Healthcare Workers Fighting the Pandemic on All Fronts

The work that healthcare professionals are doing is challenging, frightening, and most of all, physically, emotionally, and mentally draining. Doctors and nurses are being asked to balance the high-risk challenges of their profession while still attending to the demands and responsibilities of their personal lives and families. 

The virus has highlighted the critical role healthcare professionals play in keeping our society functioning and healthy. For the Teach For America alumni who pursued careers in medicine and related fields out of a desire to bring high-quality healthcare to the communities in which they taught, this crisis is challenging them in ways they could have scarcely trained for—and still, they’re rising to the occasion. 

Meet some of the alumni healthcare workers—a doctor, a nurse, a consultant, and a city health official—who are responding to COVID-19. Some are on the frontlines of the pandemic treating patients, while others are behind the scenes ensuring practitioners have the resources they need. Together, their hard work and sacrifice is helping keep our students, families, and communities safe.

Predicting Hospitals’ Needs—and Helping Provide for Them

Weeks before the steady drumbeat of coronavirus coverage in the news, Catherine Castillo (Houston ‘11) had a sense of how bad things would get. As a healthcare strategy consultant at Array Advisors, Catherine spends her days projecting long-term performance and demand for different healthcare services, using that information to make strategic recommendations to healthcare systems and hospitals.

“When we started to realize that the pandemic was going to severely impact our health system here in the United States, we recognized we needed to help hospitals across the states recognize how much demand for care this was going to generate,” Catherine says. 

She and her firm have been focused on modeling all sorts of scenarios related to the pandemic. The very first model she created focused on the need for beds—hospitals need to anticipate how many patients with COVID-19 will arrive, how long they’ll be in the hospital, and what level of care and isolation patients will require, Catherine explains. “We used publicly available data to determine when there would be an ICU bed shortage in each state.” 

But Array Advisors doesn’t just predict capacity shortages. The consultants also brainstorm solutions. Architects develop ways to overcome the strained capacity for beds—for instance, sometimes the recovery beds in ambulatory surgery centers can be used as an extension of the hospital’s space. Hospital spaces can be rearranged to safely accommodate an influx of patients with coronavirus. Also important is the need to isolate patients at the hospital for everyday urgent health needs—heart problems, kidney stones, labor, and other critical health concerns—from people with coronavirus, and from people being tested. In developing one state’s planned coronavirus response, her company also considered how hotels can be used to house vulnerable populations, such as the homeless. 

Catherine’s hours are long, and the models her firm is producing point to frightening outcomes: a shortage of beds means that some people will not get care. “The numbers on the page—I have to mentally separate myself from them,” she says. Still, the information is essential for decision-makers, she says. 

“I’m incredibly motivated to work around the clock and on weekends. Time is of the essence,” Catherine says. Her work, she says, has a new urgency. Any late hours are worth it if her work helps hospitals form a plan or convince people to stay home, she says. “I am just doing what I can to support the systems for people who provide direct care—they are our true heroes,” Catherine says. “There’s so much being asked of them, and once the nation gets a chance to breathe again, we have to show our healthcare workers on the frontlines how important they are.”

Becoming a Coronavirus Doctor in North Carolina

For Dr. Annie Dotson (Houston ‘07), the long 60-hour work weeks throughout the COVID-19 pandemic aren’t what worry her. She, like her fellow physicians, trained for that clinical time during residency. It’s the emotional strain of how her work affects her two young children and husband, and puts them all at risk of exposure, that’s hardest for Annie. That, and ensuring the safety of her patients and staff through COVID-19. 

As a clinician at the UNC Department of Family Medicine in Chapel Hill, North Carolina, and one of the hospital’s frontline healthcare workers, Annie and her fellow doctors are responsible for minimizing the risk of exposure for staff while still providing patients the care they need. 

