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World 'Such is life': In virus wards, death is a foe but a fact

11:25  11 december  2020
11:25  11 december  2020 Source:   msn.com

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Experts fear that deaths from illnesses such as cholera could far exceed those from Covid-19 itself. The degree to which the pandemic is responsible for these fatalities is still under debate – it might be that there are fewer life -years lost to the virus directly than it seems.

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PARIS (AP) — During their daily morning round of the intensive care unit, hospital staffers and medical students pause outside room No. 10, abruptly emptied of the patient who lost his nearly month-long battle against COVID-19 the previous evening.

Paramedic Bertrand Brissaud, cares for the patient in room No. 10, a few hours before he died after his nearly month-long battle against COVID-19 at Bichat Hospital, AP-HP, in Paris Tuesday, Dec. 1, 2020. The patient in room No. 10 died later on Dec. 1. His was one of 775 virus deaths in France that day, adding to a national death toll now topping 56,000 and the worldwide count of more than 1.5 million dead. As one of the man's carers, Brissaud had been more physically intimate with him than many people are with their friends. (AP Photo/Francois Mori) © Provided by Associated Press Paramedic Bertrand Brissaud, cares for the patient in room No. 10, a few hours before he died after his nearly month-long battle against COVID-19 at Bichat Hospital, AP-HP, in Paris Tuesday, Dec. 1, 2020. The patient in room No. 10 died later on Dec. 1. His was one of 775 virus deaths in France that day, adding to a national death toll now topping 56,000 and the worldwide count of more than 1.5 million dead. As one of the man's carers, Brissaud had been more physically intimate with him than many people are with their friends. (AP Photo/Francois Mori)

The man died at 6:12 p.m., the medic leading the briefing tells the group. There is a short hush. And then they walk on.

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Even for ICU workers for whom death is a constant — and never more so than this year — witnessing the loss of a fellow human being to the virus can be a churn of emotions.

For their own good and for their patients, they try to remain detached. They have coping mechanisms. Meditation or talking helps for some. For others, tending the body of a patient who could not be saved is part of moving on. Because the living require their attention, and there will always be other deaths to deal with, simply functioning requires not becoming overwhelmed.

But calibrating their relationship with death isn't easy. Some worry they could be seen as callous if they're too matter-of-fact or, conversely, that emotions could hurt them if they get too involved. Some days they manage better than others. Sometimes they feel the need to confide to the ICU's in-house psychologist, in a rage, in tears, in need of her hot tea and understanding.

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This strategy saved thousands of lives both during the Spanish flu pandemic of 1918 and, more recently, in Mexico City during the 2009 flu pandemic. And there is a greater public health imperative. Even people who show only mild symptoms may pass the virus to many, many others — particularly

The trend may be due, in part, to the fact that many elderly people have chronic medical conditions, such as heart disease and diabetes, that can The first reported coronavirus death in the U.S., for instance, occurred when the virus somehow damaged a woman's heart muscle, eventually causing it

A patient lying in bed in room No. 9, as he battles against COVID-19 at Bichat Hospital, AP-HP, in Paris Tuesday, Dec. 1, 2020. Even for hospital staff for whom death is a constant, witnessing the loss of a fellow human being to COVID-19 is a churn of emotions. At the Paris hospital that recorded the first virus death outside Asia, nurses and paramedics in the intensive care unit have their own coping mechanisms. (AP Photo/Francois Mori) © Provided by Associated Press A patient lying in bed in room No. 9, as he battles against COVID-19 at Bichat Hospital, AP-HP, in Paris Tuesday, Dec. 1, 2020. Even for hospital staff for whom death is a constant, witnessing the loss of a fellow human being to COVID-19 is a churn of emotions. At the Paris hospital that recorded the first virus death outside Asia, nurses and paramedics in the intensive care unit have their own coping mechanisms. (AP Photo/Francois Mori)

This is what it is to encounter death, over and over, in the COVID-poisoned days of the 2020 pandemic.

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“Seeing people dying one after the other after you’ve spent hours and hours in a room, doing everything you can, really, to get them out of there is very, very tough," says Melanie Serra, a paramedic at the ICU ward in the Bichat Hospital in Paris. It was the first hospital outside Asia to report a COVID-19 death, back in February.

