PH DOC TAKES ON COVID-19

As COVID-19 cases swelled in early 2020, hospitals and health care clinics ramped up resources and canceled elective procedures and routine patient visits. Some, like Brigham and Women’s Hospital in Boston, opened new intensive care units to critically ill, highly contagious patients.

“All were very sick, with multi-organ failure,” says pulmonologist Aaron Waxman, M.D., Ph.D. “A lot of these patients were in septic shock. Within a matter of days, they had stiff lungs. This was an epidemic of ARDS (acute respiratory distress syndrome).”

Dr. Waxman, director of Brigham and Women’s Pulmonary Vascular Disease Program, led one of seven ICU teams responsible for 21 patients each. Brigham and Women’s is a Pulmonary Hypertension Association-accredited pulmonary hypertension care center.

Initially, each team spent at least 13 hours a day in the hospital, administering antibiotics, managing fluids and adjusting care plans. Many patients needed dialysis. Every three hours, the medical teams repeated rounds, wearing hats, masks, face shields and gowns.

At the beginning of the pandemic, the hospital weathered a brief period of personal protective equipment (PPE) shortages. Each health care professional received one N95 mask a week, and the hospital temporarily ran out of certain types of gowns. Everyone had to wash and change before leaving the hospital.

“We were super vigilant about watching out for each other and not bringing any of that home,” says Dr. Waxman, who worried about spreading the virus to his wife and adult son.

In between rounds or after their shifts, many doctors checked in with their regular patients through televisits. “I got the sense my patients were more worried about me,” Dr. Waxman says. “It was pretty touching.”

During the 12 weeks the PH clinic was closed for in-person visits, few patients reported serious problems. “Amazingly, they all did remarkably well. I would ask patients to take pictures of their ankles and legs to see if they had edema. We made sure they all had masks, knew how to keep them clean, wash their hands and stay away from people who were potentially infected.”