How the AIDS Epidemic Offers Hope for the COVID-19 Pandemic
As the reality of the novel coronavirus began to unfold in early March, my first inclination and greatest concern was for our frontline healthcare workers. My mind was transported back to my own experience as a bedside nurse during the HIV/ AIDS epidemic of the mid 1980’s to 1990’s. As the young assistant nurse manager of a 54-bed medical-surgical unit in Florida, our state was among the top three in the nation affected by a surge in HIV/ AIDS patients. These patients died of mysterious and horrific symptoms at unprecedented rates due to an unknown cause. The fear and uncertainty of how the virus spread, its origin, how it might be contained, and how it might be treated was almost paralyzing; we learned something new about the virus almost daily. Since I had no children, I was assigned the first patients by my nurse colleagues. Having been raised in the Judeo-Christian tradition which places a high value on human life and caring for the sick, I found courage from within to provide care for these suffering patients at unknown risk to myself. It was a sobering and deliberate choice to risk my own safety to support the life of a stranger and perform my duties, collaborating with the physicians who were also finding their way through the experience.
At that time, each patient was placed in “isolation” to avoid transmitting the virus to other patients within the hospital environment. Outside of each isolation room was a steel cabinet full of protective gowns, gloves, masks, shoe covers, plastic eye shields, hair covers and sterile packages of commonly needed supplies. We were fortunate that while supplies often ran low, we did not run out. But like COVID-19, at times, we had to make arrangements with hospitals both within and outside of our state to secure enough mechanical ventilators, in the case of HIV/ AIDS to treat pneumocystis carinii pneumonia, a frequent cause of death.
I was acutely aware of how very difficult it was for these patients to lie in a hospital bed, in a full-blown health crisis, in total isolation, separated from their families and loved ones, and not knowing if they would ever return home again. Many did not. With the isolation gear I had to wear, a patient could not see me, only the bright yellow gown and gloved hands administering medications, IV fluids, and assistance with basic human needs. Visitors were sparse; many of these patients were either infected by someone who had recently died, or they had unknowingly infected the people they loved, who were too ill to visit. It was overwhelming and heartbreaking. I was often the only one present to hear patients’ last words of confession or witness the last dying breath. In my soul, I could not bear that one of them die alone, so it was my oath to be present, that no one would die alone on my shift, and it was my highest honor to be available to share their tears, their deep sobbing, their desperation. I became acquainted with their deepest secrets and sources of pain, humiliation and fears. I encouraged them and tried to assuage their guilt, clasping their hands until the end. I held grown men, women, and infants in my arms, dying from AIDS. My patients did not die alone, and my memory of these moments is as real to me today as it was then.
Was I afraid? At times I was very afraid of transmission, which we realized could be through serum or contaminated needles, and while never infected, I was exposed and placed on employee health protocols more than once. Yet, looking back, I was constantly educating myself about the virus and listening to the recommendations of the authorities, including our hospital administrators and physicians who were receiving new information daily and updating policy accordingly. We were all novices. The information was a moving target, there were uncertainties, unknowns, and so much death. Until one day, there was not. Our great scientists and national organizations rallied to find treatments, the HIV/ AIDS community and public health officials relentlessly campaigned to end HIV/ AIDS, and today it is no longer the threat it once was. People are now able to live long and healthy lives with the virus and the stigma and panic are no longer present in our world.
And so, it will be with COVID-19. We live in a great country. Our brilliant scientific community, public/ private partnerships, and entrepreneurial spirit will lead us beyond this temporary period of uncertainty. This generation of frontline workers, who have been present for patients dying in isolation, felt the camaraderie of an exhausted team, and been celebrated by their communities, can only be strengthened by this experience.
While I am no longer working at the bedside, and instead practice as a clinical/business leader, my passion for people is at the heart of who I am. To meet the needs of our community during the COVID-19 pandemic , we developed a simple, free tool to calculate the medical exposure of COVID-19 claims, our Analytic-Powered COVID-19 calculator. Rapidly calculating individual or batch claims for COVID-19 exposure aligns with our mission to offer claim tools at scale that help our partners resolve claims, minimize litigation, and meet the needs of those beset by injury or illness. This crisis will pass, but for now, we are here to support you.
Deborah Watkins, EMHL (MBA/MPH), MSN, RN, CCM, CRRN, CLCP, MSCC
Founder & Chief Disruption Officer, Care Bridge International
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