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Something that is not alive, such as a virus , does not have self-generated or self-sustaining actions, he said. "I don't think viruses qualify as being alive. Yang agreed, saying, "Without a cell, a virus cannot reproduce. And so from that standpoint, it's really not alive, if you consider life to be something that

It was also where the ICU patient in room No. 10 died on Dec. 1. His was one of 775 virus deaths in France that day, adding to a national death toll now topping 56,000 and the worldwide count of more than 1.5 million dead.

The man was alive on the first of two days that Associated Press journalists spent immersed with the ICU staff. But by the time the overnight shift handed back to the day crew on the second morning, room No. 10 was empty and had been disinfected twice. The vacated bed had fresh linen. The TV monitor that had displayed the patient's vital signs was black and blank.

Medical staff, including Dr. Philippe Montravers, second left in background, attend a morning meeting, at Bichat Hospital, AP-HP, in Paris Tuesday, Dec. 1, 2020. Even for hospital staff for whom death is a constant, witnessing the loss of a fellow human being to COVID-19 is a churn of emotions. At the Paris hospital that recorded the first virus death outside Asia, nurses and paramedics in the intensive care unit have their own coping mechanisms.(AP Photo/Francois Mori) © Provided by Associated Press Medical staff, including Dr. Philippe Montravers, second left in background, attend a morning meeting, at Bichat Hospital, AP-HP, in Paris Tuesday, Dec. 1, 2020. Even for hospital staff for whom death is a constant, witnessing the loss of a fellow human being to COVID-19 is a churn of emotions. At the Paris hospital that recorded the first virus death outside Asia, nurses and paramedics in the intensive care unit have their own coping mechanisms.(AP Photo/Francois Mori)

He was, quite simply, gone. But not from the thoughts of those who worked hard to heal him. That morning, during his meditation that helps him process emotions from the ICU, paramedic Bertrand Brissaud set aside time to think about the patient, “a little positive thought.”

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As one of the man's carers, Brissaud had been more physically intimate with him than many people are with their friends. The former fire officer was among the last staff members who had suited up in protective gear and tended the man in his final hours, rolling him onto his side and massaging his back, shoulders, buttocks and heels to slow the buildup of bed sores.

But because the patient had been maintained for weeks in a coma, they never exchanged words.

Brissaud knew the man was originally from Egypt, lived in France, was a father. His admission details attached on the door of room No. 10 with a sticker marked ”COVID+" showed that he would have celebrated his 64th birthday in December. Beyond that, the patient remained somewhat of an unknown to the carers who became so intimately acquainted with his body.

Medics walk along a corridor at Bichat Hospital, AP-HP, in Paris, Wednesday, Dec. 2, 2020. Even for hospital staff for whom death is a constant, witnessing the loss of a fellow human being to COVID-19 is a churn of emotions. At the Paris hospital that recorded the first virus death outside Asia, nurses and paramedics in the intensive care unit have their own coping mechanisms. (AP Photo/Francois Mori) © Provided by Associated Press Medics walk along a corridor at Bichat Hospital, AP-HP, in Paris, Wednesday, Dec. 2, 2020. Even for hospital staff for whom death is a constant, witnessing the loss of a fellow human being to COVID-19 is a churn of emotions. At the Paris hospital that recorded the first virus death outside Asia, nurses and paramedics in the intensive care unit have their own coping mechanisms. (AP Photo/Francois Mori)

“These deaths are so quick, happening in front of you. You get a little spasm of heartache, a 'Oh, he’s gone,’” Brissaud says. “There is all this work you have to do in yourself to understand that we do our best but that we are not God."

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Nurse Hyad Boina, prepares to care for patients in room No. 9 and 10, both battling against COVID-19 at Bichat Hospital, AP-HP, in Paris Tuesday, Dec. 1, 2020. (AP Photo/Francois Mori) © Provided by Associated Press Nurse Hyad Boina, prepares to care for patients in room No. 9 and 10, both battling against COVID-19 at Bichat Hospital, AP-HP, in Paris Tuesday, Dec. 1, 2020. (AP Photo/Francois Mori)

In the man's final hours, the ICU staff sensed the end was close. But nurses and paramedics still tended to him as if it wasn’t. They rolled him onto his front to aid breathing and later rolled him onto his back. They checked and readjusted tubes going in and out of his body, hooked to machines that kept him alive but which, ultimately, could not arrest his inexorable decline.

