By Uriel Heilman, JTA
When it became clear that the coronavirus pandemic would reach Israel, Dr. Elli Rosenberg was one of a small number of medical professionals at Beersheva’s Soroka Medical Center to answer a call for volunteers to treat the sick.
Dr. Rosenberg, a clinical immunologist who works as an internist at Soroka, now runs the coronavirus unit there. As of Mar. 19, his hospital, the largest in southern Israel, had 14 confirmed coronavirus patients.
How long do you think this will last, and how bad will it get?
Dr. Rosenberg: Nobody really knows. I’m mentally preparing for a few months. I’m also preparing for a situation where it gets worse before it gets better. We’re trying to make the most out of the resources we have, to maximize our ability to provide care in the event that this turns out to be very significant.
Will we be overwhelmed, will we find ourselves in a similar position to what’s happening unfortunately in Italy, where doctors are making horrible choices of who to treat and who to turn away? I dread that possibility. We’re trying to do the best with what we have to avoid that situation
Were you prepared for this?
We imagined this day might come, but we never really translated that into operational contingencies. Everything is new here. Setting up an isolation unit for patients with this disease has definitely been a challenge. The last two weeks have been a learning process and a training process for something that might get much worse very quickly.
What did you do on Day 1?
When the first patient was admitted to our unit, I remember suiting up and getting into all the layers of protective gear and entering an airlock that separates the clear zone from the infected zone. It was an astronaut-like experience. As I held the door of the airlock, I felt, ‘Wow, I’m stepping into the unknown and taking part in something that’s a worldwide challenge.’
It was a mixture of fear and excitement and a reminder of why I chose to do what I do. Then I walked into the unit, approached the patient and introduced myself.
What is the course of treatment?
There is no evidence-based treatment yet. There’s a lot of research being carried out right now around the world on various forms of medication that interfere with the virus’s ability to impede the inflammatory response the virus may cause, or the virus’s ability to attach to DNA. We’re basing what we do on developing supportive care, usually with oxygen, and waiting for the patient’s own immune response to kick in and eliminate the virus.
How long does it typically take for patients to get through coronavirus?
Between several days and a few weeks. That’s the challenge with this disease. If there’s an influx of patients that require hospitalization for long stays, that might overwhelm the health care system’s capacity. There won’t be enough beds, there won’t be enough staff, there won’t be enough respirators. That’s the real concern. We’re trying our best to prepare for an uncontrollable wave of patients.
How are patients managing the emotional burden of isolation?
It’s very difficult. They don’t know how long they will be hospitalized. Every cough, every fever, every change in their oxygen saturation level is usually a cause of a lot of stress. The cough and shortness of breath are nasty. The isolation from family is very difficult. They’re essentially locked in. It’s a very unsettling experience. Using telemedicine, they speak daily with a social worker to try to vent their feelings, their concerns, their fears.
We’ve been blessed with patients who are very positive. They eat their meals together in a common dining room, they’re playing board games together, building puzzles, helping each other pass the time.
What are the greatest risks to you and your staff?
The true front lines are the people working in emergency rooms. Any patient that walks in potentially has corona, and the staff there doesn’t have the ability to protect themselves from every single patient. That uncertainty increases the risk of accidental exposure. In our unit, there’s no uncertainty.
Do you check yourself or your staff for the virus?
No. The protocol is that as long as we feel well, we’re not tested on a routine basis. If any of us develops fever or respiratory symptoms suggestive of the disease, we’ll obviously test. The consequence of positive results among any of our staff would be quarantine for everybody. And that has extensive repercussions, so we’re hoping we all stay healthy.
What does your family say about your work?
I think they understand the importance of what I’m involved in. My 12-year-old daughter specifically pointed out that she’s proud of me, which moved me greatly.
How do you feel Israel has handled the pandemic?
In the beginning, I thought this was handled way too aggressively and that the measures the government decided on were extreme. As time progressed, especially with examples coming in from different countries around the world of how governments responded and what the consequences were — for better and for worse — I slowly shifted to the point right now where I hope we’re not too late with the actions we’re taking.
Uriel Heilman writes for the JTA global Jewish news source.
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