Monday, August 2, 2021
 
 
Sun Valley ER Doc Went From Coronavirus Skeptic to Believer
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Dr. Terry O’Connor described the awe that drives us to take even risky adventures during a TEDxSunValley talk in 2017.
   
Wednesday, July 1, 2020
 

STORY AND PHOTO BY KAREN BOSSICK

Sun Valley-area government leaders would do business owners a favor by mandating that everyone wears masks inside commercial and public buildings, the Dr. Fauci of the Wood River Valley says.

“To protect others, I personally endorse mask wearing,” said Dr. Terry O’Connor, an emergency physician who has headed the medical response to the coronavirus pandemic since it rampaged across Blaine County. “This enables business owners to do what they want to do but might be afraid to do because they can tell customers, ‘The county requires you wear a mask.’ ”

O’Connor took part in a virtual discussion organized by the Sun Valley Institute with Lisa Wing, head nurse of Bellevue Hospital in New York City, on Monday.

 
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Paul Ries’ Curve shows Blaine County’s numbers in the hundreds on the left and Idaho’s numbers in the thousands on the right. Also depicted: Twin Falls County, which recently surpassed Blaine County’s numbers. The numbers have been going up big time since Idaho entered phase four of its reopening plan.
 

Both found themselves providing care to communities with the highest per capita rate of COVID in the nation in March, noted Peter Horton, star of the medical TV drama “New Amsterdam” and emcee of the discussion. But O’Connor’s St. Luke’s Wood River had just 25 beds, while Wing’s, which is the oldest public hospital in the United States, has 850 beds that burgeoned to 1,100 at the height of the crisis.

It’s a pandemic that crosses borders that are not political but have become political, noted Horton, who sits on the board of the Sun Valley Institute. It’s become a rich/poor pandemic, a liberal/conservative pandemic.

“I have a conservative father who’s a doctor that feels this is media hype,” he added.

“In the past, we got through these moments with resiliency by coming together, whether World War II or 9-11. With this, we stayed apart, saving thousands of lives. With cases spiking again, how can we come together again to do what we need to do?” he asked.

Wing, the technical director on “New Amsterdam,” recounted that her staff was well-prepared for its initial case, a room all decked out and waiting. Within a week, the hospital was full of COVID patients—"it hit hard and fast.” Patients were on ventilators for weeks at a time; even the emergency room was turned into a COVID unit as respiratory therapists, social workers and volunteers from around the country left their regular jobs to assist.

“We had 60 nurses at one time in the ER,” she said. “Then we went from a hundred miles per hour to zero. We don’t have many cases coming in at all.”

Fighting the highly contagious disease was anguishing for caretakers who feared they were putting family members at risk. One risked infecting his pregnant wife. Wing worried once that she had passed the virus to her son who never left quarantine.

Yet, when doctors and nurses got sick, they always came back ready to take up the fight after recovering, she said.

O’Connor said his own evolution from skepticism to worrying that COVID could find its way to Sun Valley  to raising the alarm escalated faster than anything he’s ever seen.

He started as a skeptic, rationalizing that a foreign disease couldn’t impact a non-densely populated community in the Rocky Mountains.

“I saw how SARS and Ebola were self-contained and I was thoroughly convinced the Chinese would contain this,” he said. “Blaine County Commissioner Jacob Greenberg sent me email after email saying, ‘I’m worried coronavirus is going to come to Idaho,’ and I’d reassure him with reasons I didn’t think it would come here.”

But O’Connor began to see articles in the publications like the New England Journal of Medicine that began to worry him. Chief among them, an article about how the first person diagnosed with COVID in Germany was believed to have been infected by a Chinese car factory employee who was asymptomatic while in Germany.

His concern ramped up as Washington colleagues shared their experiences with a man who then was believed to have been the first American to contract the disease.

“Then it became a sprint to raise the alarm,” he said.

He briefed his crew. Then he set about convincing community leaders they needed to cancel the Sun Valley Film Festival and other events.

Two days later—on March 14--the first case of coronavirus was confirmed in Blaine County, followed that same day by a second. The next night O’Connor tended to a woman who went into cardiac arrest while having a CT scan for gastrointestinal problems.

Seventeen different staff members had contact with the woman and O’Connor managed her ventilation before learning she had COVID. Multiple people were coming to the hospital by then, worried that they too had COVID. And each bed had to be taken out of service for two hours after use to disinfect and sanitize it.

By then, two nurses who had been exposed to the first two cases had been sent home to self-quarantine.

“We’re shift workers—we punch a clock and go home. But with this we’re bringing our work home with us. The professional became personal,” O’Connor said.

