San Antonio, Texas NP Joseph Vine must be a descendant of the Unsinkable Molly Brown. After a brutal bout with Covid-19 left him in a medically induced coma for two months last year, our Nurse of the Week proceeded to push through a lengthy recovery period. Now, glad to be back treating youngsters at his pediatric urgent care clinic, he says, “I’m almost back to where I was before.”
But Vine endured a frightening ordeal in the interim between “before” and now. In June 2020, Covid entered the life of the 41-year-old father of three. Coughing and gasping for breath, he reached the ED at Northeast Baptist Hospital – just barely. “I was feeling so horrible,” he told News 4 San Antonio. “I was sure I had Covid, and basically as soon as I got to the ER, they were telling me they were going to have to intubate me.” His prospects for survival were dubious. In fact, Vine’s wife Anayuri said, “They thought he was not going to make it.” The couple had been married less than two years and Anayuri had recently given birth to a girl when Vine was admitted. Suddenly, her husband was inaccessible, lying comatose in the ICU and breathing with the aid of machines. For Anayuri and the baby, he had effectively vanished. “I couldn’t see him for two months,” she recalled.
Vine survived, after spending 56 days on a ventilator. His return to consciousness in August 2020 was met with relief – and relieved surprise – by his wife, friends, and doctors. He recalls, “I actually came out of it, which they never thought I would do… They were like, ‘Wow, he’s actually awake!’ A lot of people didn’t expect that to happen.”
When Northeast Baptist finally discharged him in October last year, Vine, like many post ICU patients, was almost as helpless as a newborn infant. (The NP, who has no insurance, had to cope with financial helplessness as well. He emerged with nearly $2 million in medical costs, and friends helped raise the funds for his rehabilitation treatment).
When he came home, Vine was suffering from nerve damage, and his right foot was entirely out of commission. Doctors warned that the foot might never regain its function. “They said,” he recalled, “If it’s not going to be here in 48 hours from when we first observed it, it’s most likely not coming back at all.” However, drawing upon the special reserves of discipline, determination, and “Yes I can” attitude that allows nurses to do what they do, the NP learned to walk again before his baby daughter Charlotte had mastered crawling. Charlotte – who was born just five months before Vine entered the hospital and is now 21 months old – had to become reacquainted with her father when he finally came home. She will be able to keep pace with Dad better than most toddlers, as he’s still wearing a foot brace, but Vine cheerfully remarked, “… I’m a lot more mobile now. I’m very encouraged. I think it’s going to come back even more.”
As his recovery progressed, Vine started treating patients via telehealth while still on a walker. By January 2021, he returned to the clinic on a part-time basis and transitioned to full-time two months later. “Being here and making a difference and helping people was a motivating goal to get back to. I missed the connections with my patients.” Since his recovery from Covid, Vine is also well-positioned to comfort families when one of his young patients contracts the disease. “When I talk to families, they’re often nervous, scared. It may be their first time that this has touched their family. I’m able to give them advice or help relieve some of the symptoms and talk about the course, and then also follow up with them… kind of being part of their process to make sure that nothing’s getting worse for them. That seems to really help them.”
Lost on the Frontline is the most complete accounting of U.S. health care worker deaths. The federal government has not comprehensively tracked this data. But calls are mounting for the Biden administration to undertake a count as the KHN/Guardian project comes to a close today.
The project, which tracked who died and why, provides a window into the workings — and failings — of the U.S. health system during the covid-19 pandemic. One key finding: Two-thirds of deceased health care workers for whom the project has data identified as people of color, revealing the deep inequities tied to race, ethnicity and economic status in America’s health care workforce. Lower-paid workers who handled everyday patient care, including nurses, support staff and nursing home employees, were far more likely to die in the pandemic than physicians were.
The yearlong series of investigative reports found that many of these deaths could have been prevented. Widespread shortages of masks and other personal protective gear, a lack of covid testing, weak contact tracing, inconsistent mask guidance by politicians, missteps by employers and lax enforcement of workplace safety rules by government regulators all contributed to the increased risk faced by health care workers. Studies show that health care workers were more than three times as likely to contract covid as the general public.
