Nurse’s experience underlines Covid-19 reality

As South Africa’s latest Covid-19 death toll jumped past the 24,000 mark, the reality of what is happening in overwhelmed hospitals has become the focus of public health officials trying to keep the second, likely deadlier, wave of the pandemic under control.

In another of his ''family chats'' this week, South African President Cyril Ramaphosa once again was left with little option but to appeal to his countrymen and women to do the basics – especially around mask wearing and proper social distancing, with no ''Covid fatigue'' parties – until Covid-19 vaccines can play a role in curbing the death and disease being wrought.

South Africa overnight had recorded 892,813 known cases of Covid-19, with 24,000 known deaths, a further 184 infected people dying in the last 24 hours.

With beaches being closed for popular public holiday outings until after the New Year, many South Africans are tiring of the mask-wearing, social distancing and other necessary measures called for by public health authorities.

But in hospitals in overwhelmed areas, such as the Eastern Cape Province and, lately even Cape Town, the picture remains bleak and rapidly worsening.

One Cape Town nurse found she could stay silent no longer about what many, who are not yet themselves facing the impact of the pandemic, but who are acting as if all was normal.

Daily experience

In a social media post which has drawn significant attention, Covid nurse Simona Rinfreschi said she felt as if she had a personal responsibility to describe her daily experience for those living as if Covid was not real.

“When I look outside from my home, everything looks calm and ‘normal’. People are walking and laughing in the streets. Shops are buzzing with frantic Christmas shopping,” wrote Rinfreschi.

“There’s a constant pulling towards ‘how things were’, especially during this season of togetherness. If I didn’t work in the environment I am in, I would also have a growing mindset of ‘Covid is over’, ‘Covid was a giant conspiracy’, and I would be joining in on the tug rope pull towards normal.”

Unless one worked in health care, directly dealing with the Covid pandemic, “you won’t know”, she added.

“A few minutes’ drive from the comfort of looking out my window is a consuming hell where I have to clock in and pretend to survive for the duration of my shift.

“I arrive at work and I am assaulted with an overflowing ICU. There’s no staff, no beds, and definitely no ‘normal’. I’m assigned a Covid ventilated patient and three Covid patients on high-flow oxygen. This nurse-to-patient ratio is dangerous and I am scared.

“I’m scared I am going to miss something that leads to their deterioration and possible death. I am scared I am going to go to jail for a medical error. I am scared for my mental health,” added Rinfreschi, expressing feelings widely felt among over-stretched health workers, not merely here but everywhere that the pandemic is spreading.

Like so many others, her working conditions are extreme and overwhelming.

Zero beds available

“The phone rings. Constantly. No visitors are allowed in hospital so I am the family’s eyes and ears. Some of the families think that we are not doing enough, others are grateful. The phone rings again. Casualty and the wards looking for ICU beds.

“My fingers are constantly doing maths equations. How many ventilators are left, how many high flow machines are left, how many beds do we have, how many staff members do we have?

“The maths equations have become easier now, because the answer has become the same for all: zero. Zero beds available, zero high flow machines available, zero ventilators available, zero staff available. Zero. Zero whether the patient needing the bed is young, old, rich, poor, with medical aid or without medical aid.

“The wards are scary. No-one is connected to a monitor so there’s no early warning of deterioration. The nurses are running between patients with a monitor to check their oxygen levels. Some of the patients in the wards need high flow and ventilators, but we can’t help them.

“We turn their oxygen flow the highest it can go and hope. We hold back the fear and tears in our own eyes to not show the patients how dire they are.

I go home and cry

“Casualty is scary. The ambulances keep pulling up with more and more patients needing oxygen even though the hospital is on divert. There’s nowhere else for them to go.

“Other emergencies still exist. Car accidents, heart attacks, strokes, diabetic emergencies, surgical emergencies, etc. Where do they go?

“I go home and cry.

“I cry because I feel guilty that I am at home resting when the hospital needs help. I cry because I am overwhelmed and exhausted. I cry for all the lives we lost. I cry because everything is out of my control. My instinct to help and save lives is cancelled out by the limited resources and it kills me.

“Your healthcare workers are either dead or tired. No new healthcare workers have arrived as reinforcements or replacements or relievers. It’s still us. The same ones who have been fighting since March. We need you to please help us. Please be responsible.

“It may look normal outside, but it is not. It really is not.”

While government officials drone on in zoom meetings, it is the story of nurse Rinfreschi, and those other brave souls like her, which have rung true and deep for some who had become ''accustomed'' to ''living with Covid'', and which have served to underline the daily battle being raged in hospital wards around the world.