The hours in the day did not seem enough sometimes to take care of everything that needed to be done. Beyond that, I think the hardest part has been the loss of lives. We invest so much of ourselves in this profession that, when we lose one of our patients, it is a loss that is palpable. But the work goes on. We all go on because this is what we do and who we are.”

Dr. Janet Pedro

COVID-19: One Year Later

BaytoBayNews is releasing a series of stories reflecting on the year since COVID-19 arrived in Delaware and the progression of the pandemic in the First State. Read the full coverage.

By Mike Finney

While some people have fretted over trivial things like wearing face masks and social distancing over the past year, doctors and nurses throughout Delaware have come face to face with COVID-19 daily, all the while fearful of transmitting the virus to family members at home.

This year has been one for the history books, leaving an everlasting mark on the medical community.

Since March 2020, nearly 1,500 individuals in Delaware have succumbed to the coronavirus — and each one has left an indelible mark on the medical professionals who have treated and cared for them.

“My heart has broken over and over this past year. I grieve every single patient we lose,” said Hanna Goss, a registered nurse and manager of the Clinical Decision Unit/COVID Isolation Unit at TidalHealth Nanticoke in Seaford. “I remember their faces and their last moments. It’s emotionally exhausting.

“I hide it from my family because I don’t want them to have to feel the same emotion I feel. I am supposed to be strong. I hide the heaviness of caring for COVID patients because no one will really understand unless they experience it. I try not to be angry with people who think that COVID isn’t serious and am also thankful that they haven’t had to endure the stress and trauma my fellow health care team members have,” she said.

Behind the doors of hospitals, there have been environments most people have not had to witness, except for those tireless workers on the front line in the battle against the coronavirus.

This is the career that doctors and nurses signed up for — to help assist and heal people — just not at the alarming level of the last 12 months, a level they could have never imagined coming.

“COVID-19 has changed every interaction, whether at work or in the community,” said Jacob Lorea, an emergency department nurse for Bayhealth Hospital, Kent Campus. “As health care workers, we picked this career to serve our community.

“From the beginning, we knew we had to show up every day to care for our community. We had the mind-set that no matter what, we would get through this, and no matter how hard things became, we had to be there for the people who needed us.”

Just like the rest of the public, every day of the pandemic is a learning experience for hospital workers, as they try their best to save lives.

“COVID has changed so much in my life, personally and professionally,” said Amy Williams, a charge nurse for COVID-19 patients at Beebe Healthcare in Lewes. “First, I am a mother. So the fear of bringing it home to my kids was a huge stress. When schools shut down and my kids’ learning became my responsibility, (that) was another stress.

“When the COVID cases began to rise in our hospital, we almost went on autopilot. We were learning as the country was learning. People began to get sicker and sicker and even passing away. The reason that I kept going was because of our community. They were scared and looked to us for help. When visitors were no longer allowed, we had to be that comfort for our patients,” she added.

Dr. Joseph Kim, who works at TidalHealth Primary Care in Laurel and is also vice president of the medical staff at TidalHealth Nanticoke, said COVID-19 has a long reach of tentacles that didn’t just impact those who fell sick to it. It also touched large swaths of communities throughout the world.

“Over the past year, COVID-19 increased my fear and anxiety over the health of my patients, friends and family,” Dr. Kim said. “I ended up reading more journal articles and watching more videos about COVID-19 to be better informed.

“I witnessed the devastating impact of COVID-19 not only medically, but also economically, psychologically and even socially, especially in children and in vulnerable populations. It pains me to see families struggling, children going hungry and patients suffering.”

Dr. Nicholas Perchiniak of Beebe Healthcare said COVID-19 has been a two-pronged issue that has affected medical staff not only professionally but personally — inside and outside of emergency rooms.

“There’s always been that fear of infection and uncertainty,” said Dr. Perchiniak. “There’s been quite a change in the terms of how we manage from day to day. I’m a dad, and I have three kids. They’ve been getting home-schooled, and adjusting to that has been a challenge. We’ve been able to manage pretty well as time has gone by.

“Obviously, professionally, it’s been a significant experience, a once-in-a-lifetime pandemic to deal with, kind of going through some of the suffering, the illness, the loss of life, and you know, families have had to deal with ... their loved ones becoming ill. (It) has been … it’s been a very challenging experience.”