“We rightfully refer to these people without hyperbole — that they are true heroes and heroines,” said Dr. Anthony Fauci in an exclusive interview with The Guardian and KHN. The covid deaths of so many are “a reflection of what health care workers have done historically, by putting themselves in harm’s way, by living up to the oath they take when they become physicians and nurses,” he said.
Lost on the Frontline launched last April with the story of Frank Gabrin, the first known American emergency room doctor to die of covid-19. In the early days of the pandemic, Gabrin, 60, was on the front lines of the surge, treating covid patients in New York and New Jersey. Yet, like so many others, he was working without proper personal protective equipment, known as PPE. “Don’t have any PPE that has not been used,” he texted a friend. “No N95 masks — my own goggles — my own face shield.”
Gabrin’s untimely death was the first fatality entered into the Lost on the Frontline database. His story of working through a crisis to save lives shared similarities with the thousands that followed.
Maritza Beniquez, an emergency room nurse at Newark’s University Hospital in New Jersey, watched 11 colleagues die in the early months of the pandemic. Like the patients they had been treating, most were Black and Latino. “It literally decimated our staff,” she said.
Her hospital has placed 11 trees in the lobby, one for each employee who has died of covid; they have been adorned with remembrances and gifts from their colleagues.
More than 100 journalists contributed to the project in an effort to record every death and memorialize those who died. The project’s journalists filed public records requests, cross-connected governmental and private data sources, scoured obituaries and social media posts, and confirmed deaths through family members, workplaces and colleagues.
Among its key findings:
More than half of those who died were younger than 60. In the general population, the median age of death from covid is 78. Yet among health care workers in the database, it is only 59.
More than a third of the health care workers who died were born outside the United States. Those from the Philippines accounted for a disproportionate number of deaths.
Nurses and support staff members died in far higher numbers than physicians.
Twice as many workers died in nursing homes as in hospitals. Only 30% of deaths were among hospital workers, and relatively few were employed by well-funded academic medical centers. The rest worked in less prestigious residential facilities, outpatient clinics, hospices and prisons, among other places.
The death rate among health care workers has slowed dramatically since covid vaccines were made available to them in December. A study published in late March found that only four of 8,121 fully vaccinated employees at the University of Texas Southwestern Medical Center in Dallas became infected. But deaths lag behind infections, and KHN and The Guardian have tracked more than 400 health care worker deaths since the vaccine rollout began.
Many factors contributed to the high toll — but investigative reporting uncovered some consistent problems that heightened the risks faced by health workers.
The project found that Centers for Disease Control and Prevention guidance on masks — which encouraged hospitals to reserve high-performance N95 masks for intubation procedures and initially suggested surgical masks were adequate for everyday patient care — may have put thousands of health workers at risk.
The investigation exposed how the Labor Department, run by Donald Trump appointee Eugene Scalia in the early part of the pandemic, took a hands-off approach to workplace safety. It identified 4,100 safety complaints filed by health care workers to the Occupational Safety and Health Administration, the Labor Department’s workplace safety agency. Most were about PPE shortages, yet even after some complaints were investigated and closed by regulators, workers continued to die at the facilities in question.
The reporting also found that health care employers were failing to report worker deaths to OSHA. The data analysis found that more than a third of workplace covid deaths were not reported to regulators.
Among the most visceral findings of Lost on the Frontline was the devastating impact of PPE shortages.
Adeline Fagan, a 28-year-old OB-GYN resident in Texas, suffered from asthma and had a long history of respiratory ailments. Months into the pandemic, her family said, she was using the same N95 mask over and over, even during a high-risk rotation in the emergency room.
Her parents blame both the hospital administration and government missteps for the PPE shortages that may have contributed to Adeline’s death in September. Her mother, Mary Jane Abt-Fagan, said Adeline’s N95 had been reused so many times the fibers were beginning to disintegrate.
Not long before she fell ill — and after she’d been assigned to a high-risk ER rotation — Adeline talked to her parents about whether she should spend her own money on an expensive N95 with a filter that could be changed daily. The $79 mask was a significant expense on her $52,000 resident’s salary.
