Hudson doctor warns pandemic 'far from over'
Akron General physician dealing with COVID-19 patients
Dr. Michael Kaufmann hasn’t been with his wife and infant twins in months, and even though more and more public venues are reopening, he still hesitates to touch door handles and says he likely won’t be dining out any time soon.
And he worries it may be quite some time before things return to normal.
Following medical school and a four-year residency in Chicago, he took a one-year specialization in anesthesiology and started working at the Cleveland Clinic — Akron General.
For the past five years, Kaufmann’s routine had been an early morning wake-up – before 5 a.m. – so he could arrive at the hospital early to read up on the patients under his care, including those being prepped for surgery, childbirth or for management of chronic pain. He would consult with his staff nurses, then check on the patients to offer encouragement and provide instructions.
“For the most part, we’re caring for patients pre-operatively ... in more detail, we also manage all the obstetric patients, women who are having babies, but also, we do pain management,” he said. “I get up probably about 4:30 a.m. but the day ends early too.”
Three or four times a month, he works overnight in the hospital handling obstetric patients, emergency surgeries and trauma cases, as the hospital is a Level I trauma center.
He said things changed around the end of March, when the governor stopped elective surgery, the hospital’s “bread and butter,” but things didn’t slow down.
“It actually became a little more stressful,” he said, as he began to be called on to perform intubations on coronavirus patients.
“Intubation” is the procedure where a breathing tube connected to a ventilator is inserted into a patient’s trachea to ensure oxygen can reach the lungs.
“The highest risk thing you could do with someone who’s got a ton of virus in their lungs and throat is to put a breathing tube down because it just aerosolizes everything. So, you want the most experienced person doing it. Anesthesiologists are looked at as airway experts,” he explained.
“We do it day-in and day-out; we’re intubating patients for surgery, we’re manipulating their airways. It become ingrained in you to the point that I’ll be walking through the grocery store and I’ll see someone and think, ‘Man, they’d be hard to put a breathing tube down.’”
Toward the end of March, COVID-19 patients started arriving “fairly quickly,” but since there was not enough testing available – a nationwide problem, he said, “Anybody who was coming in with a fever, anybody who was coming in with a cough ... we were treating them as though they were corona patients because we had to.
“Retrospectively, coronavirus was already here; we just didn’t know it yet,” he said.
He also had to separate from his family at the end of March.
Since then, he’s been living alone in his Hudson home. His wife, Nikki – who also is a physician – and their twin sons, Cian and Declan, are staying with her parents in Streetsboro.
“Our newborn twins were just born in January,” he explained. “We were concerned that they would be high risk, because we didn’t know how the coronavirus would affect babies.
“To play it safe, we thought it would be better to spend some time apart,” he added.
After consulting with their pediatric doctor, they decided it would be safe to get back together, as their sons have grown well.
“We’re going to reunite soon ... at five months, their immune systems are pretty robust.”
A unique threat
While the virus has spread inexorably in Summit County — from just over 200 cases at the end of March to more than 1,500 the first week of June — Kaufmann said the hospital’s patient load has varied from week to week
“It kind of waxes and wanes. In certain areas there are hot spots, while other areas tend to go down a little bit. It just varies,” he said.
He said the city of Hudson was an initial hot spot for identified cases, as were other well-to-do areas, partly because the more affluent population had the opportunity and access to tests.
And of the patients who have died, he said many have had other underlying conditions, and many were nursing home residents.
He said COVID-19 can put patients in critical condition very quickly.
“When I go and see these patients, when I get called for an intubation, they’re in a respiratory distress like I’ve never seen before. They rapidly, rapidly get worse,” he said. “They might be totally fine, and literally be fighting for their live 15 minutes later, which is something we don’t see with other illnesses.”
The hospital has also seen young patients with strokes – people in their 40s, or their 50s. He said doctors suspect the strokes are caused by an immune system overreaction to the virus in the blood stream.
One such patient, who was otherwise healthy, was treated for a stroke and tested positive for cornonavirus. Doctors subsequently found and removed two other blood clots that had formed inside her body but had not dislodged and traveled to her brain.
“This same story has been seen in many other places -- It’s got to the point that anybody who has a stroke has to be suspected of coronavirus,” he said.
The hospital is also seeing patients who don’t seem to be in any distress, but are suffering from low oxygen levels.
“There’s a young man who came in and he looked perfectly fine. I almost said you’re in the wrong room -- but his blood oxygen level was 82%. If you or I had a blood oxygen level of 82%, we’d be really huffing and puffing, trying to catch our breath.
“From the levels on the monitors, they’re in dire straits, they just don’t feel like it. No one knows why with virus there appears to be a disconnect.”
Though some of his co-workers have come down with the disease, he said there is no way to tell whether they contracted the disease from work or from “community spread.”
A hospital spokesperson said it is not releasing how many of its 5,000 employees have had COVID-19 for that reason.
“The biggest main difference is everybody is on edge,” said Kaufmann. “Everybody has COVID on mind. Everytime you see a patient, every time you touch a door handle, you’ve got to wonder if there is COVID on it.”
And he noted contact tracing and testing of individuals who had been in contact with people hospitalized with severe symptoms has identified many with asymptomatic or mildly symptomatic infections.
But that doesn’t mean one can catch the disease from contaminated groceries, he said.
“It seems like the people who get this, are getting it from prolonged exposure. It doesn’t seem like they’re getting it from going to the grocery store. They’re getting it from their family, their friends — people who they spend more than five minutes with.”
Kaufmann said he’s hopeful that social distancing measures and the increased use of masks when people are in public will continue to keep the spread of the disease at low enough levels to give the medical community time to learn more about the disease and improve treatments.
However, he added a cautionary note.
“I think that people think that because the economy is opening up, that it’s over -- It’s far from over. This is going to be with us for a long time. History has shown us that these pandemics tend to come back even worse when a second wave strikes in the winter.
“We could end up easily in a situation like New York, or Italy, where it’s been just uncontrolled spread. This is far, far from over. In fact, we may not even have seen the worse of this.”
Eric Marotta can be reached at email@example.com