Days into nights, nights into days

When COVID-19 came crashing into the state in March 2020, the world changed in the blink of an eye for Delaware’s health care workers.
Suddenly, what seemed like endless shifts turned into endless weeks, then months and, now, a year.

“I wish I had time to take up a hobby, but unfortunately, I haven’t had any free time for myself,” Ms. Williams said. “Between work and Zoom calls and homework, I have had little time to do anything for myself, which adds to the difficulty of feeling ‘How much longer can I keep this up?’”

In an effort to protect their sanity, many have had to find ways to get away from the grim reality of the pandemic — if only for minutes at a time.

“Spending time with family is so important,” Mr. Lorea said. “My fiancee is also a nurse at the hospital, and we have an 18-month-old daughter. The hobbies that I had prior to COVID-19 remain important to me. I hunt and fish on my time off as an outlet.”

Dr. Kim’s time away from the hospital remains connected to helping others. Then, there are the cartoons that he watches to get away for a moment.

“To help alleviate my stress, I have devoted more time giving back to in-need families through my charitable foundation and supporting our health care heroes dedicated to saving lives,” he said. “In addition, one lighthearted thing I have done to escape is to go back and watch animated superhero cartoons, such as ‘Batman: The Animated Series,’ ‘Justice League’ and ‘Spider-Man,’ which remind me of my childhood and a simpler time.”

Dr. Kim said the pandemic has also made him appreciate things he took for granted, like “spending time with family and friends, dining at restaurants and traveling.”

Dr. Janet Pedro, a nephrologist and president of the TidalHealth Nanticoke medical staff, said she would love to get away on a vacation but has had to settle for other endeavors.

“My usual way of decompressing from the rigors of medical practice is visiting family in Texas, traveling or getting together with friends,” she said.

“Unfortunately, these were not possible through the pandemic. We could not take vacations, since we all had to be available to make sure that all services are covered.

“As I have always loved cooking and baking, I have continued to do that on my free time to help with the stress. Literally, that was food for the soul.”

Dr. Simran Kaur Matta, an intensivist at Bayhealth Hospital, Sussex Campus, in Milford, takes care of the facility’s most critically ill patients in the Intensive Care Unit. She would also love to take a break and get away for a while but just cannot do it right now.

“Personally, I strive to maintain a healthy work-life balance and practice mindfulness for better sustainability,” Dr. Matta said. “It’s been more challenging during the pandemic. When it comes to mental health, we know it’s essential to socialize and travel, but with such trying circumstances, it’s just not feasible right now.”

Dr. Perchniak said it is crazy how much the world changed in what seemed like the blink of an eye in March of last year.

“Last spring was sort of a surreal thing. Everything emerged, and essentially, life came to a halt,” he said. “Obviously, I was still going to work, and I’m sure my family was sort of scared to be around me at times, especially at the beginning.

“I think we were trying to look at the positives, and I did a lot more baking, especially with my daughter, than I used to, and I think we dusted off some board games that we hadn’t played in a while.”

Ms. Goss said she just keeps it simple when it comes to moving at such a fast pace day to day.

“I start every day by naming three things I am thankful for,” she said. “I try to approach each day with gratitude. I am fortunate to work with the most amazing team of nurses, who truly are the most compassionate and caring team I have ever met.

“We survive by taking care of each other and by finding something to celebrate each day. My fellow nurses are my heroes. We are in this together, and together, we will make it through.”

Pandemic brings personal changes

While medical staff mourn every life lost due to COVID-19, they also find solace in watching others recover.

That healing power is what keeps many of the doctors and nurses hopeful — and going.

Dr. Matta said that getting the opportunity to watch a patient heal from the coronavirus is the satisfaction that helps her persevere.

“We meet our patients for the first time in their most vulnerable moments,” Dr. Matta said. “To be able to provide lifesaving interventions and to turn the course of the virus is deeply satisfying. It’s what keeps us going and pushes us as a health care team to persevere through these difficult times.

“When families, who, at times, could not be present, expressed how grateful they are to have their loved ones back, it gives us purpose and a sense of fulfillment.”

Ms. Goss said many don’t realize exactly how physically exhausting it is to have to wear protective equipment while caring for a patient.

“Many people are frustrated about having to wear a mask to the store but imagine wearing full protective gear for 12 hours while performing care,” she said. “Some patient’s condition continues to deteriorate even when we have done everything for them we can. It isn’t something we are used to seeing. So caring for these patients is both physically and emotionally exhausting.