That includes helping physicians who practice specialized medicine transition to where they are best needed and where they can best serve during the worst of the pandemic. For clinicians like Annie, this means moving the majority of her patient care to telemedicine and phone calls. Normally, Annie and the other clinicians provide full-service primary care at the UNC Department of Family Medicine, which includes delivering babies and pediatrics. Now, she is minimizing her exposure and focusing solely on obstetrics to protect the health of her patients giving birth. 

“There's been a lot of strategic planning around how to continue caring for patients while also not putting those patients or our staff at risk,” Annie says. “For me, I still deliver babies, and starting next week, we're transitioning to a different on-call system for those of us who deliver babies so that we can minimize our own exposure outside of what we're concentrating on.”

That responsibility weighs heavily on every doctor at the UNC Department of Family Medicine, especially as medical safety supplies across the country are becoming more and more scarce, and doctors in besieged cities like New York are forced to reuse their masks for days. In fact, the medical students at UNC are already busy making protective face masks for the hospital in anticipation of shortages, Annie says. It’s a serious concern for hospitals all over America. 

“We all have a bond, whether it's our own families or family members or friends, people we're worried about exposing to COVID-19. [But] we really don't have the ability to stay at home,” Annie says, adding that these are her own personal opinions and not that of her employer. “We are mobilized and registered to take care of patients. We’re doing our part and oftentimes stepping into situations that are not ideal and that are requiring us to make really tough decisions for our own health and our own families.”

It’s not just her own family she’s afraid for. Annie also worries about the ramifications of COVID-19 for families in low-income communities, like the ones she served while teaching in Houston. She joined the medical profession because of the encouragement of her high school students, who saw the difference Annie could make in healthcare for families who suffer from medical disparities.

Now more than ever before, Annie is concerned that those students and their families will be among those hardest hit by the pandemic: the patients without health insurance, the pregnant women who aren’t able to get their blood pressure checked regularly by an OB/GYN, the families who lack the financial means to testing or medicine.  

“I think we really just won't know the true impact until after this has calmed down,” Annie says. “So we can really look back and assess our response for all kinds of disparities, including racial and economic disparities.”

Helping Baton Rouge Respond

The healthcare workers of South Louisiana are no strangers to handling a crisis. They came together to help the community after Hurricane Katrina, and they’re doing it again now during the COVID-19 outbreak.

But that doesn’t mean it’s easy. The work to prepare South Louisiana for the pandemic to come began well before the virus hit the community, says Jared Hymowitz (South Louisiana ‘12), who today serves as the director of the Mayor’s Healthy City Initiative (HealthyBR) in Baton Rouge. 

As the director of HealthyBR, Jared’s day-to-day responsibilities involve advocating for the health of Baton Rouge citizens as well as supporting coordination, communication, and collaboration between local nonprofits and the healthcare community to help make Baton Rouge a healthier place. HealthyBR’s work is especially urgent now that the number of cases of COVID-19 in Louisiana, like the rest of the country, is increasing. 

The first priority was setting up safe and efficient community testing, something that has never been done before for a respiratory virus in Baton Rouge. 

“We began meeting with healthcare leaders to prepare for a community testing site. We met every day working on what the criteria would be, who would staff it, how we would bill patients, the process of how cars or people would go through, where the location would be, and so much more,” Jared says. “In one week, we were able to stand up the first community drive through testing site in Louisiana with no resources from the federal or state level.”

In the three weeks since the community testing site opened, the city of Baton Rouge was able to test over 1,500 people. Now, as the health lead for Baton Rouge’s COVID-19 response, Jared’s team is working to keep up the momentum by ensuring medical officials are being given the protective gear they need to safely treat the city’s COVID-19 patients. 

“After the testing site was operating efficiently, we moved to looking at hospital capacity and PPE.” he says. “We are leading the effort for community testing as well as the coordination regarding personal protective equipment and coordination of hospital capacity.”

Every aspect of the COVID-19 crisis response, from the logistics and criteria for testing to the coordination of PPE, is new to the city. But for Jared, learning on the job comes with the territory. 

After joining Teach For America, Jared worked as an educator for five years in rural Louisiana. He went on to join the Baton Rouge mayor’s office, despite his hesitation about having no prior experience in public health, because he wanted to have an even greater impact on the systems and structures his students have to navigate. 

