically distant, Remington said. But if customers wear masks and employees wears masks and possibly face shields, and both parties clean their hands before and after, the risk will be lower, he and Safdar said.
Knowing how much community transmission of COVID-19 is occurring can help, Remington said. Get your hair cut during a lull, he said.
Hair salons aren't known to be major sources of coronavirus transmission, but that could change, Safdar said. There may be clusters that will only become apparent when the salons open up, she said.
If my gym reopens, should I exercise there?
Gyms that have robust cleaning, good ventilation, physical distancing space, use of masks and good sick leave policies will be safest, the doctors said.
Olderadults and people with chronic conditions should probably avoid gyms, Safdar said. Exercising outdoors is a lower-risk alternative, Remington said.
What about traveling within Wisconsin or to another state?
Car travel is OK if drive-thru restaurants are available and hotels, if needed, are well cleaned, Safdar said. Bring wipes for additional cleaning, she said.
Airplanes can be risky even if middle seats are empty and people wear masks, she said. Youre in close quarters with a large group of people, potentially for several hours, she said. You dont know who might be incubating COVID.
Michigan's death toll from the novel coronavirus reached 4,880 on Saturday after the state added 55 deathsto its count.
The state also confirmed 425 new cases of the illness COVID-19, bringing its cumulative total cases to 50,500, according to state data.
The number of deaths is an increase from Friday when the state recorded 38 new deaths. There was, however, a delay from the state in reporting and the deaths may not have occurred from Friday.
An electronic billboard in downtown Lansing encourages residents to "stay home" amid the COVID-19 pandemic.(Photo: Craig Mauger / The Detroit News)
The number of confirmed COVID-19 cases in Michigan exceeded 50,000this week, but daily reports of new deaths have slowed in recent days.
In the last seven days, the state has reported 432 new deaths, down from 527 new deaths during the week prior. Two weeks earlier, April 25 through May 1, the state reported 781 new deaths.
Detroit's Chief Public Health Officer Denise Fair said there were two deaths in the cityaccounted for Friday and data remains fluid as state and local hospitals review and update death records attributable to COVID-19.
"Our overall week-to-week trend is continuing in the right direction," Fair said in a statement Saturday.
Detroit added 675 cases in the past week, 92 cases from Friday,bringing the total of cases to 10,351 on Saturday.
The city's death toll reached 1,257,adding 44 deaths in the past seven days showcasing adecline in deaths from the week prior, according to the city's data.
The newest data on COVID-19 testing in Michigan available showed a spike in testing on Wednesday. The state reported 23,647 tests performed Wednesday, the most in a single day yet.
According to the state's numbers, 10.7% of the tests returned positive results. Michigan had previously reported 12 straight days with less than 10% of tests being positive. The state's overall fatality rate is 10% with the average age of victims being 75 years old.
Michigan continued Friday to rank seventh nationally for the number of cases and fourth for the number of deaths, according to tracking by Johns Hopkins University. In deaths, Michigan was behind New York, New Jersey and Massachusetts.
As of Friday, 28,234 Michigan residents were considered "recovered" from COVID-19, meaning they were still alive 30 days after the onset of illness. The department doesn't have data on recoveries by county.
"In the past seven days, we have lost 44 Detroiters to the virus, considerably less than 67 reported the previous seven days," Fair said."I applaud the unwavering spirit of Detroiters who are taking this crisis seriously by wearing their mask, social distancing and other precautions to beat COVID-19 in our community."
srahal@detroitnews.com
Twitter: @SarahRahal_
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Gwen Orlowski, executive director of the advocacy organization Disability Rights NJ, said she believes state officials were doing everything within their power to try to prevent the spread of the disease as best they could, given the fact that they really didnt know who had the virus. But without being able, early on, to test asymptomatic staffers who come and go from the facility, residents couldnt be protected, she said.
The San Diego Union-Tribune reporter gets results from Covid-19 test
What have I gotten myself into? How bad is this going to hurt?
Those were some of my thoughts as I stood in line outside San Diego Countys North Inland Live Well Center in Escondido on May 7, waiting to get a coronavirus test. Ive seen videos of people claiming the tests felt like a stick had penetrated their brain, which left me a little nervous.
Publicly funded testing for the coronavirus in San Diego County had been reserved for people who had been referred to a testing site by a medical provider. That changed May 5 when new state-fund testing sites opened in Escondido, Grossmont College in El Cajon and at a closed Sears in Chula Vista.
Expanding tests to people without symptoms will be a way for the county to better track the spread of the virus, and the new sites together have a capacity of performing almost 800 tests daily.
The state contracted with Optum, which is part of UnitedHealth Group, to find 80 locations in California for the sites, and Optum has contracted with labs to get results from samples collected. The wait for results usually is 48 to 72 hours.
