“Although the anxiety of caring for COVID patients never leaves you, this has been a tremendously exciting time to be a critical care and pulmonary physician,” Dr. McComb says. “This is what we trained for. Rallying all these different groups of people to take good care of our patients was a big challenge — but we learned we are up to it. I’m so proud of UPMC Shadyside.”
“We learned we can rise to a big challenge.”
Jennifer Gonzales McComb, MD, MPH Chief,
Pulmonary Disease and Critical Care Medicine
As soon as Jennifer McComb saw the first reports in late 2019 about a new virus known as COVID-19, she and a hospital-wide team began planning how to care for patients safely at UPMC Shadyside.
“We had to determine how many floors and monitored beds we would need. We had to order equipment. We had to figure out where we could safely utilize negative pressure rooms, whereby the air supply goes in and then out through a filter and into an exhaust system. We had to set up safe processes for donning and doffing personal protective equipment (PPE), which included powered air-purifying respirators, N95 masks, eye protection, gowns, and gloves. Putting all this on takes at least three minutes. And you can’t take it off without help.
“There were added levels of complexity at each stage of care, including maintenance of the rooms, feeding patients, getting samples to the lab safely, and having supplies at hand for emergencies. Before our first patient arrived on March 17, I would wake up at night worrying if we were getting it right, especially since the world kept learning new things about this disease every day.”
But soon Dr. McComb began to feel confident that UPMC Shadyside could provide safe, compassionate care for COVID patients whose symptoms ranged from fever, cough, profound fatigue, and low oxygen levels to loss of taste or smell, dehydration from diarrhea and vomiting, even heart attacks and blood clots in the legs and lungs.
“Along with these symptoms, we have to manage all of a patient’s other chronic conditions, such as high blood pressure, kidney disease, or diabetes. And, if a patient goes into respiratory failure, a ventilator is needed, along with the specialized mechanics of giving high levels of oxygen support. Some patients were so critically ill that they had to be chemically paralyzed in order to tolerate the mechanical ventilator.”
Despite the strains, Dr. McComb remembers the wins. “We cared for a critically ill, 42-year-old bone marrow transplant patient who went home. We had a 33-year-old who was critically ill but went home and recovered. We had a lymphoma patient who was receiving immunotherapy who also went home.
"This is what we trained for. Rallying all these different groups of people to take good care of our patients was a big challenge — but we learned we are up to it."- Dr. McComb