In April, New York City was a disaster. Refrigerated trucks waited for bodies outside overcrowded hospitals. Sirens echoed across unusually quiet nights. Residents locked themselves inside for weeks, afraid of the virus and each other.
Now, while life remains far from normal – the city has seen more 23,000 COVID-19 deaths – the only obvious evidence of the pandemic are face masks. The virus has nearly disappeared in the city, and the death rate is back where it was in mid-March.
To understand what turned things around in New York and other COVID-19 hotspots, USA TODAY asked a half-dozen caregivers what they learned fighting their own local surge and what advice they had for people in places suffering now.
Here are 10 tips they offered from their experience on the front lines:
Masks topped everyone’s list. Dr. Helen Chen, the chief medical officer of Hebrew SeniorLife, which runs senior living communities in the Boston area, said her biggest regret is that it took time to realize the importance of masks. Now, they’re essential in all SeniorLife facilities, she said. Chen said it makes her sad to see hospitals in communities that are struggling now – in Florida, Texas, Arizona and Southern California, among other places – still facing shortages of masks and gloves to protect healthcare workers and patients.
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‘You can beat the pandemic.’
Dr. Thomas Tsai, a surgeon and Harvard health policy researcher, wants people in hard-hit areas to know that. New York, Boston, Detroit and many other places all did. Rather than feeling helpless, he said people should take the pandemic seriously and practice the public health measures, like masking and social distancing, which have been proven to work.
Test on demand
Even in nursing homes where most residents were in their late-80s, about 40% did not show significant symptoms or know they were ill, before they tested positive for COVID-19, Chen said. “Unless you know what the positivity rate is, they end up infecting other people who end up getting really sick,” she said. Rapid testing allowed her team to quickly isolate people who had the virus and keep it from spreading.
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Use video-chat technology
Chen wishes she’d had more at the beginning of the outbreak. “I think we were all caught a bit off guard in terms of the need for enhanced technology,” she said. But even people with dementia can benefit from seeing friendly faces via video chat. “What we’ve learned from this is that it’s really, really important for people to at least have that if they’re going to be isolated away from their families,” Chen said.
Identify and isolate
That’s what turned the tide in the tiny town of Vo, Italy, according to Andrea Crisanti, a microbiologist at the University of Padua. In early March, the town was locked down when its first resident died of COVID-19. Every resident was tested for the virus. Those who didn’t carry the virus were allowed to go anywhere in town, but couldn’t leave the community. People diagnosed with COVID-19 – 40% of whom had no idea they were infected – were told to stay home.
‘Change clothes and shower at the hospital.’
Dr. Alden Landry, an emergency medicine physician at Beth Israel Deaconess Medical Center in Boston, advises his fellow healthcare workers to be careful not to bring the virus home. Landry, also an assistant dean at Harvard Medical School, initially sent his wife and four children to live at her parents’ house, because he was afraid of giving them COVID-19. But his house was far too quiet without them, and once school was canceled for the year, the separation became unbearable. “They are back, the house is loud, and I’m happy,” Landry said.
Follow the six c’s
Avoid crowds, close contact and closed spaces, cover your mouth, clean your hands, and take care of yourself, said Dr. Steve Pergam, an infectious disease specialist at the Fred Hutchinson Cancer Research Center in Seattle. “Those are pretty straightforward,” Pergam said, but they can substantially reduce someone’s risk of infection and are within an individual’s control. Although Washington State has a fairly low infection rate right now, he’s still avoiding indoor restaurants, bars and other indoor, crowded places. Taking care of yourself involved sleeping and eating well and getting plenty of exercise – though he struggles with that one himself, because he’s been tied to his desk from 8 a.m. to 2 a.m. seven days a week.
Air your emotions
Allison Applebaum, a clinical psychologist and director of the Caregivers Clinic at Memorial Sloan Kettering’s Counseling Center in New York City, said emotions like grief, anger and sadness are normal at a time like this, and it’s important to acknowledge them. For some at the cancer clinic, this was their last six months to travel, or their time to celebrate the end of treatment, but instead they’re stuck at home. Obviously, that’s going to spark some strong emotions, and she suggests people write, think, talk, and cry to get them out. “When we give them air time, we are almost able to use them to motivate us,” Applebaum said.
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Applebaum said some of her patients have turned the challenges of quarantine into an opportunity. One is now writing the book she always dreamed of and another is recording her family’s history. For a patient in recovery who was really sad about not being able to go back to his office, Applebaum helped him realize that what he really missed was the comradery of his colleagues. So now, he’s using technology to connect with them and get that feeling of teamwork while staying safely at home.
Take the long view
Like everyone, Pergam said he’s feeling the loss of many things he used to do pre-COVID-19. He’s tired of being at home. He wants to get back to traveling. Eating out. Hugging his parents, instead of sitting six feet away from them, masked, in a public park. “We all miss things we used to enjoy, but I think we do have to shift our thinking about this,” he said. “It’s a long haul. It’s not something that is going to be a shift for a couple of weeks. It’s something we’re going to have to do for a while.”
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Health and patient safety coverage at USA TODAY is made possible in part by a grant from the Masimo Foundation for Ethics, Innovation and Competition in Healthcare. The Masimo Foundation does not provide editorial input.