'It's a fierce ongoing war': An ICU doctor who flew from Utah to New York to fight the coronavirus describes resilience and loss on the pandemic's front lines

• Dr. Dixie Harris, a pulmonary critical care doctor based in Utah, is one of 100 healthcare workers who flew out to help staff New York hospitals during the coronavirus pandemic.
• Based at Northwell Health's Southside Hospital in Bay Shore on Long Island, she's overseeing a full intensive care unit of severely ill, often younger, COVID-19 patients.
• She'll be in New York through the end of April, helping give New York-based doctors a break and learning how staff are handling cases.
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On April 10, Dr. Dixie Harris learned she was headed to New York.

Harris is a pulmonary critical care doctor with Intermountain Healthcare, based in the Salt Lake City area. She volunteered to help a state hit hard by the coronavirus pandemic.

Four days later, she was on a plane bound for New York City, where she and 99 other colleagues would spend the next few weeks helping two health systems in the city and on Long Island care for patients critically ill with COVID-19, the disease caused by the novel coronavirus.

While there, she's overseeing an intensive care unit full of critically ill patients, learning how staff have cared for patients, navigating the tragic reality of not having loved ones around to support patients, and giving doctors who've been on the ground for weeks a break.

Coming to New York

Earlier on in the course of the pandemic, Utah experienced high-profile cases of the novel coronavirus when a Utah Jazz player tested positive on March 11, suspending the NBA's season.

To date, Utah has had about 3,600 confirmed cases, 301 of which have been hospitalized. Just 35 people have died. Coronavirus hasn't overwhelmed hospitals in Utah the way it has in New York and other parts of the country.

When on Tuesday, April 7, the call from Intermountain came out for volunteers, Harris applied.

Two days later, 700 healthcare workers — doctors, nurses, and respiratory therapists— had applied. Harris found out that Friday that she was among the 100 that would be sent to hospitals affiliated with Northwell Health and NewYork-Presbyterian for the next two weeks.

Over the weekend, she filled out paperwork, got her flight set up, and made sure her patients that she'd been slated to meet with virtually over the next few weeks would be covered. The team arrived in New York City on April 14.

"We're answering the call," Harris said in a conversation ahead of her departure to New York. Her goal for the trip was in part to help give doctors on the ground some time off, as well as learn more about how patients with severe cases of COVID-19 are being treated, so that she can apply that to her practice back in Utah.

'They're clearly not beaten'

Upon arriving, Harris spent her first two days working in the ICU, learning the protocols and getting the lay of the land. She'd been placed at Northwell's Southside Hospital in Bay Shore on Long Island overseeing an intensive care unit and responding to crises around the hospital.

We spoke on Monday as she was heading into her third night shift, chatting as she picked up moisturizer to combat irritation caused by the N95 masks she's been wearing.

At the hospital, the ICUs are full, she said. Intensive-care nurses are assigned to four patients, with another nurse not necessarily specializing in intensive care assigned to help.

For the most part, it's similar to her usual work in critical care, though there are more patients than usual, and the patients are sicker. The possibility of catching the virus herself, in turn requiring more substantial protective gear, was also a new hazard.

Typically, Harris said, ICU nurses might care for only one or two patients at a time. When Harris asked the staff if they'd had days off, they told her it's been like one long five-week shift.

Even so, she said, spirits are higher than she expected.

"The thing that's surprised me the most are the attitudes of the staff," Harris said. "They're clearly not beaten."

Caring for severely ill COVID-19 patients

Inside the ICU, almost every patient is intubated, Harris said. A few have come off ventilators and are still recovering before being transferred out of the ICU.

Patients have been on more medications than she had initially expected. Some have four or five medications — from antibiotics to sedatives to blood pressure medications — being infused into the body constantly.

The ICU has patients as young as in their 20s up through their 70s, she said. It's somewhat unusual to care for so many young people, and doctors feel extra pressure to find ways to help them recover.

"For someone in their 40s, 50s, you want to try every thing you can to get them to survive," Harris said.

During a given shift, the team in the ICU is constantly reevaluating their treatments, seeing if blood pressure has gone low, if patients are bleeding. "It's just not a static process, "Harris said.

The way that's done is still changing constantly. As a colleague at the ICU told Harris, "These are the protocols for now."

Harris said she's sending notes back to her colleagues in Utah about some of the methods Southside has put in place, especially around the practice of placing patients on their stomachs rather than backs, known as the prone position. She's signed on for shifts in the ICU at home in Utah in early May shortly after returning from New York.

'That's the tragedy'

Inside, the ICU is silent without family allowed to be in the rooms with patients.

"To me the thing that's the tragedy in this whole process is they don't have their family members there at the bedside," Harris said.

Hospitals have limited visitors to help prevent the transmission of the coronavirus to otherwise healthy individuals.

That's proved difficult because it's harder for staff to form the same relationship with families when providing updates on their loved ones as they might if the family was there in the hospital. And the conversations they're having, Harris said, are hard discussions.

"We want the families there, we just can't have them there," Harris said.

Often, she said, the conversations are difficult because families haven't seen their loved ones in weeks by the time they're admitted into the ICU. They're not able to see the condition their loved ones are in, which can make having conversations about what to do next when patients aren't recovering even harder.

Just past surge

When Harris arrived, New York had made it past the surge in cases to a point where the number of new cases being admitted to the hospital had started to become more consistent.

That's meant that Harris hasn't had to think about adding additional critical care space.

"I expected we'd be opening more ICU beds, but we're not," Harris said.

Inside, she said, the hospital is starting to think about how to reopen to non-emergent cases and cases not just related to COVID-19.

The staff she works with are invested in patients who have been there for weeks as they recover from COVID-19, Harris said. They keep lists and check back in on patients, even if they've switched services.

"You're wanting to see some victories," Harris said.

And they've had some victories.

Early in April, a pregnant mother had been admitted to Southside with pneumonia from COVID-19.

She was ultimately put on a ventilator to help her breathe. While on the ventilator, she had an emergency C-section. After 11 days, the mother came off the ventilator, and on April 15, the mother met her 12-day-old son for the first time.

Overall, Harris said, the tone at the hospital has been serious.

"It's a fierce ongoing war," she said. "It's clear this is going to be going on at these hospitals for a while."