As the first shipments of the COVID-19 vaccine arrive, the rising number of infections still threaten to overwhelm workers at Pittsburgh-area ICUs and nursing homes. For workers in these settings, the tragedy of the pandemic has been an inescapable part of daily life for months. They've seen it all: from being called a hero to being shunned, and from working 16-hour shifts to quarantining at home. Despite hopeful news, they fear the worst is yet to come.
Below are the stories of three women who’ve spent most of 2020 working on the front lines.
Shannon Tully, ICU nurse in Forbes Hospital’s COVID-19 unit
At the end of March, Shannon Tully was the first nurse to tend to a COVID-19 patient in the intensive care unit at Forbes Hospital in Monroeville. She was also the first to intubate a very sick COVID-19 patient. And then, on April 2, she was the first nurse in the hospital who tested positive for the virus.
“When I found out, I cried hysterically,” Tully said. “I was terrified because at that point there was so much we didn’t know yet about COVID. I didn’t know whether I had exposed family or coworkers.”
It turned out to be a mild case. Tully quarantined for two weeks and then was back in action, working 12-hour shifts in the ICU. Today, she explained, it’s almost normal for a coworker to have a positive COVID-19 test.
Despite the threat of infection, the ICU staff is directing all it’s attention to the patients.
“In the beginning of the pandemic, we maybe had three or four COVID patients,” she said in early December. “Around June and July, that second wave, we had maybe eight patients. But now, we’re almost filling up the entire ICU unit with 16 to 18 patients.
“Right from the beginning, we saw that this is a type of nursing none of us have experienced before. You’re gowning up in all this PPE and then when you go into a room, you have to make sure you have all the supplies you need because you cannot quickly go in and out again.”
The biggest difference, however, is the amount of suffering the nurses are witnessing.
“Some patients do well,” Tully said, “while others do terribly, and then on top of that, we’re experiencing more death than ever before. There was a week in October where we lost five patients. It was terrible.
“A lot of our patients come into the hospital terrified because of what they’ve seen and read in the media about COVID. They ask me: ‘Do you think I will survive?’ It’s hard to say to them, ‘Yes, you’re going to beat it,’ because we’ve seen so many people die already.”
With the suffering of patients, comes the pain of their loved ones.
“I have seen more grief than I ever thought possible. Like sitting next to patients as they’re dying, while their families are watching on FaceTime or through a glass at the hospital.”
Seeing so much grief and death and working extra shifts takes an emotional and physical toll on the nurses. Tully talks, and cries, to a therapist on the phone to be able to deal with the situation.
“I think that I and some of my coworkers are experiencing PTSD. I wake up sometimes and I had a nightmare in which I see the faces of patients that have died. Before COVID, you would be able to separate work and life. But now it has encompassed all of our lives. It’s all your family and friends ask you about. You turn on the TV and that’s all that’s on the news.”
On the positive side, Tully has felt a lot of support from friends, family, co-workers and the leadership at Forbes. She also has seen a lot of love and patients recovering.
“We had a patient who was intubated, and his wife would call in every single night. We would put the phone next to his head, and she just talked to him. And we heard her sing songs to him, and read him letters. And this man did survive.”
After testing positive for COVID-19 antibodies, Tully was able to donate convalescent plasma.
“I’ve donated plasma 13 times and I like to think that I’ve given plasma to 13 different COVID patients in the Pittsburgh region. It’s hard to say if it's really benefiting patients or not. I’ve seen people that look really great the day after they’ve gotten it, and with other patients it doesn’t seem to make a difference at all.”
It’s early December, and Tully is mentally preparing herself for the pandemic to get worse. “They started putting two monitors in the rooms, so, if necessary, we can start doubling up patients in the ICU rooms. The problem is, where do you get the nurses from to take care of all those people?”
She tries to stay away from social media: “Sometimes, the people that are posting things about encouraging health care workers and calling them heroes are the same people that are doing the things that they shouldn’t be doing, like going to bars and stuff like that.
“Some days, I wish I could bring a camera into the ICU so people could see what the virus can do.”
Shelby Dille, certified nurse assistant at Brighton Rehab in Beaver
Shelby Dille believes the workers at Brighton Rehabilitation and Wellness Center in Beaver got a bad rap after 82 residents of the facility died of COVID-19.
“The people that work at Brighton want other people to know that whatever management did or didn’t do had nothing to do with us,” said Dille. “The workers don’t deserve the bad rap they’ve gotten. Most of us work eight to 16 hours a day, day after day. We’ve been giving up days off, we’ve been giving up vacations and holidays. We’ve done the best we can to take care of the patients in the building.”
She detests the fact that Brighton Rehab and its high mortality rate have become a sort of poster child for all the things that went wrong in nursing homes during the pandemic. She believes Brighton is like every other nursing home and hospital in the country.
“Everybody has to deal with COVID,” she said, “and they’re doing the best they can to keep it under control. You do your best, but it may be getting away from you. But that isn’t intentional.”
It’s difficult for Dille to talk about all she has witnessed since March without shedding tears. Apart from the sickness and deaths she’s seen at Brighton Rehab, she also lost her 85-year-old mother, who died from a disease not related to COVID-19.