“We said, you buy this mask, you buy the filters, your father and I will pay for it. We didn’t care what it cost,” said Abt-Fagan.
She never had the opportunity to use it. By the time the mask arrived, Adeline was already on a ventilator in the hospital.
Adeline’s family feels let down by the U.S. government’s response to the pandemic.
“Nobody chooses to go to work and die,” said Abt-Fagan. “We need to be more prepared, and the government needs to be more responsible in terms of keeping health care workers safe.”
Adeline’s father, Brant Fagan, wants the government to begin tracking health care worker deaths and examining the data to understand what went wrong. “That’s how we’re going to prevent this in the future,” he said. “Know the data, follow where the science leads.”
Adeline’s parents said her death has been particularly painful because of her youth — and all the life milestones she never had the chance to experience. “Falling in love, buying a home, sharing your family and your life with your siblings,” said Mary Jane Abt-Fagan. “It’s all those things she missed that break a parent’s heart.”
KHN (Kaiser Health News) is a national newsroom that produces in-depth journalism about health issues. Together with Policy Analysis and Polling, KHN is one of the three major operating programs at KFF (Kaiser Family Foundation). KFF is an endowed nonprofit organization providing information on health issues to the nation.
Brand-new RN, Nurse of the Week Chelsie Turrubiartez didn’t allow anything to stand between her and her dreams of becoming a nurse. Over the course of nine eventful months, the 23-year-old Adel, Georgia resident was hospitalized for Covid, graduated from the School of Nursing at Abraham Baldwin Agricultural College, passed her NCLEX, and found an RN position at the hospital where she’s worked since high school as a nurse extender. “It’s like a nurse’s aide,” she explained. “I have always wanted to be a nurse, and now it feels really good to be able to do that.”
In March 2020, as much of the world was locking down and healthcare workers found themselves on the “frontlines” of the pandemic, Turrubiartez was busy studying, attending classes at ABAC, and looking forward to graduating with her class. Then, on the very last day of March, she was hospitalized for Covid and began fighting for her life. “The ventilator was on max setting,” she told the Albany Herald. “They put me in the ambulance, and I had to be on my stomach the entire way. I don’t remember the ride at all. I was out of it.” Her condition started to improve in late April, and Turrubiartez was finally able to go home on May 4, 2020. She hadn’t seen her family since March 31, had missed her last month of school, her eagerly anticipated virtual graduation ceremony, and, well, you do not simply bounce back after spending weeks on a ventilator in the ICU.
As she recovered from her frightening ordeal, ABAC gave Turrubiartez the opportunity to repeat her spring semester coursework that fall and graduate on December 3, 2020. “I was really happy when I graduated!” she said. “I didn’t think I would get a chance to do that.” Adding to her happiness that day, during the pinning ceremony, Turrubiartez received the Lisa Purvis Allison Spirit of Nursing Award and a scholarship check for $500. She followed that up by passing her NCLEX, and then, Southwell Tifton Hospital hired their former nurse extender to work as an RN on their general medicine surgical floor.
Now—with some help from that scholarship check—Turrubiartez is planning to study for her BSN as well. For more details on her story, visit here.
As Xinyi Christine Zhang watched the COVID-19 death toll among healthcare workers rise this spring, she wanted to find a way to give solace — and thanks — to their families.
The 15-year-old teen, of South Brunswick Township, New Jersey, joined her church in commemorating members who had died of COVID-19. But she was driven to try to do more, something personal. “I thought there could be something more meaningful I could do for the families of the doctors who lost their lives fighting the pandemic,” said Christine.
A gifted artist, Zhang resolved to draw the fallen U.S. healthcare workers in colorful memorial portraits, distribute them to their families and post them on her website. She wanted the relatives to know that people appreciated those who were trying to help Americans heal while putting their own lives in jeopardy.
Zhang frequently draws portraits for her friends and knew memorial portraits are usually rather expensive. She realized that drawing front-line workers could actually help families and was a better use of her time than drawing her friends — whom she said she’d drawn “like 10 times already.”
