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On the front line

Meet some of the health care workers fighting against virus

The numbers are not pretty at J.W. Ruby Memorial Hospital, WVU Medicine’s flagship hospital.

Since the start of  COVID-19 last March, 140 patients have died from the virus or a COVID-related cause at the health care facility. Medical providers said the virus isn’t selective either,  young and old, male and female, have been its victims.

The volume of people being treated at Ruby for COVID-19 has not let up. Not only are patients from north-central West Virginia, but they also come from Charleston, Huntington,  as well as parts of Pennsylvania, Maryland and Ohio.

“We’re the backstop for the state,” said Dr. Ron Pellegrino, Ruby’s chief operating officer.

“Also, everyone’s life outside the hospital has changed. It doesn’t leave you when you leave the building,” he said.

 As of Friday, West Virginia had 28,189 active cases of the virus, a high mark since the pandemic began less than a year ago. There are more than 800 people in the hospital, including 217  in intensive care, state officials said Wednesday. Plus, 1,481 West Virginians have died from COVID-19.

Between Oct. 6 and Dec. 6, the number of hospitalizations in West Virginia from COVID-19 increased by 263%, while the number of people who needed an ICU bed increased by 183%, and the number of people who needed a ventilator increased by 196%, according to WVU Medicine.

 “It’s been a rough couple of months,”  Pellegrino said.

The command center

Frank Briggs, vice president of WVU Medicine’s Heart & Vascular Institute, is wearing a different hat these days. 

Since the pandemic began, Briggs has been in charge of the hospital’s command center. On the first floor of Ruby, Briggs and  team members keep an eye on the virus. They track the number of patients at Ruby and other WVU Medicine hospitals and care facilities throughout the state. On Thursday, for example, 130 patients at Ruby had the virus and 68 were infectious. System-wide, 260 people were hospitalized with the virus.

“We have 12 people on the waitlist (for a room), said Briggs, adding these individuals are from Summersville, Wetzel, Grant and Cabell counties.

By keeping track of the positive cases, Briggs can ensure   an available bed for someone who needs treatment. The problem is a bed doesn’t usually become available unless a patient recovers or dies. 

In an attempt to have room for patients who need to be in the hospital, WVU Medicine officials said they have decreased the number of “non-essential” surgeries for now. So far, that strategy appears to be working.

“Our goal is to add 30 more beds since the beginning of December,” Briggs said.

Suzanne Madeya prepare equipment
Suzanne Madeya prepare equipment in COVID-19 room on Eight South floor at J.W. Ruby Memorial Hospital.

 Eight South

The bulk of Ruby’s COVID-19 patients are on the eighth floor in its South wing. Here, patients are looked after 24/7 by a team of nurses who typically work 12-hour shifts, sometimes longer.

“There are three patients for every nurse,” said Sara Belch, the nurse manager.

Nurses wear masks, goggles and sometimes have their heads covered when dealing with a positive patient — usually on an hourly basis. Belch said patients are not considered infectious after 10-20 days.

Because family members can’t always visit, Belch said the hospital tries to set up a video call so they can talk to each other.

“They seem happy with that,” Belch said.

It’s rough, too, on the nurses who work with the COVID-19 patients. Oftentimes, a nurse and patient become friends. Then because the virus can be tricky, there are times a seemingly stable patient will take a turn for the worse and die.

Hospital officials said three-to-five patients die from the virus on a daily basis. Many who die from the virus already have an underlying health issue.

“For some of the nurses, it’s like losing a family member,” said Belch, adding there is counseling available to staff who lose a patient to the virus. 

“It’s a roller coaster,” she said.

Jessica Bragg, a registered nurse who works on the eighth floor with COVID-19 patients, said she works around 116 hours every two weeks, but so do many of her co-workers. 

Jessica said one of the harder things she has had to deal with during the pandemic is being away from her husband — who had a liver transplant several years ago — and their 5-year-old daughter.

“It’s a learning experience,” said Jessica, adding her family has understood about her schedule and the precautions she takes.

The last resort

Awori Hayanga is a thoracic surgeon at Ruby who works with the sickest patients, especially those who have respiratory problems caused by the virus.

In some cases,  Hayanga will use an ECMO machine, shorthand for Extracorporeal Membrane Oxygenation. Ruby has the only ECMO machine in the state. The next closest ECMO machine is at Cleveland Clinic, he said.  

With an ECMO machine, the patient’s blood is pumped outside of his/her body to a heart-lung machine that removes carbon dioxide and sends oxygen-filled blood back to tissues in the body. Blood flows from the right side of the heart to the membrane oxygenator in the heart-lung machine and then is rewarmed and sent back to the body, according to

ECMO can’t cure an illness, but can help provide much-needed oxygen to the body. This method allows the blood to “bypass” the heart and lungs, allowing these organs to rest and heal, Mayo said.

“Eight out of 10 of our patients leave the building,” he said.

 Hayanga and other Ruby medical providers said they are optimistic the COVID-19 vaccine will be effective in curbing the virus but caution it will still be several months until everyone is vaccinated, and its impact won’t be known until then.    

To date, roughly 4,500 WVU Medicine employees — out of 10,000 — have been vaccinated.

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