That’s what this work is all about: supporting the community. 

“Our organization has been around for 10 years. That is 10 years of all five hospitals in our parish coming together for the common goal of helping to make Baton Rouge a healthier place,” Jared says. “Our community is always ready to rally and help each other at a moment’s notice. It’s one of the best parts of being a part of this community.”

Triaging Patients in New York City

The skin on Kaitlyn Hansen’s hands is dry and cracked from her sanitizing ritual, which includes placing her shoes and lunch box by the door, putting her phone under a UV light, and using tons of Lysol wipes. Sometimes, Kaitlyn (Greater Chicago-Northwest Indiana ‘15) will retrace her steps, second-guessing if she got everything. “It’s tricky because I just washed my hands, but then I go back and touch something I’ve touched before,” Kaitlyn says.

Kaitlyn was inspired to go to nursing school by the healthcare inequities she saw in the classroom as a corps member. She graduated from nursing school in August, after which she worked as a pediatric nurse practitioner in a school-based health center in New York City. Three weeks ago, she was brought in to help with COVID-19 response and triage on-site at her clinic’s main location on the Upper West Side of Manhattan.

Kaitlyn’s work is in telemedicine at the clinic; she fields calls from sick community members, providing care over the phone and telling patients if they should call 911 or go to an emergency room. There was a learning curve at first. But now, on day 18, those on Kaitlyn’s floor are finding a rhythm amid the chaos.

Kaitlyn says her clinic is pretty well set up with personal protective equipment. But she hears horror stories from her colleagues at other hard-hit New York facilities, which worries and frustrates her. “I wish people understood that healthcare workers have all of the stress and anxiety that all other citizens have,” Kaitlyn says. “I feel for our essential workers who are all in this same position; it’s not just healthcare workers. Many other professionals are putting themselves at risk to keep society going.”

At the Manhattan clinic, some days feel nonstop. “I hang up the phone and it’s already ringing again,” Kaitlyn says.

People who call are often scared and overwhelmed by the amount of information that exists. Part of Kaitlyn’s role is being a source of reliable information. Symptoms people call about include everything from fatigue, body aches, cough, and fever to gastrointestinal symptoms, chest pressure, and difficulty breathing.

Patients are often told to self-isolate, which isn’t easy for many. When talking to patients, work plays a big part in the conversation. “I’m asking, ‘Is there any way you can stay home and not be exposed?’ And for some, the answer is no. They have to go to work because they’re a security guard and their services are needed,” Kaitlyn says. “Low-income families don’t always have a choice.”

For Kaitlyn, it’s the isolation that makes the virus particularly brutal. It’s hard for Kaitlyn to be separated from her family back in Dallas, and it’s hard for her to talk to patients and be physically unable to help them in a hands-on way. “I had a patient I talked to every day for almost two weeks; they were alone and felt really bad and were scared they were going to get worse,” Kaitlyn recalls. “It was them saying they didn’t want to be sick anymore and me not being able to do anything for them.”

It takes a toll—a toll that Kaitlyn often doesn’t have time to process. “It’s my job to care for other people’s emotions as well as their physical needs. It’s hard to put all of that on pause,” she says.

The other day on her lunch break, Kaitlyn stepped outside to breathe. “I just wanted to see the sun. I was just looking around at everyone wearing masks. I saw this woman helping someone who seemed to be her grandmother walk on the sidewalk, and they just seemed so scared of everyone," Kaitlyn says. "While looking around at what’s going on in the world, it all hit me—I want this to be over, but it’s not. It might not even be halfway over yet.” 

A sense of solidarity with other healthcare professionals helps Kaitlyn get through this. It’s also the kindness and empathy of others. Kaitlyn pauses for a moment to listen to people just outside her window clapping for healthcare workers as they head home, a new daily 7 p.m. ritual throughout New York City.

“Do you hear the applause?” she asks. “It’s so cool!”

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