Both Wing and O’Connor noted how isolating the disease was, with patients having to go through perhaps the most vulnerable time in their lives without friends or family.

One 20-year-old Hailey man commented how isolated he felt not seeing a nurse for six to eight hours at a time while hospitalized, O’Connor said.

“I’m reconciled to the fact that no patient of mine is going to see my face for a couple of years,” he added, noting the need to wear personal protective equipment.

Wing said her nurses covered adult children in PPE so they could sit at the bed of a dying mother. They held cellphones for hours, allowing family members “to talk and talk and talk” to a loved one on a ventilator. They even played Italian music on a cellphone, singing along for a patient who was about to be taken off a ventilator. Only later did they learn she spoke Spanish, not Italian.

“A few weeks in, Journey’s song, ‘Don’t Stop Believin,’ began to be played throughout the hospital, and we thought, ‘What’s happening?’ It was the hospital’s way of saying someone is going to get extubated,” she said.

In a 2017 TEDxSunValley talk, O’Connor described how the adventure gene in our DNA makes us hardwired to want a sense of awe, whether from watching the total solar eclipse or from climbing Mount Everest. Those who experience this sense of awe daily are more likely to be connected to others, even to the point of being more willing to sacrifice themselves for others, he said.

There have been moments of awe throughout the pandemic because of catastrophic interruptions that  have brought people together to take care of one another, he said.

“Because of the connectedness in this community, everyone was 1 degree of separation from someone with the disease, and everyone thought: What’s best for the community? And at 8 o’clock everyone howled. You could hear the howling from the mountaintops—that was a remarkable thing for the community.”

New Yorkers likewise rallied around the fact that they had a problem and needed to do something, Wing said.

“Within two weeks, once St. Paddy’s Day parade was cancelled, Times Square emptied. Everyone knew someone who was hospitalized or they knew someone who had died. Thousands of people are on their balcony every night blowing horns, clapping—they still do it.”

The best way to keep people motivated to wear masks and practice physical distancing, O’Connor said, is to tell stories that resonate with people.

“As health care professionals, we have to be careful about trying to motivate people with numbers and statistics. There’s a saying that ‘statistics are human beings with the tears dried off.’ People have been affected by this in their own private lives—maybe their spouse is an essential worker at the grocery store. Talking about your experience—it spreads.”

WHAT TO DO ABOUT THOSE TAKING WEEKS TO RECOVER?

O’Connor said there’s not much guidance about how to deal with those taking six to eight weeks to recover: “We’ve had bounce backs who have been sent home and come back needing more support. Others are positive for weeks at a time, even when there are no symptoms. We don’t know what to make of that.”

THE BIGGEST FRUSTRATION?

Lack of testing. That includes the early days when hospital staff tested one member of a family to conserve tests, concluding others were likely positive if that person was.

Even today, Wing said, her hospital can only do a certain number of rapid tests a day. “We’re concerned about what this means in the fall when flu picks up.”

WHAT HAVE DOCTORS LEARNED ABOUT TREATING COVID PATIENTS?

“We’ve had better outcomes with a little less than more in some cases,” said O’Connor. “People are hot to find a silver bullet for this and that’s led to some boondoggles, such as hydroxychloroquine. Some of the preliminary evidence for treatments not only didn’t have good studies but perhaps had a lot of falsified evidence.”

WHEN WILL WE HAVE DATA ON WHETHER ANTIBODIES CONFER IMMUNITY?

“We’re trying to figure out the antibody question. It’s not going to be soon,” said O’Connor.

STATE OF IDAHO EXCEEDS 6,000 CASES

Idaho's number of confirmed coronavirus cases are climbing so precipitously the state was named as one of 16 whose citizens will be asked to quarantine for 14 days should they attempt to go New York or New Jersey. The European Union, meanwhile, is banning most Americans from visiting member countries because the United States' rate is out of control.

Idaho has 6,117 confirmed cases of coronavirus statewide, with 365 new cases reported on Tuesday for Idaho's worst day ever. Last week was the worst week for Idaho since the pandemic began in mid-March, with nearly 1,500 cases in seven days, said Paul Ries, a Hailey resident who has been charting the cases.

But the state still has adequate healthcare resources.

Blaine County gained three new cases on Tuesday, giving the county 535 total. Twin Falls County had its worse day ever with 33 new cases bringing it to 599; Canyon County, 856; and Ada County, 2,169.

Bear Lake and Oneida counties reported their first cases a couple days ago, meaning someone has now had the virus in 40 of the state’s 44 counties. Only Butte, Clark, Lewis and Shoshone have been virus free.

The state has lost 92 of its citizens to the coronavirus.

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