Placards reading : © Provided by Associated Press Placards reading : "Be Courteous with the Staff" and "All Verbal or Physical Aggression with the Hospital Staff is liable to Criminal Prosecution" are adhered to a wall at Bichat Hospital, AP-HP, in Paris, Tuesday, Dec. 1, 2020. (AP Photo/Francois Mori)

“He is not doing well,” nurse Hyad Boina said after treating the patient on what proved his final morning. Boina, 35, said that if the man’s family called for an update, he would feel obliged to say that “it’s very serious and that the patient is between life and death.”

Making her rounds, the unit's psychologist, Emmanuelle Busch, sought out one of the staffers who worked for weeks with the man and was reassured to find that she was doing fine. The man's age and the fact that his death wasn't unexpected made it easier for his carers, Busch determined.

A nurse cares for the patient in room No. 9, during his battle against COVID-19 at Bichat Hospital, AP-HP, in Paris Wednesday, Dec. 2, 2020. Even for ICU workers for whom death is a constant — and never more so than this year — witnessing the loss of a fellow human being to the virus can be a churn of emotions. (AP Photo/Francois Mori) © Provided by Associated Press A nurse cares for the patient in room No. 9, during his battle against COVID-19 at Bichat Hospital, AP-HP, in Paris Wednesday, Dec. 2, 2020. Even for ICU workers for whom death is a constant — and never more so than this year — witnessing the loss of a fellow human being to the virus can be a churn of emotions. (AP Photo/Francois Mori)

Some other deaths during the pandemic hit harder. She says the virus death of a young lung-transplant recipient made one ICU paramedic “very angry.” Another came to her “in tears, saying, ‘They are all dying. What we are doing is useless.'”

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A medic works in the resuscitation room at Bichat Hospital, AP-HP, in Paris Tuesday, Dec. 1, 2020. Even for hospital staff for whom death is a constant, witnessing the loss of a fellow human being to COVID-19 is a churn of emotions. At the Paris hospital that recorded the first virus death outside Asia, nurses and paramedics in the intensive care unit have their own coping mechanisms.(AP Photo/Francois Mori) © Provided by Associated Press A medic works in the resuscitation room at Bichat Hospital, AP-HP, in Paris Tuesday, Dec. 1, 2020. Even for hospital staff for whom death is a constant, witnessing the loss of a fellow human being to COVID-19 is a churn of emotions. At the Paris hospital that recorded the first virus death outside Asia, nurses and paramedics in the intensive care unit have their own coping mechanisms.(AP Photo/Francois Mori)

But as well as being a foe, death is also accepted. “It's never pleasant," Busch says, “but nor is it necessarily experienced as a failure.”

Serra, the 32-year-old paramedic who also treated the man in room No. 10, says that seeing patients "slowly go downhill without being able to do anything is very, very complicated" emotionally. She tries to protect herself by not dwelling on her experiences but also says: “The hardest thing is losing a patient. That’s the truth. Even if you distance yourself."

“We can’t allow ourselves to be affected by all the deaths because, otherwise, how do you cope? We’d fall into depression and stop working," she says. “With this gentleman, because of how his condition evolved, we’d been expecting it for several days. It is very hard and very cold but we have no choice but to say to ourselves, ‘So be it. Such is life.'"

Dr. Philippe Montravers poses in front of a collection of portraits of medical staff at Bichat Hospital, AP-HP, in Paris, Wednesday, Dec. 2, 2020. Even for hospital staff for whom death is a constant, witnessing the loss of a fellow human being to COVID-19 is a churn of emotions. At the Paris hospital that recorded the first virus death outside Asia, nurses and paramedics in the intensive care unit have their own coping mechanisms. (AP Photo/Francois Mori) © Provided by Associated Press Dr. Philippe Montravers poses in front of a collection of portraits of medical staff at Bichat Hospital, AP-HP, in Paris, Wednesday, Dec. 2, 2020. Even for hospital staff for whom death is a constant, witnessing the loss of a fellow human being to COVID-19 is a churn of emotions. At the Paris hospital that recorded the first virus death outside Asia, nurses and paramedics in the intensive care unit have their own coping mechanisms. (AP Photo/Francois Mori)

But in saying so out loud, she also frets that “I will come across as a monster."