The countys announcement about signing up for the tests was described as three easy steps, but there reportedly were problems with the website and issues with scheduling on the first day.
Glitches supposedly had been worked out and were running smoother the day after it launched, which was when I made a reservation, but there still were some kinks. After logging into https://lhi.care/covidtesting and creating an account after proving I wasnt a robot, I filled out several pages asking about my employment, whether I lived or worked in a congregate living facility, had any COVID-like symptoms and other questions.
The site also asks for insurance information because the insurer will be billed at the Medicare rate, though the person getting the test is not supposed to be charged a copay or any out-of-pocket expense under a government rule.
Filling out the questions took a few minutes, and then things got more frustrating.
After putting in my zip code to find the nearest testing site, all of the locations I was given were in Orange County. I was in Oceanside, and Escondido was just 15 miles away, but the website directed me to a location in San Juan Capistrano.
I changed my home location to an El Cajon zip code and set the search function to 50 miles, but got a message that there were no locations within that distance, which wasnt true as there is one in Grossmont College.
After a few experiments like that, the Chula Vista and Escondido sites suddenly popped up, but I couldnt book an appointment because the entire month of May was grayed out.
One page said the Escondido site had an opening on May 7, but when I selected it, the calendar still was grayed out so I couldnt make an appointment. I checked again later and the calendar did work, but the opening now was in about 30 minutes, much too soon to make.
By then I had called (888) 634-1123, the number to make an appointment to talk to a person directly. I lost count of how many times I heard the recorded message, We are experiencing longer than average hold times.
After 40 minutes on hold, an appointment in Escondido popped up for 2 p.m. the next day. I jumped on it. I learned later that day that all appointment slots had been filled for that week, so maybe openings were sporadically popping up because they were becoming available through cancellations.
Or maybe they were just glitches. I talked to someone at Optum who said they were looking into some issues with the website. In any case, the problems werent keeping people away from the testing sites.
I arrived a few minutes early for my appointment, and there were five people ahead of me, all wearing facial coverings and standing on blue Xs taped to the ground 6 feet apart.
Tip for anyone going to their appointment: have your email on your phone ready to show someone at the door, and write down the ID number you were assigned, because theyre going to ask for it.
The check-in process was smooth, and people were polite. I was invited inside through a side door, not the main lobby, and told to stand on a blue line while someone asked for my ID number. I then was directed to another room where I stood 6 feet from a table and talked to a woman I could barely see sitting at a table behind a sheet of thick plastic.
She double-checked my birthday and address and got other information, then handed me a couple of pieces of paper and a plastic bag with a swab and tube inside. I was asked to go around the corner and stand inside a blue square on the floor to wait my turn.
A woman who introduced herself as Sarah told me to sit in a blue plastic chair, then took the plastic bag and top sheet of paper. I asked her how many tests she had done that day, and she said,'Millions. She probably was a bit worn out, but still polite and patient. She told me I was getting a PCR test, which stands for polymerise chain reaction and involves a 6-inch nasopharyngeal swab to collect a sample that will be tested for viral particles.
Thats probably the part youve heard about. Sarah told me to drop my bandanna to expose my nose but still cover my face, and then she slid the swab into my right nostril. It felt like she got the whole 6 inches in there.
I was relieved I felt no sense of gagging or pressure. What I felt was, well, just weird. It felt like something was expanding deep inside my sinus as the swab rotated.
Another 10 seconds, she said. Youre doing great.
It felt like another 20 seconds might have passed before she said, Another five seconds. Doing great.
She then began extracting the swab, which she advised might be the uncomfortable part. It never hurt, but it felt like it was about to hurt, and like something - gray matter? - was being pulled out of my head.
And then it was all over. The actual test takes about 15 seconds. I saw the swab. It had not expanded after all and didnt appear to have brains or anything else stuck to it.
I was directed to follow more blue markings on the floor toward the exit, and I was out about 30 minutes after I arrived. About two hours later I got a text saying my results would be ready in 48 to 72 hours on the LHI.Care website.
My test was on a Thursday, and the nurse who administered it said results might not be ready until the following Monday as the weekend was coming up.
I still hadnt received a text notification late Monday, so I called a number on the LHI website and heard a message to press 2 for results, but got a recording that said, We are currently unable to answer your call. I might have called too late.
I called again the next morning, May 12, and got someone on the phone who said my results still were pending, five days after the test, and the delay might have happened because my test was in the afternoon, and the samples might not have been sent to the lab until the next day.
Then around 3:30 p.m. I got a text that the results were ready.
I logged in and downloaded a PDF that said I was....negative! The page also gave instructions for people with a positive or inconclusive result. People who tested positive but dont have symptoms were advised to stay home unless they need medical care and stay in a specific room as much as possible. People with serious symptoms are told to seek immediate care.
