‘Desperate for This Moment’: Vaccine Brings Lift to Battered ICU
On Monday at 7:30 a.m., a FedEx Corp. truck pulled up at aUniversity of Iowa Health Care system loading dock to deliver a small, heavy box. It contained 195 vials, each about half the size of a stick of lip balm, that were packed in dry ice at the Kalamazoo, Michigan plant where they were made.
Each tiny bottle held five doses of the Covid-19 vaccine developed by Pfizer Inc. and BioNTech SE. It was the best news that UI Health Care workers overwhelmed by the pandemic had gotten in a long time.
Most of the precious doses went into an ultracold freezer that the system in Iowa City bought months ago in anticipation of this exact moment. Pharmacy staff removed a hundred to thaw in a refrigerator, and nurses began administering those first shots to their colleagues at 9:42 a.m. Clinicians from intensive care and the emergency department who encounter the SARS-CoV-2 virus daily became among the first Americans outside of clinical trials to get immunizations with the power to disarm the deadly pathogen.
Just one month ago, Iowa experienced its worst surge yet. Coronavirus cases began soaring there in early November, as they have throughout the United States. By the middle of the month, Iowa was recording about 4,000 new cases every day. At the peak, 1,527 Covid-19 patients were hospitalized statewide. On the day the vaccine arrived, U.S. coronavirus deaths surpassed 300,000.
Among the first to be inoculated was Allison Wynes, a 39-year-old nurse practitioner in the intensive care unit at the health system’s main campus. Wynes was up all night Sunday in nervous anticipation before her shift started at 7 a.m. on a fourth-floor surge unit. It was created in early November, when the system outfitted 10 extra beds for critically ill patients after the regular 26-bed medical ICU filled up. Both have been full for weeks.
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Around 9:30 a.m., she went to an improvised clinic on the 12th floor of the UI Health Care children’s hospital building. The facility overlooks the city and the 45,000-seat Kinnick Stadium where the University of Iowa Hawkeyes play football. In normal times, at the end of the first quarter, the crowd and players would turn and wave to young patients watching the game from their windows. This year the stands are empty.
Wynes said she “bounced” into the immunization area. “The energy in that room was so much different than the energy I’d been working in and living in for the past six, seven, eight months,” Wynes said.
She was fifth in line for the shot. Cameras from press invited for the occasion clicked away. The jab was like any other, but Wynes cried quietly to herself when she got it.
Gregory Schmidt, 64, was taking a vacation day Monday when he got the call. Eager to get the shot, he fretted that his car might break down during the drive to the hospital.
As a physician and director of critical care programs, he’s watched the ICU fill up, expand, and then reach full capacity again. The hospital typically accepts complex critical patients transferred from smaller facilities in the region, but lately it hasn’t had space.
He got the hospital’s 50th Covid shot around noon. It was a glimpse of hope, and he texted a photo to his three sons, went to lunch with his significant other, and planned to head out for a bike ride in the afternoon. “Everybody in that room, me included, has been so desperate for this moment for so long, and now here it is. It’s within our grasp,” he said.
Yet there’s still a long way to go. It will be months before there are enough shots to reach the broader public. “This has been a tragedy,” Schmidt said. “It still is, and for months is still going to be a tragedy.”
Mike Brownlee, the health system’s 46-year-old chief pharmacy officer, met the box from Pfizer at the loading dock that morning. Part of the system’s incident command center, he got the shot around 11:30 a.m. Brownlee said he wanted to “demonstrate to our staff that we’re in this with them,” he said. “We’re on the precipice of a change.”
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Chetana Daniels, a 32-year-old nurse in the medical intensive care unit, was vaccinated around 3:30 p.m. While she’s accustomed to working with critically ill patients, Covid’s death toll has been hard to take. Sometimes patients appear to be improving, and then she’ll return to find them even sicker than before. She’s lost more Covid-19 patients than she can count on both hands.
“It’s a combination of losing so many people and people who are even young and otherwise healthy, and feeling like we need to do the work that we would normally do and then the work of their families since they can’t be there,” she said.
The experience has drained health-care workers across the country. Seth Jackson, another ICU nurse at UI Health Care, said he’s cycled through sadness, anger, anxiety and a feeling of ease or Zen. “I can only do as much as I can do,” he said.
Jackson’s wife is a social worker at UI Health Care, and their first child, Lucy, was born two months premature on March 27. Lucy spent weeks in the neonatal ICU. At first, Jackson and his wife could spend time together with her, but at some point visitor rules tightened and they had to trade off.
Jackson, 34, went back to work after parental leave around the start of June. Covid cases were no longer rare enough to be handled in the hospital’s special pathogens unit. “When I got there, they were in full swing,” he said. “It was a steep learning curve, for sure.”
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He’s had to rush to organize Zoom calls to enable dying patients to say goodbye to loved ones. “Sometimes you’re the only one there,” he said.
He was at the dog park Monday morning when he got notice that the shots had come in. He ran home, showered, and rushed to the hospital, crying on the drive there. He was third in line for a vaccine, two spots ahead of his friend Wynes, and was glad to see familiar faces.
“We’ve been in the thick of it forever,” he said.
Amid the Covid surge, Jackson’s daily after-work ritual has been to blare music – Pandora’s Hip Hop BBQ – to decompress. After getting the shot, he picked up a coffee, got in his car, and turned up the volume. He drove around for a while, he said, shouting “woo” like the wrestler Ric Flair.
The shots continued until 8 p.m. and by the end of the day, UI Health Care had vaccinated 178 people. More were planned the next day, and the day after that.
“This is the light that’s finally come,” Jackson said. “And sure it’s dim, and it’s going to take months, but every day it’s going to get brighter and brighter.”
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