'Like Watching a Tidal Wave Coming at You.' The View of South Carolina's Student Nurses

Apr 8, 2020

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News from hospitals in much of the United States right now is bad. In major cities like Detroit, in population-dense states like New Jersey, medical staffs are sometimes unable to keep up with the crush of new COVID-19 cases.

Emergencies are gobbling up hospital beds; doctors nurses, and assistants are risking their lives just by going to work; and supplies of personal protective equipment, or PPE, are in some places so bereft, ICU healthcare workers have taken to wearing trash bags and goggles because it was the best they could do.

To date, that kind of thing isn’t consuming South Carolina’s medical facilities. But Dr. Alicia Ribar, interim associate dean of academics, assistant dean for graduate studies, and clinical associate professor at the University of South Carolina College of Nursing, says the college’s working students are worried about when it will be.

“Many of them are talking about how eerily quiet things are right now,” Ribar says. “They’re expressing to us that it’s kind of like watching … a tidal wave coming at you. There really isn’t anything that you can do to stop it.”

The state is certainly trying to stop it. On Tuesday, Gov. Henry McMaster issued a statewide stay-at-home order. It allows residents to go to work, go to the supermarket, and get some exercise, but even then the order recommends that if you don’t have to leave the house, don’t.

McMaster’s order is, for some, a long time coming. Despite a growing chorus of calls to implement a shutdown, McMaster resisted for weeks, even as he introduced a series of increasingly restrictive orders aimed at keeping people home as much as possible. He’d argued that South Carolina has certain advantages over other states where COVID spread exponentially – namely that the state is not densely populated and lacks major cities.

But, says Ribar, “We also don’t have the same number of healthcare facilities that places like Ohio and New Jersey and New York do. We don’t nearly have the amount of beds and we already had a nursing shortage in this state.

That worried Ribar, as did early projections that put South Carolina’s COVID spread rate on par with that of her home state of Ohio. Measures to decrease public gatherings in South Carolina have greatly slowed the spread, though. Yes, the coronavirus is still spreading in every corner of the state, but not as rapidly as it at first appeared it would.

Those early projections identified the first predictions of when that tidal wave would crash onto the state as early April. Now, Ribar says, that date looks to be more like May.

That’s good and bad, she says. It’s bad because it drags out the time in quarantine, thereby hurting businesses and extending the time of angst for healthcare workers waiting for the wave to hit the beach.

The good, though relative, is that by socially isolating and distancing, we can limit the number of people who become critically ill from COVID-19 at one time.

“Everyone, probably, in our population will be exposed,” she says. But if we can spread out the number of cases over a longer time, “our hospitals can take care of them.”

The mortality rate of COVID-19 worldwide is not easy to get a bead on. Percentagewise, the rate of death

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per positive cases varies immensely from country to country, from Canada’s 1.85 percent (across more than 15,000 cases) to Belgium’s 7.84 percent (across 20,000 cases), according to stats released Monday by the Center for Evidence-Based Medicine.

What Ribar is afraid of is South Carolina facing what happened to Italy, where more than 132,000 people have contracted COVID-19 and more than 16,500 have died from it. That’s a mortality rate of almost 13 percent. By comparison, according to the South Carolina Department of Health and Environmental Control, the mortality rate in the Palmetto State is 2.1 percent.

Were South Carolina to get to where Italy is, Ribar says, doctors, nurses, and families would have to start making the same crushing choices about who lives and who dies, based on two main criteria – how old is the patient and do they have underlying health concerns independent of this?

In other words, she says, choices would have to be made as to who has a better chance to make it.

“We’re trying to avoid that,” she says. “That’s why we’re doing this social distancing.”

We’re also doing it to keep healthcare workers as safe as possible, Ribar says, because hospitals don’t want to lose any of their already stretched staffs.

“The biggest thing you can do [to help healthcare workers] is stay home,” she says. “There isn’t anything else that the general population can do.”

Scott Morgan is the Upstate Multimedia Reporter for South Carolina Public Radio. Follow Scott on Twitter @ByScottMorgan.

For complete coverage of the coronavirus in South Carolina, visit the homepage of SouthCarolinaPublicRadio.org.

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