On the front line: Inside OLOL’s COVID-19 ICU
BATON ROUGE, La. (WAFB) - Many of the sickest coronavirus patients in the Baton Rouge area pass through Dr. Jonathan Richards. He wants you to see what’s happening inside the intensive care unit where he works at Our Lady of the Lake. It’s the true front-line of the ferocious battle against COVID-19.
“In a normal ICU shift, we may have a week where we don’t have a death,” Richards explained. “But it’s different here. When people are dying, they’re dying quickly, and sometimes a little bit unexpectedly, and one person doesn’t wait for the next person.”
Our Lady of the Lake gave WAFB’s crew permission to document some of the tragedies and the triumphs. Much of the video featured in the story was captured by Dr. Richards and his team.
“I think people have the right to understand the struggles that we have and the victories that we’re having too,” he said.
Richards works in Critical Care Medicine Services within the Lake Physician Group.
As of Thursday, April 23, OLOL was treating 140 patients in eight COVID units. Two weeks prior, the hospital system peaked at 250 patients in 12 units. That’s a sign the curve has flattened, but it’s of little comfort for those patients still hooked to machines.
“I've been here 28 years. I have never been in a position where we've had this many patients this sick,” Melanie Guillory said.
The registered respiratory therapist explained, like many of her colleagues, that she was emotionally and physically exhausted. Watching her work, you’d never know it.
Guillory is in charge of those all-important ventilators, the machines keeping many COVID patients alive.
As the lungs struggle to get enough oxygen, the team uses a technique called “proning” to up the patient’s chances of survival. It involves flipping a patient onto their belly in an effort to reduce fluid buildup and open the lungs. Patients stay in the prone position for up to 18 hours before being turned back to an upright position for six hours. The process is repeated as doctors see fit.
“Part of why we’re so eager to do the proning is there haven’t been many other therapies that have proven to be beneficial, and it’s something that has pretty low risk or side effects, you could say. It’s not like some of the drugs,” Richards said.
“We’re trying our best to help these patients live and to live a normal life and come off the breathing machines, and this is one thing that’s helping most people,” Guillory added.
There’s another glimmer of hope in the form of plasma from the blood of patients who’ve already recovered from COVID-19. It contains a potentially helpful antibody.
“Perhaps obtaining that antibody from a recovered donor and administering that to a recipient, a patient who is unable to mount that kind of robust immune response, might in a way kick start their immune system,” said Dr. Vince Cataldo, an OLOL hematologist and medical oncologist. He’s the principal investigator in the open-ended trial being done in collaboration with the Mayo Clinic.
Three patients at OLOL have gotten plasma transfusions so far, but it’s too soon to say if the therapy will work. Doctors hope to ramp up its use as they get more donations.
“The only thing that the potential donor needs is proof that they were previously positive, they need to have the 28-day recovery time, or they just need to know where they were screened and we are able to get our hands on the proof of the positive test,” Cataldo said.
Those who think they may qualify can call the OLOL Blood Donor Center at 225-765-8843. Donors can avoid going inside the hospital by using the donation bus parked outside.
Cataldo and Richards are confident they’re trying every therapy they can to battle the invisible coronavirus. They and thousands of other dedicated professionals suit up every day, often sacrificing family time and personal relationships.
“We have a newfound name for work family,” Guillory said. “Everybody works together as a group and a team, and everyone gets along, and this is our family now.”
For those patients who don’t recover, families are now being allowed inside the hospital to say goodbye. They’re able to hold their loved one’s hand instead of saying goodbye over a cell phone.
“That has made it much more personal for us,” Richards said.
“It has really relieved a lot for everybody, for the therapists, the doctors, the nurses, the family members,” Guillory added.
A real relief would be fewer families to call, fewer patients to flip, and fewer hours of overtime to work. Richards says that depends on the actions of individuals, along with good planning and preparedness.
“If we start thinking about a future in two or three weeks as returning to normal, then that means you’re not planning for what is most likely to happen,” he explained. “We’re going to have to alter our daily lives to keep us safe.”
There are no politics in the halls of the ICU, just a continuous flow of sick people, even with a flattened curve. The front-line soldiers who work at OLOL want you to remember their reality as you live yours.
“You can go to Walmart, you can go to Home Depot. Wear your mask. Hand sanitize. You don’t have soap and water? I [always] have a little hand sanitizer. Stop the spread of the germs,” Guillory implored.
“If we don't do that, there's a chance that this is going to become a resurgence,” Richards warned. “Probably not to the degree as it was when it first started happening, but we'll definitely see an uptick.”
He also believes we will eventually get COVID-19 behind us.
“We’ll probably look back in our lifetimes and remember coronavirus for a lot of the bad things that happened. It’s the pattern of how sick people are that’s going to be memorable, a pattern of how difficult it is to get them better, but I think we’re also going to remember a lot of the good things that happened when teams are coming together and working much more efficiently under pressure than you’d expect," he said.
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