The results gave me some peace of mind, though they were from a test taken five days earlier. Ill still work from home, wear a facial covering around others, wash my hands frequently and use hand sanitizer when I touch anything outside. And while it was a concern, I have not developed a fear of cotton swabs.
Editor's note:This article will be updated throughout the day with the latest COVID-19 news.
Posted 8:28 a.m.
As of Sunday morning, Pennsylvania has 61,611 positive cases according to the Department of Health. The state has also seen 4,403 total deaths.
As for Lancaster County, the county now has 2,470 positive cases according to the DOH.
-As of Saturday, May 16, Lancaster County has seen 255 COVID-19 related deaths.
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A former Navy nurse who did two tours in Afghanistan, Cynthia Lam has always felt compelled to do her part for the country.
So in late March, Lam flew from San Diego to the greater New York City area to work for eight weeks at a hospital on the front lines of the coronavirus pandemic.
Analise Eastman left her San Diego nursing job shortly before the coronavirus flared up, planning to travel abroad before starting graduate school.
Instead, she drove 31 hours to Chicago for a 12-week crisis response position at a hospital short-staffed because of the outbreak.
Elena Johns had stepped away from intensive care nursing to pursue her doctorate at the University of San Diego and focus on her passion, hospice care.
When she learned quarantined COVID-19 patients were dying alone, however, Johns returned to the ICU for a four-week assignment at a hospital in Brooklyn.
Dying alone is unacceptable to me, she said. If nothing else, I can go and be there for that person if the family cant be there.
Despite the risk of exposure to the deadly virus, these three San Diego health care providers signed on as travel nurses, taking short-term positions at hospitals hit hard by the pandemic.
They got the assignments through San Diegos Aya Healthcare, which links hospitals with contract labor nationwide. Aya has filled more than 5,200 crisis jobs since the outbreak began.
Another San Diego-based company, AMN Healthcare, also provides travel nurses to medical facilities, as well as other medical specialists. Since mid-March, AMN has placed more than 10,000 health care workers.
Lam and Eastman are first-time travel nurses. Johns has done it before. While each of their stories is different, they have a few things in common.
They either are enrolled in graduate school or are headed there to become nurse practitioners. When classes moved online, they gained the flexibility to travel while continuing their studies.
They all sought to go where they were most needed. Hospitals in the San Diego region have not been overrun with COVID-19 patients at least so far.
All said the supply of personal protective equipment, including N-95 masks, has been good. They have been vigilant and meticulous with safety gear to avoid putting themselves at risk.
And theyve had both heartbreaking and touching experiences along the way. Here are their stories.
Former Navy nurse Cynthia Lam expects to work through June as an ICU nurse at a hospital in Connecticut, just outside of New York City, helping COVID-19 patients.
(Cynthia Lam)
Lam, 34, works in the ICU at a hospital in Stamford, Conn., about 40 miles outside New York City. She puts in four, 12-hour shifts per week. Early on, she would pick up extra shifts because the hospital was fairly overwhelmed with COVID-19 patients.
In some ways, the work reminds Lam of her time as a Navy nurse in Afghanistan when the call came to drop a nine-line, or medivac casualties from the battlefield.
Every day you are like go, go, go because these patients are very sick and they decompensate very quickly, she said. Sometimes you feel helpless because youve exhausted all of the typical life-saving measures that just dont seem to be as effective in this population.
Now a reservist, Lam spent eight years as a military nurse, most recently working at the Balboa Naval Medical Center. After leaving active duty, she began full-time graduate school while working per diem as a fill-in nurse at local hospitals.
With the coronavirus, Lam thought she would pick up more hospital shifts locally. But she didnt.
The cases were pretty low in San Diego, she said. They canceled a lot of elective surgeries. I just felt like I wasnt being utilized as an ICU nurse. I was like, there are people who need me in the Northeast, and Im sitting here in San Diego in my backyard, hanging out.
So Lam tried travel nursing. Its been a whirlwind few weeks. When she was hired, the hospital wanted her to start in six days. That meant finding a place to live across the country on short notice. The Airbnbs she contacted were either too expensive or taken.
I would say, Oh really, because its still online, said Lam. It was almost like they were concerned, rightfully so, about having someone in health care in their house.
She tried an apartment complex, but it did not offer furnished units. They began inquiring about me, and I told them I was just coming for eight weeks to help with the crisis, said Lam. What they ended up doing was buying stuff from Amazon and furnishing the apartment for me. They were super helpful.
Lams hospital has one ICU unit. For the outbreak, it converted three other rooms into pop-up ICUs. During her first few weeks there, Lam worked mostly in the main ICU with very critical patients.
I am a positive person and dont let things get to me, but in the moment, the deaths seem to pile up and that is sad, she said. I thought my patient yesterday was going to die all day despite all the measures we were doing, and it just hits home because the patient is the same age as my dad, who is 66.