“We may have lost people,” Dille said while choking up, “but I want all the families who have lost somebody to know that our hearts break as bad as yours does. You have to know that we were with your loved ones and held their hands; we made sure they weren’t alone.”
The Post-Gazette reported that by the first and second weeks of April, when positive COVID-19 cases and deaths started to climb at Brighton Rehab, staff members began refusing to come to work or started to get sick themselves.
“Some of the staff had health issues of their own,” Dille said. “Their doctors told them not to come to work. We had girls that were pregnant. There’s no history to say what COVID would do to the baby or to the mother. So it made sense that they didn’t come to work. Others had breathing issues. When you put on those masks and you put on the goggles and you put on the face shields, some days you pretty much feel like you're suffocating.”
Some other workers, according to Dille, felt that they hadn’t signed up for the sickness and death they were dealing with at Brighton Rehab.
“If you have workers who are scared and nervous and don’t want to deal with it, it’s not going to help you get the job done,” she said. “So, maybe it was better that they went. It did create the problem that some days we didn’t have enough staff in the building.”
The staff also has to deal with the fear in their communities that they are spreading the virus. For precisely this reason, Dille doesn’t want to say whether she ever tested positive for COVID-19.
“A lot of our families don’t want us near them. Stores didn’t want us to come inside because of where we worked. ... Even now, people are afraid to be near us.”
Despite these challenges, Dille said she received support from her family, from families of patients, from her union, from complete strangers and from her church.
“My preacher at Chippewa United Methodist put out a call to the church to say a prayer every day at 2:45 just for Brighton Rehab” Dille said. “So every day at 2:45, the people of the church ... stop what they’re doing and say a prayer for us.”
Dille has been a certified nurse assistant since 1980. Sometimes she gets tired or frustrated, and she wants to stay in bed for a day or just go to the beach. But she has learned to push her own needs back and focus on the needs of the residents.
“Sometimes it hurts, but you do it anyway. You just think, I’ll be off at 3 and then able to spend some time with my family.”
Meilin Young, M.D., pulmonary and critical care specialist at Allegheny General Hospital
“We’re no heroes,” Meilin Young said as she and her colleagues prepared for an expected surge in COVID patients at Allegheny General Hospital. “We’re just doing what we are trained to do: make people better and try to save lives. That’s our job.
“We’re basically the last defenders. It starts with everybody in the public, wearing masks, washing hands, social distancing, minimizing gatherings, etc.. Those are the ones that are helping us the most. We’re just picking up the pieces at the end.”
The beginning of 2020 was a perfect storm for Young: She was expecting her second child, preparing for her graduation from a fellowship in pulmonary and critical care medicine and worrying about the news from China.
“I still have family in China, so when the pandemic started happening there, it was terrifying on a personal level because of my uncles and my grandma, who’s 90 years old.”
Young knew it was just a matter of time before the virus would show up in the United States.
“I was seven months pregnant and worried about being potentially high-risk for working in a hospital and worrying what would happen to my baby.”
In April, Young gave birth to a healthy baby girl and in August, she graduated while the ICU at Allegheny General Hospital began to fill with COVID-19 patients. As a pulmonary and critical care specialist, Young got involved from the start.
“In a way, it was business as usual because we know the basics of how to manage individuals with respiratory failures on a ventilator,” said Young. “But one thing that was challenging was the realization that COVID not only affected the lungs but can manifest itself in so many other organs.”
Young felt defeated when she had to deal with the first death among her COVID-19 patients. “We did everything we could, gave him all the medications that were available, the steroids, the remdesivir, convalescent plasma, everything you hear about in the news. It was heartbreaking, because even then, his body still succumbed to the disease.”
“The most terrifying [part] is that families cannot see their loved ones here in the hospital. So, when they die, we have to bring the news to them on the phone. That is the hardest thing to do, to tell the father or the wife or the child that their mom or dad died.”
In the first months of the pandemic, Young made four or five such calls every week.
“What keeps you going is that most people still do well. For every person that dies from COVID, we do have many success stories of people that get well.”
After months of battling COVID-19, the team at Allegheny General Hospital now has a better picture of what to expect when a patient comes in.
“We can now better predict the course of the disease in patients,” Young said. “Some patients we know will do better. Others we absolutely know they won’t do better. But we still do the treatments and hoping that the ones we think will not do better still will turn around.”
Young still worries about bringing the virus home, where her mother takes care of the children.
“The minute I come home, I go nowhere near my kids. I go straight to the shower, a long hot shower. I scrub everything, and only after that, I can touch my kids.” Her husband, who also works in a hospital, has the same routine.
Dealing with the pandemic made Young realize she was more resilient than she thought, but it is definitely not business as usual: “I do feel closer to the gas tank is half empty, than the tank is half full. I’m hoping for the best, but, right now, preparing for the worst.”
Teake Zuidema is a photographer and journalist living in Pittsburgh. He can be reached at firstname.lastname@example.org.
This story was fact-checked by Emily Briselli.