According to KHN and The Guardian’s “Lost on the Frontline” project, more than 900 healthcare workers in the United States have died after helping patients battle the coronavirus. The pandemic overburdened many hospitals and led to shortages in protective equipment such as masks and gowns that endangered many of those assisting patients.
Zhang found her subjects through that project. She set up a website to upload her portraits and to let families request drawings of their loved ones. Her portraits are free and easily accessible online, she said.
She has finished and posted 17 portraits since she started in late April. Each one takes six to eight hours, and Zhang spreads that work out over a few days so as not to interfere with her school assignments. Using a close-up image as a reference, she first digitally sketches the proportions of the person’s face with a pencil and then adds unique colors to “really bring life to the portrait.”
Her largest obstacle is getting in touch with the families. She hopes more families will request portraits through her website so she can work with them from the beginning.
One person Zhang featured is Sheena Miles, a semiretired nurse from Mississippi who died of COVID-19 on May 1. Christine tracked down her son, Tom Miles, who expressed his gratitude on Facebook.
“When you’re going through a loss like that, like the loss of a mom, to get the email from out of the blue just kind of gives you a profound feeling that there are some good people in this world,” Tom Miles said in an interview. “For her to have such talent at such a young age, and that she really cares about people she doesn’t even know — she is what makes America what it is today.”
This kind of response is exactly what Zhang aims for — she wants the families to know that she is thankful for the work of their loved ones.
“Someone they don’t know personally, even a stranger, appreciates what their loved one has done,” she said.
The portraits may be a source of brightness for grieving families, said Zhang’s mother, Helen Liu.
“I hope that families who receive these portraits will have a feeling of hope that better times will come,” Liu said. “A memorial is something meaningful and permanent, and I feel her portraits capture the happiness that will forever be with them.”
She hopes to get additional requests for the memorials from families.
In addition to drawing, Christine is a member of the South Brunswick High School’s Science Olympiad team and helps build projects for competitions. She’s interested in exploring engineering or product design as a career. Anything related to building or creating, she said.
She plans to either major or minor in art in college. For now, she wants to continue this project throughout high school — hopefully with help from others who know how to create digital art. She has a form on her website where others with art experience can sign up to help out. She said they can also add “other heroes in our society, such as war veterans or firefighters.”
“There are so many people that need to be honored, but I can’t do it by myself,” Zhang said.
Published courtesy ofKHN (Kaiser Health News), a nonprofit news service covering health issues. It is an editorially independent program of KFF (Kaiser Family Foundation), which is not affiliated with Kaiser Permanente.
Sharon Tapp learned that a severe case of COVID-19 can threaten not only your life but also your sense of self. After a lifetime of good health, COVID transformed Tapp from a busy nurse case manager into a comatose ICU patient attached to a feeding tube and ventilator. Sharon fought for her life for 117 days. By the time she regained consciousness, her world had changed. “I was just like a newborn baby in a diaper,” she says. “I took care of everybody. Now, everybody wants to take care of me.”
At first, 60-year-old Tapp, who works at the VA Medical Affairs Center in Washington. D.C. lost her sense of taste. When she started suffering common COVID symptoms such as headache, chest pain, fever, and chills, she went to an urgent care clinic and was tested. Five days later the clinic informed Sharon that she had tested positive for COVID-19, and her boyfriend took her to their area hospital. After being admitted to the ICU, though, her condition became so serious that doctors transported her by helicopter to Johns Hopkins in Baltimore. There, physicians placed her in a medically induced coma and connected her to a ventilator.
Tapp survived the ventilator, pneumonia, and heart and lung failure before she rallied. Finally, she moved to an acute rehabilitation hospital, where she spent three weeks working to overcome the muscle breakdown and overall physical debility caused by the lengthy time she spent in a coma (she even had to learn how to swallow again).
Her recovery will be slow, as she is facing both physical and cognitive challenges, but Tapp is determinedly pursuing her speech, physical, and occupational therapy. She is using a rolling walker and a quad cane while regaining her sense of balance and building her strength to walk again. Sharon has a powerful goal in view: she is looking forward to her eventual return to the hospital (as a nurse). After all, nursing is part of who she is: “I like helping people. That’s just my nature. I really enjoy when they get better and I have something to do with it.”