The young patients also are hard. She has cared for people in their 30s, 40s and 50s stricken the virus. She had two pregnant patients.
Its crazy because I think these people are just living their normal lives, she said. Yeah, maybe they have a history of high blood pressure or diabetes or whatever it may be, but theyre living great lives. Its not like they were bed-bound.
Over the past couple of weeks, coronavirus cases have eased. We are discharging a ton, she said. We were able to close one of our pop-up ICUs.
A single mom, Lams teenage daughter is staying with her parents. Lam agreed to extend her assignment for another four weeks, but she is looking forward to time off this summer with her daughter.
It will be nice to have a small break and just be with family, she said.
Analise Eastman, a Point Loma Nazarene graduate, is a first-time travel nurse, working at a hospital in greater Chicago.
At the Chicago-area hospital where Analise Eastman works, the staff plays the Rocky movie theme song over the intercom every time a COVID-19 patient is discharged.
We line up and clap and cheer for them as they leave, she said.
Eastman, 29, graduated from Point Loma Nazarene. She worked in nursing locally for five years before taking a break before grad school. As coronavirus cases grew nationwide, she felt a responsibility to contribute.
If I didnt step in and help the health care system at this time, I honestly would have felt really guilty just sitting around while my fellow nurses are working their butts off.
Eastman is in a telemetry unit, which handles less seriously ill patients than an ICU. Still, she is seeing plenty of COVID patients. Recently, she has been floating to the hospitals designated COVID telemetry floor a lot.
Several patients are receiving oxygen. Sometimes, they are placed in the telemetry unit rather than ICU because of do not resuscitate directives.
So they come to our unit, and they will die there, she said. Its still an intense setting, even without the ventilators and really sick patients, because there are still people dying.
When she first arrived, several nurses in her group were in quarantine after exposure to the virus. I have heard of nurses just living in hotels on the days they are working so they dont bring it home to their families, she said. My boyfriend is here with me. I am so grateful for the support. But I also have this fear that he is going to get it, and of course Im afraid that Im going to get it, but I am trying to be as careful as I can.
Cases are easing slightly at Eastmans hospital, though new COVID-19 admissions still come in every day. Several of the staff previously out sick with COVID are back working now, which has helped relieve the strain on her unit.
The hospital is not allowing visitors. However, it recently began Zoom meetings between a few patients and their families.
The meetings are typically reserved for those nearing end of life, but Eastman has been advocating for wider use.
Each time I have done it so far it has brought tears to some family members eyes and meant a lot to them, she said. One patients family hadnt seen her for two months because she was in a skilled nursing facility before this. They couldnt have been more thankful to see her face and tell her they love her. It brought me to tears, too.
Elena Johns recently returned to San Diego after spending four weeks as a travel nurse caring for coronavirus patients at a hospital in Brooklyn.
(Elena Johns)
Elena Johns, 29, has been an ICU and cardiology nurse for more than four years. A Louisiana native, shes now attending graduate school to become a nurse practitioner specializing in end of life/palliative care. Shes also working fill-in shifts at San Diego hospitals and part-time in hospice.
Johns has been a travel nurse before, and she kept in touch with industry recruiters.
I was getting a lot of emails and texts saying there was a crisis, she said. My classes are all remote. I work per diem and part time, so my schedule is very flexible. They dont really need me in an ICU in San Diego, knock on wood. I can go help.
She started April 8 at a hospital in Brooklyn. The team is very good, she said. The nurses and especially the doctors are very good and very helpful.
But it wasnt what she expected.
I thought it would be more acute in terms of seeing patients when they are admitted, she said. What we me and the nurses who started with me seem to be doing is much more aftermath. These patients have been here for two-plus weeks. We are continuing the care and hoping they that they will get better when the trends are not showing that.
Its almost as if nurses and doctors are having to shift their mindset from saving everyone to thinking more like hospice caregivers. She recalled one patient from the regular COVID floor who came to the ICU struggling to breathe. The doctor told the patient they needed to insert a breathing tube or the patient would die. The patient refused.
The doctor honored the request but I could see the struggle in his eyes and the entire team because we are trained to save, to insert that tube no matter what, said Johns.
The patient died shortly afterward. It is hard for me in that respect, trying to balance my hospice side and my ICU side, said Johns. Some of these patients are just so sick, and theyre not getting better.
Johns has returned to San Diego. She had a scare and got tested for COVID-19 in New York. It came back negative.
When she left, the crisis did appear to be easing. One of the hospitals pop-up ICUs had closed, and emergency room counts were down.
Now shes focusing on school finals and is looking forward to returning to her hospice job. But shes not ruling out another travel nurse assignment later on.
If the need is great in ICUs, then sure, she said. After recovering for a few weeks, I would think about doing it again.
