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Hader

The COVID Chronicles Part 1 (...I don't know what to title these things so deal with it)

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To preface this briefly; most of this I had written last year at some point, usually while on the road and bored with not much else to do at the time. Seems I take to writing when possible when I'm that level of bored. In any case though, while I generally have strange prose, it may be even weirder here because there were many on-and-off periods of writing for me. It's somewhat comprehensive and mostly chronological, but overall, just there to be there.

You have been warned...



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Where to even begin? Coronavirus, COVID-19, the 'rona, dat covid - hardly needs an introduction. Anyone in a courtroom against it would easily be able to point to where on the doll that the covid touched them. So perhaps the slightly more interesting place to start for myself is actually a good bit before anyone knew wtf a COVID was.


I've been a paramedic some time now, and for my national guard unit, that has placed me in charge of our continuing education programs for all of our medics, of whom most all are just EMTs.


***For those in Europe where emergency medicine is probably organized better, and you Americans that still may not know the actual difference - an EMT is a basic level emergency responder certification, generally a single semester of schooling with fairly minimal clinical hours. A Paramedic is a comparatively longer program, at least a year and usually longer, with many more clinical hands-on hours than an EMT has total in everything, and they're able to give a lot more drugs and do a lot more advanced procedures without needing a doctor there to be allowed to do it. Unfortunately in the U.S., despite a paramedic's education being nearly equivalent of a 4-year degree, they rarely exist as such, and even for myself in Colorado there is just barely groundwork on making that a reality. I am as of now nearly done with that full degree, but that's been as struggle for educational institutions to wrap their own heads around mainly.


Anyways, since I am in charge of keeping these medics well trained, I spend a good bit of time ensuring we have a good continuing education program. The only detail worth mentioning here related to that is how I decided to revamp a portion of the refresher classes a couple years ago.


You see, the air force loooooooves powerpoint presentations that are as bland and boring as possible. So traditionally, some of the lectures they want us to teach amount to a horribly boring day of learning what percentage of germs hand sanitizer kills and the influenza is a thing still (but in no detail do they explain why) and that you should get your flu shot. Not wrong information for sure, but it's too easy to make something important so boring it seems the opposite.


As is hopefully not much of as surprise, I am quite the history nerd, so I saw an opportunity with these lectures to change it into something more informative and more interesting. I felt going over the 1918 Flu Pandemic was a much better way to educate here; as a military organization, we go to go into detail about the military during and after the Great War, and as a medical unit, we got to delve into important medical developments from the war as well as the Pandemic specifics itself. It basically checked all the boxes for what I was "technically" required to teach, but with a lot more flair. And as my own personal added bonus, as someone interested in epidemiology and pursuing that at a higher level in my future, it felt like a perfect blend of these two worlds for me. I gave a crap about this infectious disease and epidemiology stuff before hit the fan, okay?


It became a big WIP sort of deal, but eventually it became a comprehensive section of our refreshers that I always looked forward to teaching and everyone always gave feedback saying that really enjoyed it. I even gave this lecture to a room full of doctors/physicians, and you'd be surprised how many knew very little of this time period and the 1918 Pandemic in any detail. So all things considered, I felt it was probably my crowning achievement with these programs.


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Now then comes March 2020, when dat COVID finally hits hte U.S. full swing, and now we actually have a full pandemic on our hands. So, while I will detail some of my expeditions since then next, I think it's a sufficient prologue to show that I have actually given a damn about training our medical personnel about this stuff to some extent, and that actually combating the spread of the virus in my home state as I was called on to do was something I actually did care a lot about.


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The weeks leading up to the real full measures taking place, we were already preparing for it. Full time we're still a medical group so we're obviously expected to have that leg up on the game, in some fashion at least. Basic preparations were there. Long term ones however were not really discussed. That is in large part due to our missions; they are not stopping for any pandemic. But I definitely did not foresee what would happen for me specifically happening so rapidly.


The state's public health department eventually went to the governor about needing manpower; as a temporary solution to that, the national guard was activated to help out (and temporary was meant to be like, days). They needed help testing people, as they were just overwhelmed. So I volunteered for that without much of a thought; we went on a work from home for non essential work that week anyways, so I welcomed being able to stay out of the house while everyone was starting to stay in.


I can't speaking for other states, or even other countries, on how testing was done in those first days and weeks of the pandemic hitting, but for us it definitely paled in comparison to what it should be. And my first day on the job for testing showed that pretty quickly. They got the right people there though to see the problem and see the best solution for the time being however (spoilers, it was us!)


The national guard here has a special mission that active duty does not have, and it's known as CERFP. An acronym within an acronym, it stands for CBRNE (Chemical, Biological, Radiological, Nuclear & High Yield Explosive) Enhanced Response Force Package. In short, it deals with responding to any sort of massive event related to those things. Think 9/11 scale sorts of events. This virus may not seem like that sort of event, and it isn't wrong to argue that it wasn't then, but this CERFP unit is already equipped and ready to go with all they need for CBRNE operations, and a virus technically falls under the whole "biological" thing. We had hazmat suits, procedures, decontamination etc. - everything you would need to some degree, ready to go, and people trained to do it.


So this unit got activated to take off some of the weight from the shoulders of public health, as they just couldn't handle the surge and the logistics of something this big in a rather large state. Granted, our unit couldn't handle everything at once either, but it was a damn sight better and more ready to do so than anything or anyone else at the time.


