On the frontlines of Israel's coronavirus fight

"What if I did not wash my hands properly or I put my phone down somewhere?"

The Samson Assuta Ashdod University Hospital Emergency Department (photo credit: Courtesy)
The Samson Assuta Ashdod University Hospital Emergency Department
(photo credit: Courtesy)
When Sabrina Grodzinski returns home at the end of a 12-hour shift in the coronavirus unit at Samson Assuta Ashdod University Hospital, her three boys run to her for hugs. But they are quickly reminded that they will have to wait. Mommy needs to shower before they can touch her in case she has any traces of SARS-CoV-2 on her body or clothes.
Grodzinski, an emergency medicine physician currently assigned to the coronavirus unit at Assuta Ashdod, told The Jerusalem Post that when the hospital informed her in January that she would work with coronavirus patients it was only theoretical. The virus outbreak had just started, and she could not envision what this meant. Now, treating coronavirus patients has become part of her daily routine. 
Although Grodzinski said that the hospital currently has enough personal protective medical equipment, she fears that if the situation continues much longer Assuta Ashdod could be at the same risk as many others of lacking the supplies needed to ensure she is safe. 
“I don’t have neurosis about the infection, but there are days that I think, did my mask have a good seal? Or, I shower three times at work before I come home. For the most part, it is OK, but if God forbid something happened, I will think, ‘Oh my God, I brought something back to them.”
The situation is similar for Gila Nussbaum, an emergency department (ED) resident at the same hospital. 
“You can never help thinking, what if I did not wash my hands properly or I put my phone down somewhere?” she told the Post. 
At the start of the pandemic, Assuta Ashdod divided hospital staff into teams: red, blue, green and yellow. She now works three or four 12-hour shifts per week with the same doctors, nurses, assistants and even cleaning staff. 
“If one person goes down, the whole team goes down, but it would contaminate as few people as possible,” Nussbaum explained. “My team is a united front and we worry about each other.”
Assuta Ashdod is used to being on the frontlines of patient care. It is the only full-service medical center in the economically challenged city of Ashdod, where residents suffer regularly from a constant barrage of rockets being fired from neighboring Gaza. For the battle against coronavirus, Nussbaum said the hospital divided the ED into two areas: The standard emergency room and a respiratory ED for anyone that is suspected of having coronavirus – people with complaints of fever, shortness of breath or coughing. The coronavirus ED is sealed off and as few people as possible work there at a time. 
Nussbaum, however, works in the coronavirus ED each shift for six to eight hours. She wears a hair covering, face shield, N95 mask and full-length waterproof gown for protection. It is a long time, she admits, to operate in that environment and with all this extra baggage, although it is necessary.
“Sometimes I find myself counting hours at work,” she said. “I know that every shift does eventually end.”

 
Grodzinski said the coronavirus unit, which is different than the respiratory ED, is also divided between two types of patients: seriously ill ones and those with minor or moderate symptoms. The strangest thing for her has been treating patients without personally interacting with them.
“Everything is done via camera for the most part,” Grodzinski explained. “All patients have a chip on them that is connected to a wireless monitor and we can follow their blood pressure, heart rate, respiratory rate. I have a screen in a separate doctor’s room and that way I can access all their minute-to-minute vital signs without having to go there.”
She said there is a camera and a phone for every patient, and they talk via this system. 
However, when it comes to the intensive care patients the rounds are long and there is a lot more face-to-face treatment. For this, Grodzinski dresses like Nussbaum. 
Assuta Ashdod is caring for some of the country’s young patients who have become critically infected with the virus. Grodzinski was at the hospital the night that a 29-year-old man came in. While she could not reveal medical details about him, she told the Post that younger patients are emotionally challenging.
“We are used to seeing older patients struggling in the hospital – this is the circle of life,” she said. “People grow old and get sick and we deal with it very often in the ED.”
While Grodzinski has become accustomed to young people being the victims of trauma, such as car accidents, “things like difficulty breathing are not something we are used to, and it is much more difficult to handle.”
She also said that it is hard sometimes not knowing what to do. She said the doctors at Assuta Ashdod “read everything and look at all the research done and try experimental therapies, but it is all based on very small populations, it is not based on anything real. Very disconcerting to be there when you have a young guy and your hands are totally tied and you just don't know what else to do.”
It is also hard to be there for the patients and your family at the same time, she said. 
Over the last six weeks, Israel has implemented a partial closure on the country, including shutting down schools. Both Grodzinski and Nussbaum have kids at home. 
Nussbaum had to stop nursing her nine-month-old baby soon after she returned to work from maternity leave, as the coronavirus crisis developed. 
“I became too scared of contaminating my bottles and where to put and clean everything,” she said. “Within a shift or two, I just stopped pumping at work and now she takes formula when I am not at home. It was a very big and sad decision but I couldn't help it.”
Both Nussbaum and Grodzinski credit their “amazing husbands” for helping make it all work.
Dr. Abe Berger is a slightly different story. He made aliyah two-and-a-half years ago specifically to work in Assuta Ashdod’s ED. He described the hospital as a flagship model of integrated healthcare. 
However, Berger is over the age of 60, so he is at higher risk for complications from the virus. Yet, he said he is not afraid. In 25 years at Mount Sinai Beth Israel in New York, he helped patients during Hurricane Sandy, 9/11, ZIKA virus and SARS. He admitted that he, like all other medical professionals, has not gone through such a global mass casualty event, but “whatever I can offer, I offer.”
He praised Israel’s response and preparedness and said that he feels better working in the Jewish state than anywhere else in the world. 
“If this were a military action against the country, the country would know how to respond,” Berger told the Post. “This is a different type of enemy, but we apply the same principles and people try to listen - this is what we are seeing… All in all, if you look at the numbers we are doing well.”
He said he did not come to Israel to sit by idly. 
“If coronavirus was any other situation and Israel needed help, I would have made it my business to come and help,” he said. “I stand ready to help to do what is needed.”
The article was written in cooperation with Samson Assuta Ashdod University Hospital.