Coronavirus

Houston Safety Net Hospitals Treat The Most Vulnerable Patients For COVID-19. Here’s What It’s Like

Two of Houstons safety net hospitals have treated more than 3,500 COVID-19 patients since the start of the pandemic, and COVID-19 patients represent 18% of the total capacity in the two hospitals, slightly higher than average for all Harris County hospitals.

a Health care workers at LBJ Hospital, a safety net hospital in Houston. From left are Janie Espinoza, 35; Shibu Jacob, 43; Dawn Purvis, 52; Carma Jones, 56; Gissele Diaz, 32; and Lakisha Comeaux, 48, all of whom work in the hospital’s COVID-19 unit.

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When Houston's LBJ Hospital received its first COVID-19 patient on March 15, that person was immediately transported to Unit 3A, which for the first two-and-a-half months of the year was an intermediate care unit.

That night, it became the official COVID-19 unit at the hospital.

Each day after that was part of a steep learning curve in battling a virus that at the time few people knew anything about.

Tammy Simon, a nurse clinician in Unit 3A who works the night shift, said her friends normally look to her as someone who can handle what life throws her way. But 2020 has been challenging in ways she and her colleagues had never before experienced.

"I don't think I've ever cried so much at work in my life," Simon said. "And I'm not afraid to show them, share them. I release them whenever possible, whether it's on my lunch break, a bathroom break. Sometimes I have to excuse myself from the patient because I'm overwhelmed with everything that's going on."

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LBJ is one of Houston's safety net hospitals, providing coverage to many low-income patients without insurance or ability to pay. Together, two safety net hospitals in the Harris Health System — LBJ and Ben Taub — have cared for more than 3,500 COVID-19 patients since the start of the pandemic in Houston.

And as of Tuesday afternoon, COVID-19 patients represented 18% of the total capacity in the two hospitals, slightly higher than the cumulative average for all Harris County hospitals.

"A lot of (hospital) CEOs have labeled us the canary in the coal mine," said Dr. Esmail Porsa, CEO and president of The Harris Health System. "When you think about the segment of the population that was impacted, the racial minorities, the uninsured — that's who we care for."

Because it treats such historically underserved populations, COVID-19 filled LBJ faster than most other hospitals, Porsa said.

Nurses Deandria Winchester, left, and Dawn Purvis work in the LBJ Hospital COVID-19 unit.

Like many hospitals early on in the pandemic, LBJ had issues with supplies of personal protective equipment supply. Though the hospital never actually ran out of gowns, masks or gloves, Porsa said the team came close.

"The psychological impact of worrying about that next week, we may run out, that was huge," Porsa said.

That mental health strain was felt by health care workers across Unit 3A. Deandria Winchester, a 41-year-old nurse in the unit, said she was so worried about bringing the virus home early on that she sent her daughter away for a few months until the supply situation was better.

At that point, people in the unit were conserving PPE as best they could, including sterilizing and re-using them whenever possible.

Winchester even created a specific routine for herself at the end of her work day: she changes out of her scrubs into a clean set of clothes, changes out of her work shoes into a new pair of shoes, heads home and takes those shoes off before entering the house. Then she immediately heads to the shower, without coming into contact with anyone else.

It's a process she goes through to this day. And after nine months, it's taken its toll.

"I'm at the point where I want it to be over with," Winchester said. "I just want this to go away, I'm ready to put it in the back of my mind."

Health care workers at LBJ Hospitals COVID-19 unit. From left are Elsamma Isac, age withheld; Ike Dike, 29; Deandria Winchester, 41; and Devona Bailey, 33.

Despite that hardship, Winchester said she loves the job precisely because she's helping those most in need.

To her, working in a safety net hospital — even during hard times — is a "blessing."

"We serve the underserved," Winchester said. "Sometimes I spend some time talking about the disease process, and they're like, nobody ever told me that. Nobody ever told me if I wear a mask, things will get better. I just really love working with the population that we have."

Unfortunately, the situation in hospitals like LBJ may not be getting better any time soon. On Tuesday, Harris County Hospitals reported that just under 28% of occupied ICU beds were filled with COVID-19 patients. That's the highest its been since the middle of August.

But while there may not be an end in sight right now, nurses in the unit say they're more prepared than ever to take on whatever challenge comes their way.

When asked to describe 2020 in three words, nurse clinician Dawn Purvis chose: "chaos," "madness" and "scary." Because you never quite know what's going to happen on a day-to-day basis, she said.

Purvis said she's been a caretaker since childhood, helping out with her three younger siblings while her parents worked. She decided to become a health care worker after watching nurses care for her first husband.

Now 52, Purvis said she feels a strong sense of purpose when she goes into work every day at LBJ.

"I love the patients that we take care of," Purvis said. "They are why I do what I do."

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