“The past year has made me grateful for my health and grateful that I am nurse. Even though the grief has been great, I still feel privileged to be able to touch people’s lives and support my community. I also feel privileged to work alongside my team. They are the ones who keep me going every day. They are the ones who deserve all the thanks and praise. My hope is that each of them know how truly wonderful they are,” she said.

Mr. Lorea said nurses and doctors have had to take up dual roles during the pandemic.

“The pandemic impacted me both mentally and physically,” he said. “We had never dealt with anything like this before. We had to be the nurse physically caring for patients, while staying in contact with the physicians and being the liaison to family members, who couldn’t visit or be here.

“We knew our patients were going through so much. Being in the hospital is hard enough, let alone during a pandemic or even with a COVID diagnosis. There was a lot of fear and uncertainty, and we had to be there for patients,” he added.

One of the most difficult things medical staff cannot escape is the grim reality of death in many cases and, sometimes, promises lost.

“COVID-19 has taken a tremendous toll on me physically and emotionally,” Dr. Kim said. “During the surges, I worked nonstop by seeing patients in the hospital or in the office, calling patients and/or family members, engaging in virtual meetings and collaborating with physician and health system leaders.

“One of the most emotionally difficult situations for me during this pandemic was when one of my favorite elderly patients passed away due to COVID-19, after fighting for 30 days in the hospital. Before the pandemic, I promised her she would live to 100 due to her good health, but despite all efforts, I failed to keep my promise.”

Death cast its long shadow on all the front-line workers throughout the crisis.

“The most difficult part of the pandemic has been the amount of loss we have had to be a part of,” Ms. Williams said. “The more patients we lose to this, the more difficult it is. My heart is heavy every day. It isn’t something that I can get used to.”

Dr. Pedro has found this past year to be so difficult because there were so many unknowns surrounding the virus.

“As we were taking care of patients to the best of our abilities, at the back of our minds, there was the fear of being infected and becoming a victim to this disease or, worse, (bringing) the infection to our homes and our families,” she said. “At the peak of the pandemic, the physical and emotional burden was heavy on every health care worker. There have been sleepless nights, thinking of the work that needs to be done for our patients and the hospital.

“The hours in the day did not seem enough sometimes to take care of everything that needed to be done. Beyond that, I think the hardest part has been the loss of lives,” she said. “We invest so much of ourselves in this profession that, when we lose one of our patients, it is a loss that is palpable. But the work goes on. We all go on because this is what we do and who we are.”

Light at the end of the tunnel

While Delaware is marking the one-year anniversary of the COVID-19 virus — but certainly not celebrating it — the advancement of vaccinations and ever-decreasing numbers of positive cases and hospitalizations has many in the medical community feeling hopeful.

“We are almost a year into this,” Dr. Pedro said. “Proud to say that we all got through it. We did it through teamwork. Every member of the health care system had a job to do. We are each other’s support system.

“We can’t wait for all this to be behind us, for our lives to return to normal. We are hopeful that the vaccines can break the cycle and bring us to the road of recovery. In the meantime, we encourage all to continue practices to limit the spread of the disease with hand washing, use of masks and social distancing.”

The vaccinations are stirring up hopes of a quick return to the old normal — one shot at a time.

“Now that the vaccine is being distributed throughout our community, it’s the light at the end of the tunnel,” Mr. Lorea said. “It’s hope that things will change. And we’re seeing the numbers trending in the positive direction, which is so great to see.”

Dr. Kim can also see that light — and it is getting closer and closer.

“I keep going, knowing there is a light at the end of the tunnel with increased vaccine distribution and continual mitigating efforts,” he said. “I also have an incredible support system of family, friends and staff, who help get me through every day.”

One thing is for certain: While COVID-19 may eventually go away, Ms. Goss’ experiences over the past year will live with her forever. That is the case with all members of Delaware’s medical community.

“Patients with COVID require complete care, and the care is physically exhausting,” she said. “You’re working so hard and stretched so thin that you feel like you can’t give the quality of care you would like. You feel like a bad nurse.

“The second hardest part is the patients that die without their families by their side. We hold their hand, speak gently and even sing to them because we won’t let anyone die alone. I worry for my fellow nurses and the toll this will take on them. I especially worry for the new nurses,” she continued. “I wish I could hug every single one and tell them ‘thank you’ and they matter.”