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And that is where the first part of my adventure began. The next month would see me traveling across the state in large convoys and passing through both small towns and big cities that seemed nearly dead with the lack of foot and road traffic nearly everywhere. The mountain towns especially had a completely different feeling about them, and about the closest to a literal ghost town I think we will ever see there.


I got used to wearing the full hazmat suit and gasmask just to swab some boogers from people's noses. And that was the easy part; keeping everyone in line with social distancing, mask wearing, and professionalism (because don't forget, we're in uniform this whole time) on top of all missions standards normally was its own sort of special challenge. Personally, I never had much issue with the change in lifestyle, even for such an odd mission set and requirements. But I believe many other of our troops did, and that's really where most issues seemed to stem from to some degree.


The biggest personnel challenge I feel I had though came from within...so to speak. While I don't say this just to toot my own horn, being a paramedic is not a medical profession to take lightly or view as lesser in some way. We go through plenty of schooling and probably the one medical profession that gives you more trial by fire than even actual fires do to firefighters. I may not be a physician, but you'd be hard pressed to find any emergency room doctors in the country and probably most of the world that don't appreciate and probably trust their paramedics with more than they would almost all other hospital professions (nurses especially). The most important thing about our job though is that we have a specialized skillset. Emergencies and doing medical things right during themare our forte.


The military is of course a little more strict in rank structure overall, and on the medical side, only nurses and physicians can commission as officers. Even if I have a degree as a paramedic, they don't have a way for me to commission as an officer and stay in a medical position as a paramedic. So, enlisted I stay - which, for the record, I am totally okay with.


The issue came up on this mission for the first time though where the medical officer put in charge of all medical personnel on the mission was a nurse, and despite me having worked with this nurse plenty in the past before and having few issues with her, I suppose something about this mission and her position in it as a medical leader just set things off somewhat. Many little things were critiqued in ways that made little sense, and new precautions and procedures that had to be made for this pandemic and mission were back and forth between what was right and wrong.


Many things were hardly more than trivial however, and nothing I even took personally. However, a few instances of my technically lower rank and eventually "lower medical credentials" being used to try and shut me up or make me do something their way didn't help things overall. I feel I do a generally good job being impartial, stoic even, and not truly ever taking something personally and being actually mad about it. But it is professionally insulting that, just because I am not the same rank, my medical experience is looked down upon and I am treated as if I have no idea how to do anything remotely medical without a nurses direction.


Even that though I can brush off and not worry about overall. But it's another thing entirely when the medical officer in charge, after all the condescending remarks or actions, actually begins to give advice to our troops that is, medically speaking, wrong. A couple weeks into the mission, our medical officer and her top NCO decided to have one non medical soldier go to the store and buy the entire task force some Emergen-C. You know, that drink mix stuff that has a metric ton of Vitamin C and claims in big bold letters how it will boost your immune system and keep you healthy (with the tiny letters saying these statements are not at all FDA approved). They began handing out two of these packets to each soldier twice a day and telling them to chug the damn stuff with water. They also began singing the praises of elderberry juice for immune system boosting and all the great things it does for you.


I may soapbox a bit here, but trivial though this may seem, to me it highlighted an issue with medical leadership that should not exist. I won't go into depth on the science, or lack thereof, surrounding Vitamin C or elderberry. Whether or not you are in the medical field or not you have probably some experience with them, or at least knowledge of what some companies that market them claim them to be or to do. To keep it as short as I can though, in all my time in the medical field, as well as my time academically studying these sorts of things (not the facebook mom googling something sort of research, I really do academically and more formally study these things), I have never seen enough compelling evidence for massive doses of Vitamin C being visibly beneficial, nor that elderberry does anything either. At most, some studies point towards both being able to help boost the immune system in a way that lessens slightly the severity of cold like symptoms, or at least lessens the amount of time you experience them if you are sick. Nothing definitive seems to show that massive doses of Vitamin C is any more helpful than that.

Even without debating the benefits (or lack thereof) of these things, the real issue itself should be plainly laid out already. Medical leadership with an unhealthy focus on people and mission. That was our first struggle to go through, just as the entire world was bunkering down at home and trying to figure out Zoom and virtual learning and working...
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Comments

  1. makanyane's Avatar
    Oooh thanks for writing this! I've been wondering how you were getting on since I learnt what your job was...

    Sad to see the lack of an evidence-based approach from the command in what otherwise sounds like a well-prepared unit.


    Do keep writing these please so we can see how things progressed.
  2. Flinn's Avatar
    Damn I knew I should have blocked your blogging rights!

    Great, first blog, honestly. You are having a great experience there, aren't you? There will be much to learn I'm sure: human genius is only equaled by human stupidity, precisely

    A couple weeks into the mission, our medical officer and her top NCO decided to have one non medical soldier go to the store and buy the entire task force some Emergen-C. You know, that drink mix stuff that has a metric ton of Vitamin C and claims in big bold letters how it will boost your immune system and keep you healthy (with the tiny letters saying these statements are not at all FDA approved). They began handing out two of these packets to each soldier twice a day and telling them to chug the damn stuff with water. They also began singing the praises of elderberry juice for immune system boosting and all the great things it does for you.