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Nurse Hyad Boina cares for a patient in room No. 9, during his battle against COVID-19 at Bichat Hospital, AP-HP, in Paris Tuesday, Dec. 1, 2020. Even for ICU workers for whom death is a constant — and never more so than this year — witnessing the loss of a fellow human being to the virus can be a churn of emotions. (AP Photo/Francois Mori) © Provided by Associated Press Nurse Hyad Boina cares for a patient in room No. 9, during his battle against COVID-19 at Bichat Hospital, AP-HP, in Paris Tuesday, Dec. 1, 2020. Even for ICU workers for whom death is a constant — and never more so than this year — witnessing the loss of a fellow human being to the virus can be a churn of emotions. (AP Photo/Francois Mori)

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At the end, the monitors that show vital signs of all ICU patients — the markers of existence, rendered in colored numbers and graphs of peaks and troughs — signaled that the man in Room No. 10 had lost his battle.

“His heart just stopped beating. We saw the flatlines, like in the movies," says Brissaud. He put on a mask, went into the room, and switched off all the machines, the ventilator, the mechanized syringes and the alarms.

He says he then made way for other colleagues, including Boina, the nurse, who prepared the body for its onward journey to the morgue. They got rid of the tubes, catheters and dressings, and they washed and dried the body.

Dr. Philippe Montravers is pictured next to room No. 10, hours before the patient inside died after his nearly month-long battle against COVID-19 at Bichat Hospital, AP-HP, in Paris Tuesday, Dec. 1, 2020. The patient in room No. 10 died later on Dec. 1. His was one of 775 virus deaths in France that day, adding to a national death toll now topping 56,000 and the worldwide count of more than 1.5 million dead. (AP Photo/Francois Mori) © Provided by Associated Press Dr. Philippe Montravers is pictured next to room No. 10, hours before the patient inside died after his nearly month-long battle against COVID-19 at Bichat Hospital, AP-HP, in Paris Tuesday, Dec. 1, 2020. The patient in room No. 10 died later on Dec. 1. His was one of 775 virus deaths in France that day, adding to a national death toll now topping 56,000 and the worldwide count of more than 1.5 million dead. (AP Photo/Francois Mori)

"They had spent a lot of time caring for him, so they wanted to bathe the body to help him on his way,” Brissaud says. “It’s our way of being involved in the final process. It’s very important in the ICU ward. We often work with people who have died. Through the funeral washing, we finish the job.”

“It permits us to mourn — to say, “It’s over. He is dead.”

A nurse pauses next to room 5 at Bichat Hospital, AP-HP, in Paris Tuesday, Dec. 1, 2020. Even for hospital staff for whom death is a constant, witnessing the loss of a fellow human being to COVID-19 is a churn of emotions. At the Paris hospital that recorded the first virus death outside Asia, nurses and paramedics in the intensive care unit have their own coping mechanisms. (AP Photo/Francois Mori) © Provided by Associated Press A nurse pauses next to room 5 at Bichat Hospital, AP-HP, in Paris Tuesday, Dec. 1, 2020. Even for hospital staff for whom death is a constant, witnessing the loss of a fellow human being to COVID-19 is a churn of emotions. At the Paris hospital that recorded the first virus death outside Asia, nurses and paramedics in the intensive care unit have their own coping mechanisms. (AP Photo/Francois Mori)

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Follow AP’s coverage at https://apnews.com/hub/coronavirus-pandemic and https://apnews.com/UnderstandingtheOutbreak

U.K. Virus ‘Out of Control’; Cuomo Warns of Spread: Virus Update .
More than 16 million Britons are required to stay at home as a full lockdown came into force Sunday in London and southeast England, part of Prime Minister Boris Johnson’s effort to contain an “out of control” mutation of the coronavirus. The U.K. reported the most Covid-19 infections since the start of the pandemic. European countries responded by suspending travel links. The U.S. doesn’t need to take that step for now, a member of the White House virus task force said, but Governor Andrew Cuomo expressed concern that untested passengers from the U.K. could be carrying the mutation to New York.

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