BELOIT — “Critical care is where you go to either live or die. My job is to do my best to make sure that (you) live.”
That’s how Brittney Troxel, an inpatient critical care nurse at Beloit Health System, described her role in caring for COVID-19 patients.
Her role, along with hundreds of other Beloit Health System doctors, nurses and support staff, was turned upside down starting in March as the world grappled with a deadly virus with no known cure.
“I was no longer taking care of patients after open heart surgery, battling sepsis, suffering a cardiac event, or critical post-operative patients,” Troxel said. “Instead I was battling a monster that was foreign to me, that did things to the body that I had never seen before, that caused otherwise healthy individuals to need lifesaving care.”
COVID-19 came to the Stateline Area’s front door, wreaking havoc on daily life as schools closed, businesses shuttered and people scrambled to make sense of something not seen in a century: A global pandemic.
“The world woke up to a viral infection that had impact on lung function and extra-pulmonary effects that hits multiple systems in the body,” said Dr. Joseph Kittah, the health system’s lead intensivist and pulmonologist who has attended to all COVID-19 patients at the hospital.
Before the health system converted a critical care detachment into a COVID-19 unit with an adjoining COVID-19 floor, Kittah, along with Infectious Diseases Specialist Dr. Vijaya Somaraju, knew the virus was coming—and fast.
“We did in-house training for nurses, technicians and providers as to what to do,” Kittah said. “The administration was able to get personal protective equipment (PPE) in good time and we had a flow put together as to how to bring patients who where either confirmed or suspected cases.”
A testing site opened at the Beloit Memorial Hospital campus in March and hospital staff were shifted from their usual roles to handle the health system’s COVID-19 response.
Beloit Health System nurse Stephanie Wicks, who works in the Beloit Memorial Hospital Emergency Department, called the ED “the first line of defense for illnesses, accidents, and any number of things in between.”
Wicks said “many aspects” of the ED changed with the onset of COVID-19, noting that staff are trained within their scope of practice to be able to provide care to patients.
“The basis of how we care for patients hasn’t changed, we still approach each patient prepared to address and care for their needs,” Wicks added. “What has changed is being more diligent in assessing for symptoms that could be related to COVID-19 and making sure to ask the right questions and perform thorough assessments to identify things the patient themselves may not be aware of.”
COVID-19 humbled doctors around the world, forcing health care experts to “go back to basics” in terms of critical care management and patient care, Kittah said.
“It’s been a steep learning curve, but we’ve learned a lot about the disease and I think we better understand it now from three months ago,” Kittah said. “I think that right now from how the workflow is designed; how the ICU is organized; how our nurses care for these patients; we are beginning to be able to anticipate patient needs. The teamwork has been remarkable and the outcomes we see here are a reflection of the kind of work that we’ve learned from this disease.”
Nine Beloit residents have died due to COVID-19 as of July 13, but Kittah says the health system is bucking a national trend of seeing spiking death counts, something he directly attributes to the teamwork of the entire health system.
Kittah recalled a female patient who has been in the COVID-19 ICU unit the longest—over two months—that is now “thriving” after being placed on a ventilator twice. Those on the COVID-19 unit adapted to an unforgiving cycle of twists and turns as patient conditions worsened as their bodies attempted to fight off the virus.
“As a critical care physician, you thrive on reward and the positive reward and positive outcomes keeps you going,” Kittah said. “She had written her last words. She thought she was going to die, but she made it. That is rewarding to see that the strategies we have in place work and she’s alive today in part because of them. That’s what we live for and we hope to continue to make an impact on these patients.”
Troxel highlighted the fragility of the condition COVID-19 patients were in, saying, “We saw otherwise healthy patients teeter tottering on the plane of the living and that of the dead. The condition of the patient could change from stable to life threatening in seconds.”
As critical care units in the Stateline Area and around the world continue to care for critically ill patients, work on a vaccine is underway, but the path for any immunization will be lengthy and require countless hours of research, Somaraju said.
Somaraju added it could take 12 to 18 months or more for a vaccine to reach public distribution.
“In a normal time, vaccines aren’t released for three to five years,” Somaraju said. “In a crisis, that can be minimized down to that shorter time frame, but that takes a lot of scientific knowledge and so much goes into that. I think we have the technology and all the science is there, but testing trials is where I think the real challenge will be.”
On July 14, the National Institute of Health announced that an experimental COVID-19 vaccine was “generally well tolerated” by healthy adults in a 45-person study, according to interim results published in the New England Journal of Medicine.
Work fighting the virus in the Stateline Area is far from over, Kittah said.
“By no means is this virus gone,” Kittah said. “This is by no means over. We still have cases coming in seemingly every day. We still have patients in the ICU right now. We anticipate going into the fall it’s a possibility to see an uptick in the number of cases but we are better situated to deal with this virus.
“Don’t think about just yourself. This goes beyond the end of it all. We have to have a team approach to this thing. The least the community can do is adhere to basic principles of pandemic control by masking, physical distancing and proper hand hygiene.”
Even when the incidence of COVID-19 slows down, Kittah said the implications of combating a pandemic will have changed the U.S. medical community.
“I think there’s been a fundamental change in the way we practice medicine in this country,” Kittah said. “I’ve seen how COVID has restructured medicine generally. From how we do research, how we care for patients, even learning to protect ourselves to care for these patients. Research has moved quite a way. It’s touched the way we practice medicine.”
If there’s COVID-19 in the Beloit area, healthcare and frontline workers will continue to selflessly care for the public.
“I was never afraid to work in the COVID unit,” Troxel said. “When I was asked to go there I didn’t even give it a second thought. I knew that people needed help and I was in a position to help them, but I was fearful that I would bring COVID home to my family.”
All Beloit Health System staff interviewed by the Beloit Daily News said everyone should take responsibility to practice basic public health guidelines like social distancing, wearing a mask and hand-washing.
“These things you feel that someone has taken your rights away, but when you see that these are important things to build back the economy and build back that autonomy, if we all practice these things we will come out of this with flying colors,” Somaraju said.
“I would definitely recommend that you take precautions when you are out in public,” Troxel said. “Please wash your hands and use hand sanitizer. Try not to touch your face and mouth and wear a mask if you are able.”