How COVID-19 is closing in on Alabama healthcare workers

Critical care pulmonologist Dr. David Thrasher starts his day at 4:30 a.m. That’s when his alarm goes off and he heads to the emergency department to start patients on infusions of monoclonal antibodies he hopes will keep them out of the hospital.

After that, it’s off to intensive care units all over metro Montgomery. His medical group, which specializes in treating patients with severe breathing impairments, attend patients at all Montgomery-area Baptist health hospitals on a ventilator.

“Today, our group is seeing 150 people in the hospital, Thrasher said. “Not all of those are COVID but the vast majority are and many of these are on ventilators. That pretty much takes up the whole day in the hospital.”

Lately, that task has been even harder. Four of Thrasher’s partners and one nurse practitioner have COVID-19. Only three doctors remain to handle a patient load about 50 percent higher than last winter, Thrasher said.

“Normally at this time of year I would be at the hospital 7 or 7:30 and have a tough day and have tough weekends,” Thrasher said. “Normally I would expect our group to have about 100 patients a day. Today, as of right now, it’s 150.”

As the number of Alabama cases hits all-time highs, healthcare workers have been increasingly affected.

“We are seeing our highest number of COVID-19 positive patients since the beginning of the pandemic,” said Kadie Agnew, a spokeswoman for Baptist Health in Montgomery. “We are experiencing a higher number of team members who are out with COVID as well. Patient care remains our top priority and our teams continue to provide that with compassion and strength, but it’s certainly challenging.”

Doctors aren’t the only ones affected.

“We are also seeing the terrible devastation to my nurses, my respiratory therapists,” Thrasher said. “Our cleaning people. Our environmental people. They are mentally and physically exhausted. They’ve been doing this nonstop since March in Alabama. And they’re sick. A lot of these people are sick. We’ve had some critically ill nurses and janitors and I’m personally treating, as of today, 34 doctors. So nobody is immune to this thing and it’s hitting our staff. It’s hitting my group personally very hard. And it’s tough. Mentally and physically, it’s tough.”

Thrasher’s work has gone non-stop since cases started rising in late October. Now many of his patients receive treatment as outpatients. To treat them at home, he gives them pulse oximeters, nebulizers and a cocktail of supplements and medications to address the more serious symptoms. Between hospital visits, he calls more than 70 patients receiving treatment at home.

Recent advances in treatment have improved outpatient care for people with COVID. Thrasher estimated that about two-thirds of the patients he treats at home would have been hospitalized over the summer. He credits monoclonal antibodies for much of that improvement, but limited supplies have restricted the treatment to high-risk patients age 65 and older and those with co-morbidities.

It’s labor intensive. Patients must check oxygen levels and report to Thrasher daily.

“Last weekend I was quote, off,” Thrasher said. “And I barely see my wife. I spent the two days I was off, probably 12 to 14 hours calling patients and outpatients with COVID. And I get texts and email and calls all the time. And I just can’t say no. Some of these people are not going to do well if I don’t help them.”

The Alabama Department of Public Health reported that 14,684 health care workers have tested positive for COVID this year, about 6 percent of the people working in that field. Although Thrasher has been on the front lines of the pandemic from the beginning, it has hit especially close to home when he lost two friends to the virus last month. Former state Sen. Larry Dixon fell ill in November. The two spoke every day until doctors placed Dixon on a ventilator.

“He said, ‘David, there is a light at the end of the tunnel,’” Thrasher said. “And I said, ‘Yeah, there is. But right now, I’m looking at that tunnel and I see a locomotive coming right at me.’”

Thrasher expects COVID case numbers and hospitalizations to increase after Christmas. Public health messages to avoid social gatherings haven’t gotten through, he said.

“It’s going to get nothing but worse after Christmas,” Thrasher said. “And no matter what we say, it’s just going to happen. I get frustrated every day.”

After he gets frustrated, he gets back to work. Thrasher received his COVID vaccine last week and believes it will end the worst of the pandemic early next year. When it’s over, the first thing he’s going to do is hug his grandkids.

“I just made up my mind, I’m just going to go as hard as I can between now and summer, when I have declared the pandemic to be over,” Thrasher said. “Independence Day. So we better behave.”