First of two parts
HANCOCK COUNTY — Last March, Dr. PJ Halter was all set to fly to Las Vegas to enjoy the early rounds of the NCAA basketball tournament with friends.
Then COVID came to town.
So the Hancock County pediatrician unpacked his bags and spent his scheduled vacation time with colleagues, hastily setting up a respiratory triage clinic in the strip mall just south of Kroger in Greenfield.
The mysterious virus that has since killed more than half a million people in the United States — including more than 130 in Hancock County and more than 12,400 in Indiana — struck with a vengeance, sending the medical community scrambling to save lives.
“We knew it was out there, we knew it was circulating the world, but we weren’t quite sure not only when, but even if, it was going to affect the United States,” said Halter, director of pediatric services at Hancock Regional Hospital.
“Was it going to affect Greenfield, Indiana, the same way it has in the rest of the world? We had no idea.”
No one could have guessed how quickly it would traverse the globe, and how many altered lives it would leave in its wake.
Halter said doctors, nurses and medical assistants quickly found themselves in an “all hands on deck” situation, facing a mixture of fear and a call to duty.
“There was this equal sense of fear but also this readiness to say, ‘What do I need? What do you need me to do? Where do we need to go? Put me anywhere that I’m needed so that I can help,’” he recalled.
Now, a full year to the date of its onset, local doctors and nurses reflect on those first few chaotic, confusing weeks.
‘Nothing prepares you’
Like most people, Dr. Taryn Papandria never thought she’d see a global pandemic in her lifetime, but she suddenly found herself facing numerous patients in respiratory distress in Hancock Regional Hospital’s emergency room, where she’s worked for the past 15 years.
“Nothing prepares you for something you’ve never seen before,” said Papandria, chief of the emergency department and president of the hospital’s medical staff.
The memories of those early days are vivid.
Papandria recalled many days spent at the bedside of patients struggling to catch their last breath, and feeling terrible when being called away to treat another patient in distress. “You feel so bad when you have to leave the room when they’re near the end of life. It’s very emotionally taxing,” she said.
One day a woman came in with severe respiratory distress, after calling an ambulance to her apartment a day after being diagnosed with COVID-19. It took 10 minutes for EMTs to find the right apartment.
“By the time she got to the hospital, she was very much struggling to breathe, but because we knew she had COVID we had to take time to put on our personal protective equipment,” Papandria said.
“Our gut instinct is to run to her bedside, but you can’t in this situation. By the time we were able to get to her, she had to be intubated, and unfortunately she died within minutes.”
The seasoned physician recalls a feeling of utter helplessness wash over her, “which in the emergency department is not something we’re used to experiencing,” she said.
“Our goal is to save lives, and we do everything we can to do so,” she said. But saving lives isn’t always possible when dealing with a deadly virus.
The majority of COVID patients her staff has treated over the past year ended up doing fine, she said, but others quickly succumbed to the disease.
“It was such a dichotomy; either you got super sick or you hardly got sick at all,” she recalled.
The sickest patients
Steve Long, president and CEO of Hancock Health, which operates Hancock Regional Hospital, said COVID-19 patents are among the sickest patients hospitals ever see.
“They often require one-on-one care, high-tech interventions and monitoring, and isolation requirements that make the simple act of entering and leaving a patient room simply exhausting,” he said.
“On top of this, severe illness from COVID-19 is excruciating for the patient and devastating for the caregivers. The lungs become incapable of transferring oxygen to the blood, triggering a cascade of devastating effects…. Internal organs begin to die, consciousness fades, breathing ceases, heart failure ensues, death follows,” Long said.
“Unfortunately, this process can take days to unfold, and there is often little that can be done except make the patient as comfortable as possible while they die. You can imagine the impact to clinicians as they watch this happen over and over again,” he said.
The fact that COVID patients’ families can’t be with them has compounded the trauma for doctors and nurses, who have been serving as both health care providers and the sole support system for many patients.
Dr. Carmen Cudiamat recalls feeling helpless at how little she could help patients when doctors were first confronting COVID-19.
“It was certainly all new to us. The information we had about the COVID then was very limited, so there were certainly a lot of unknowns and uncertainties,” said Cudiamat, a physician with Hancock Family Medicine.
Working at the hospital’s respiratory triage clinic, she and her physicians had few testing or treatment options at the onset of the virus.
“All we could say was, ‘Yes we do think it’s COVID, but unfortunately we don’t have anything to offer you,’” she said. “We were just following whatever information we had for the day, and every day it would change. It was definitely a very fluid situation.”
Cudiamat and her colleagues would peel off their surgical gowns and face masks after each shift, get in their cars and drive home, not knowing if they had contracted the virus or if they were carrying it to their families back home.
Dr. Matthew Surburg, a general practitioner with Hancock Family Physicians, said the past year is one health care providers will never forget.
He recalls approaching patients in their cars at the Hancock Health respiratory clinic, as they stared at him wide-eyed in his protective face shield, gloves and gown, awaiting a nasal swab that would detect whether or not they had the potentially deadly virus.
“It was certainly an interesting time to be practicing medicine,” said Surburg, who made sure to scrub up and remove any clothes from work before returning home to his wife and five kids. “That was a time when, largely because of the uncertainty of what was going on, things were done very much by the book. But the book was still being written.”
COVID-19 data through early Friday, March 12
- 314 new tests administered
- 15 new cases
- 3.1% seven-day (Feb. 27-March 5) positivity rate all tests, 10% cumulative rate
- 0 new deaths
- 88,699 total tests administered
- 7,517 total cases
- 7.5% seven-day (Feb. 27-March 5) positivity rate unique individuals, 19.2% cumulative rate
- 135 total deaths
- 17,958 first vaccine doses administered
- 11,634 fully vaccinated
- 37,814 new tests administered (Aug. 25, 2020-March 11, 2021)
- 973 new cases (Dec. 4, 2020-March 11, 2021)
- 3.1% seven-day (Feb. 27-March 5) positivity rate all tests, 9.6% cumulative rate
- 28 new deaths (Nov. 25, 2020-March 10, 2021)
- 8,391,163 total tests administered
- 3,172,282 total individuals tested
- 671,023 total cases
- 8.7% seven-day (Feb. 27-March 5) positivity rate unique individuals, 21.2% cumulative rate
- 12,409 total deaths
- 415 total probable deaths
- 61.7% ICU beds in use – non-COVID
- 4.8% ICU beds in use – COVID
- 3.5% ICU beds available
- 17.6% ventilators in use – non-COVID
- 1.6% ventilators in use – COVID
- 80.8% ventilators available
- Hospital census: 608 COVID-19 patients (365 confirmed, 243 under investigation
- 1,230,710 first vaccine doses administered
- 792,217 fully vaccinated
Source: Indiana State Department of Health