At Wyoming’s Ground Zero – COVID cases surging – there is no end in sight

By Amy Surdam, FNP

4

November, 2020

COVID-19
Stitches
Testing

The Surdams own Stitches Acute Care Center in Cheyenne, Laramie, and Wellington and are advancing telemedicine with InstaClinics. Contact amy.surdam@stitchescare.com for more information.

When Dr. Daniel Surdam, my husband, returned to Wyoming from his Emergency Department residency, he knew there was a need for urgent care in Laramie. Little did he know what a critical role urgent care would play in the current COVID pandemic.

When COVID started in China less than a year ago, we watched the news just as stunned as everyone else. It was like a foreign film. It seemed like overkill.

 As more and more people contracted COVID, we realized that the inevitable would happen: COVID was going to come to the United States. In early January, we received our first indication that there would be supply chain issues. Masks were in short supply and already on allocation with orders only permitted every five days. At that time, we didn’t know what we needed, but we knew we need more, and we knew we would run out of something.

Our teams started ordering items we thought we would need for a heavy flu season: gloves, masks, IV fluids, albuterol. By the time March rolled around, we had a small stockpile of supplies that saved us in the early days. On March 13, we started car testing via a private lab in Cheyenne for COVID in full PPE. It felt surreal for our patients and our healthcare team alike. Testing was minimal at the time and difficult to procure.

 On that first day, one woman said she felt her privacy was violated; then, she drove away. Despite that, we continued to car test. For seven months, our teams have worn snow pants, tank tops, and rain gear under protective paper gowns as an effort to keep patients as safe as possible.

Our supply chain issues have become desperate at times, yet, our community has graciously donated all that they could. The boxes of N95’s from rancher’s sheds have helped keep us safe.

Likewise, we have shared with others when we could. When gowns were hard to obtain, we gave what we could to home health agencies, long term care facilities, and others. For a while, we traded PPE like it was part of an underground market. We texted, swapped, and shared protective equipment with competitors and other healthcare friends.

There was a lot of unclear communication at first. It wasn’t easy to know where and how to find information. I think we have all gotten into our grove of fighting the COVID battle in whatever way we can fight it. The counties have done a phenomenal job of contact tracing and providing PPE as they are able. The State Department of Health has been an innovative and fantastic partner that has provided free testing to many citizens.

Our constant mantra as a way to decrease cases has been “mass testing, mass isolation.” Like so many others, we have tried to educate the public: wear masks, wash hands, social distance. Despite that education, masks are still being resisted and not worn by some. Change is slow, even during a pandemic.

We were heroes at first, with donuts, pizza, and lunches delivered daily. Our communities embraced us. As the months have worn on, the novelty has worn off, and COVID has become deeply politicized. We all want things to go back to “normal”; however, there is great debate on when and how that should occur.

 The drastic spike we see in Wyoming is a result of two things:

  1. Failure to be proactive in protecting oneself and others.
  2. Increased exposure.

Employers call continuously and ask what to do about exposures at work. My first question is always, “Do you require masks at work?” Often the answer is no.

After seven months.

There are events, large family gatherings, BBQs, trick or treating, and more. All of these events and being in the workplace without a mask lead to increased exposure. Increased exposure leads to an increase in COVID cases. The desire for human connection often wins over the sound reasoning of wearing a mask and social distancing. This is perhaps the most significant dichotomy of the pandemic that I have seen.

 Now, we are starting to see reinfections. The waning of antibodies causes pause and concern that an anxiously awaited vaccine won’t provide an immediate solution. The seasonality associated with most coronaviruses may apply to COVID 19 as well.

 Wyoming cases have surged, and there is no end in sight. We have seen a record number of patients day after day for months, and the community hospitals are filling up.

This last month was incredibly trying. We literally cannot hire and train people fast enough. Even if we could, there are only so many parking spaces, only so many computers, only so much PPE. Our phones ring endlessly, and often people can’t get through. The paperwork involved with COVID testing is cumbersome and maddening. In a highly technologic world, the rudimentary processes involved in healthcare are more exposed than ever.

Getting through the next few months, let alone days will be mentally challenging. Other logistical challenges lay ahead, such as delayed shipping as we compete with online holiday shoppers, rapid COVID tests no longer being provided by the State come January, the Federal Cares Uninsured Program possibly ending at the end of the year.

We anticipate some positive future developments, such as saliva testing, the continued adoption of telemedicine, and ongoing safety measures that help prevent other diseases.

For the most part, our patients have been very understanding. They say thank you, are kind, and give our teams the smiles they need to keep going.

Our healthcare team is a “well-oiled machine,” as Katie Sanne, FNP, likes to say. They work to their maximum capacity day after day and continuously adapt to every change made and every type of weather that Wyoming gives them.

This is their new normal.

None of us have experienced a pandemic such as this. The virus is still very new, and we don’t know its lasting health effects. It will be years before we understand the actual economic and social impacts our collective responses have had. Lost wages, businesses closing, increased abuse, and the elderly spending their last months alone are only a few examples of the negative impacts our society has endured.

We know that hospitals in Wyoming and throughout the nation are reaching capacity, and many more COVID related deaths will occur. We know that while healthcare workers have risen to the COVID occasion, they are tired and worn out.

My 92-year-old grandmother, who lives in a nursing home, contracted COVID and recovered. We know that most of us will get to the other side of this. May we get there with compassion, kindness, and a newfound appreciation for human connection and solemn remembrance of those who did not survive.