To find Keter A, one of the two coronavirus wards at Shaare Zedek Medical Center in Jerusalem, you have to follow the signs to the staff dining room. Sometime during the second wave of the virus, the hospital realized that group meals wouldn’t be possible in the near future, so it turned the space into a ward.
Inside, beyond the double doors, there are familiar scenes. Medical staff, looking like astronauts in their protective gear, walk among the dozens of beds with patients in varying conditions. Most of the patients seem to be seriously ill.
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Some are unconsciousness or barely conscious. Others are clearly suffering. One cries out in pain; the others silence him with groans. Over the moaning and coughing you can hear the beeps of machinery, the breathy sound of ventilators and the rustle of the white coveralls.
But contrary to how things look from outside, inside there is no feeling of collapse. There are only professional medical concerns – oxygen saturation levels, medications, measurements, food, and urine.
Pressure on the ward has increased as the third wave worsens. Last Thursday morning, Shaare Zedek had 89 coronavirus patients. By afternoon, the number had risen to 96, and Friday morning it hit 108. By Sunday morning, it was at 116, of whom 62 were seriously ill, including 26 in critical condition.
“It’s very difficult, but in time, you get used to it, physically, sociologically and emotionally,” said Dr. Ramzi Kurd, the ward’s director, who has been at the forefront of the battle against the virus in Jerusalem ever since the first wave. Kurd, 32, is a specialist in internal medicine and geriatrics who lives in East Jerusalem’s Beit Hanina neighborhood.
“The workload is increasing, the number of patients has risen and also the number of very serious cases,” he said. “We’re constantly increasing the number of beds, but it’s not enough. It’s the exact same disease, but the rate of deterioration is higher.”
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“We try to be inside for only two or three hours, but often we’re there for six or seven,” Ayelet Cohen, a nurse who has worked in the ward since the first wave, added.
The main battle is over the level of oxygen in the patients’ blood. Today, it’s waged mainly with external breathing machines that inject oxygen in high concentrations, rather than ventilators that require an induced coma and intubation of the lungs.
“We try to keep them off ventilators as much as possible, because once they’re on, it’s very hard to wean them off the ventilator,” one staffer said.
A tour of the ward shows that this war also entails a battle for the patients’ mental health. The frightening feeling of suffocation, the isolation and the separation from their families, coupled with the absence of human faces, since staffers are covered from head to toe, make it very hard for patients to deal with the illness and push some of them into a searing emotional state.
Medical staffers said they sometimes need security guards to keep patients from running away or to help them calm a patient.
“There was one case involving a man I knew from before, and his character changed,” one said. “He was anxious, confused, almost psychotic. This was emotional distress that went far beyond what I’d seen in other wards.
“People who come off ventilators are a catastrophe,” he added. “They’re disoriented. You wake up and everyone around you is like an alien. There were three who were sure they’d been abducted.”
“The emotional side matters,” Kurd agreed. “They feel the suffocation, the coughing that wakes them in the middle of the night; they hear the beeping and see what happened to their neighbor in the next bed a day ago. The nature of the ward makes things extra difficult for the patient.”
“It’s very lonely, the isolation is oppressive,” said Koby Schwartz, a 62-year-old patient who normally runs the hospital’s CT unit.
Another patient, former Judge David Frenkel, 84, said: “It’s better not to describe it. It’s more bitter than death. It imprisons you. It’s impossible, you’re very weak. And I was an active, athletic man.
“But I’m not someone who’s afraid,” he added. “I’ve been saved from death five times already. I was in Bergen-Belsen, most of my family was murdered in Auschwitz. The medical team here is exceptional, and I hope they’ll help save me from this misery.”
Occasionally I heard complaints about not being helped to get into bed or delays in serving the food. But at least three patients specifically asked me to say good things about the staff’s dedication and attitude toward them under the difficult conditions of a coronavirus ward.
“Write that there’s nothing like the staff here,” bus driver Hagai Kuzran instructed. At 50, the Ma’aleh Adumim resident is apparently the ward’s youngest patient, and he’s certain he knows just how he was infected.
“I saw a passenger standing beside me and coughing,” he said. “I asked him to move away, because I’m diabetic, but he refused. In the end, he complained about me. Two days later, I got sick,” Kuzran said.
Dr. Yitzhak Adler, an ultra-Orthodox physician from Jerusalem who is now a patient in the ward, said: “We need a lot of repentance. You don’t have to be smart to realize that.”
Adler caught the virus just two days after being vaccinated, despite all his precautions. He is on oxygen, but seems to be in relatively good condition.
“I’ve been very careful with my patients since the first wave,” he said. “For eight months, I prayed without a minyan. But people made light of it and the government made light of it. They don’t understand that this virus has no mercy,” he added.
At that point, he was forced to stop by a fit of coughing.
When he first got infected, he said, “It felt like the flu, and I thought it was from the vaccine.” His wife, from whom he caught the virus, recovered well, “but I got hit very hard.”
Both Frenkel and Schwartz also got infected shortly after they received the first dose of the vaccine. Schwartz thinks he caught it from a nurse he works with. “We’re always careful,” he said. “But from time to time you lower the mask to drink; what can you do?”
Kurd said that getting the first dose of the vaccine might make people feel protected and therefore become a bit less cautious. “But you have to continue being careful,” he said. “The light at the end of the tunnel is closer now than ever. We all have to be vaccinated or immune from having the virus, and then we’ll all take our masks off together.”
The desperate battle for the patients’ lives, the resuscitations and the deaths, are part of the ward’s daily routine. For the staff, it’s especially frustrating when a patient deteriorates after he seemed to be getting better.
“There are people who take this hard, and then you see rapid deterioration,” said Cohen, the nurse. “There was one patient who really affected us. We managed to keep him alive, he was about to be discharged. And then one day, he got a blood clot in his heart. They tried to resuscitate him for an hour, but he died in our hands.”