Vogelaar described the medical community’s general annual rhythm: gearing up for flu season in October, staying focused through a slog of respiratory illnesses in January and February, then breathing a sigh of relief in March. “But this year, we are anticipating our [winter patient volume] is going to increase drastically with COVID,” she said.
She and her colleagues are concerned that there’s not a “reliable point of care test” that would quickly and accurately help providers determine which patients have flu and which have COVID. On the one hand, the protocol doesn’t change: treat the symptoms. But patient anxiety is real. Vogelaar said her practice is expecting the “fear factor” seen in a typical cold and flu season to “increase tenfold.”
We’re far removed now from the “healthcare heroes” appreciation events that seemed commonplace in April, when entire cities would take to balconies and front steps to cheer on medical industry professionals at predetermined times. Bush’s organization is trying to coach its providers that this is a “marathon, not a sprint.” They’re expecting COVID-19 to be an “18-month run,” and they’re taking steps to keep patients and providers safe. That means equipping doctors and nurses with adequate PPE and educating them on the latest coronavirus techniques and therapies, which seem to be changing “month to month, week to week, day to day right now,” Bush said.
He’s also focused on keeping his physician teams agile and ready for deployment to hotspot regions, as he did earlier this month in Tucson. When an ICU in the city became overwhelmed, Bush pulled together a team of doctors from throughout Questcare’s network and sent them to relieve busy hospital workers. They did the same when COVID-19 overran New York and New Jersey hospitals earlier this year.
After weeks of plateauing mortality rates, the uptick in COVID-19 cases around the country is just beginning to correspond to an increase in deaths. Both Bush and Vogelaar agree that doctors and nurses have become more adept at treating critically ill COVID-19 patients. “If you get it today, you have a better chance of surviving than you did three months ago,” Bush said. Another possible reason deaths haven’t matched spikes in positive cases: Younger people are getting the disease. The Arizona-based nurse practitioner I spoke with said she’s seen a noticeable jump in 20- to 40-year-old patients who have fewer complications and better outcomes.
But Vogelaar warned it’s possible we may see the death toll rise significantly in the weeks to come.
“Mortality is a lagging indicator,” she said. “And the typical stay of someone in the ICU with COVID is about three weeks. So we are going to be maybe a month to five weeks lagging in our mortality, based on current reporting and the trends that we have now.”
Back at Von Sims’ home, daughter Sherry Tutt is sorting through the belongings of her deceased mom and drowning in a flood of memories. Each object reminds her of some connection Tutt now misses, as when she came across dozens of unopened dollar store purchases. They used to go deal-hunting together.
Tutt’s mother would call her multiple times a day: “And she’d say, ‘I’m coming over to your house today when I get off work. We’re going to go to the Dollar Tree by your house.’ And I don’t have a person to call like that now. I just feel this void.”