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Politics first, health second: Heed Virginia's example on electing 'moderate Republicans'

I’ve spent the past two years working in the emergency room on the front line of this pandemic, where I have lost count of how many people have been intubated, brought back to life, were told they will never see a loved one again, or learned they have life-altering conditions due to COVID-19. So to say I’m disappointed about Wednesday’s passage of an anti-masking bill in the Virginia Senate is an understatement.

For those of you who aren’t keeping up with Virginia politics, we’re finding out in excruciating detail what happens when the media mindlessly sells someone as a “moderate Republican,” a “six-foot-seven mystery date,” and as “charting a new path forward for the Republican Party.”

Am I surprised? No. Newly elected Gov. Glenn Youngkin is like a toddler with a shotgun: enormous power, nowhere near competent enough to wield it, prone to fits of petulance, and unable to care about the damage he causes. Nor am I surprised that he seems to have coordinated his rabid anti-mask agenda with Democratic state Sen. Chap Petersen, a person who has demonstrated time and again he cares more about seeing his name in the news than protecting health care workers and families.

Nobody here should be surprised about Sen. Petersen. He made it clear his crusade against masking has everything to do with how he feels, and nothing to do with facts. I guess after the 2020 fiasco where he casually observed that segregation wasn’t great but at least the schools were open (except, ahh, they weren’t!), we should have seen this coming.

The tantrum Petersen had, though, where he made it seem like we were back in April 2020 is just … bizarre. I mean, I get it, cynically. You make a strawman argument with no bearing in reality so it makes your own argument seem reasonable in comparison. (Although it’s hard to take anyone wearing a bow tie seriously. I know a couple of friends of mine who’ll read this and go “Awwww,” but sorry guys, it’s true.) As for Petersen, telling people that you have “a doctorate in common sense” is one of the most hilarious and tone-deaf things I’ve ever heard uttered and, man, I have heard some pretty hilariously tone-deaf things.

Because the masking rules in public schools were the only measure the Commonwealth still had in place to support our emergency services system from the COVID surge. The rest of them have been gone for months, at least. Well … except for, you know, the fact that every hospital in the Commonwealth of Virginia had to shut down their elective surgeries in January and run commercials during the NFL playoffs begging people not to come to the ER in a desperate attempt to keep our health care system from total collapse.

But I think we can all agree that’s a totally normal occurrence that doesn’t merit further discussion or introspection. Right? Right.

I mean, I can go eat in any restaurant I like. I can go watch Jackass Forever! at a movie theater. I guess I have to wear a mask on an airplane. Otherwise, society, by and large, has moved on. And trust me, as an ER nurse, I am acutely aware of that dichotomy. I just can’t describe the mental whiplash one gets going from an environment of “What pandemic? Woooooo!” to “I need a room, I need a room right now. This guy just walked into triage. He’s decompensating rapidly. It’s Day 10; room air sats were only 57% when they walked in, and the high flow isn’t working. It’s just not doing enough. No, don’t even bother sending them to the COVID unit. He’s not going to make it there. We’re gonna have to tube them or we’re gonna lose them. No, we can’t … we can’t, it’s gonna be too late. We have to do it. Call respiratory! I need the RSI kit in Room 26! Can someone call this guy’s wife?! We need to get them on the phone before we do this! Right now! Tell them he can’t talk, he’s too out of breath, but he can at least hear her and the kids beforehand! Okay, sir, listen, it’s gonna be okay. It’s gonna be okay. We got you, man. I promise, okay? Hey, look at me. Look at me. It’s okay. It’s okay. We got you. You just work on breathing. You work on breathing and let us do the rest. Okay, ma’am, he can hear you. Go ahead.”

Folks. I am tired of the pandemic, too. Bone tired. Soul tired.

There was a stretch of six weeks in a row this fall during the delta surge that I worked 60+ hours a week in full COVID gear, 12+ hours at a time (somehow managing not to succumb from a combination of carbon dioxide poisoning and bacterial pneumonia from wearing a mask, if COVID skeptics are to be believed). I spent more time in that month-and-a-half with COVID patients than my own family. Listen to me: I am ready for the pandemic to be over.

When I hear from people like Glenn Youngkin, or our new MAGA Attorney General Jason Miyares, or Chap Petersen, people who have never had to do this kind of work for a living, never held the hand of someone so they didn’t have to die alone, never watched the gut-wrenching mix of dawning realization, panic, and utter fear that plays on someone’s face when they realize it’s too late—I can’t help but get angry. They’ve never been a Louisa County EMS unit having to wait three hours at VCU Medical Center to drop off a patient. They’ve never been a Wintergreen Rescue Squad desperately trying to bag a patient in respiratory distress who has a saddle PE and residual ground glass four months after they “recovered.”

Though, to be fair, I know plenty of folks in Richmond who’ve never done any of those things either, and still (somehow!) manage to stand behind the health care workers who sacrifice day in and day out. Apparently, a little empathy can go a long way—amazing, I know.

It’s tougher for us here in central Virginia, too. My community—Charlottesville, Albemarle, Louisa, Nelson, Fluvanna, Greene, Orange, Buckingham, Madison—is out on an island. We represent damn near 10% of the state by area. Just short of half a million Virginians live in our footprint here. That’s hard enough on its own, but when things go wrong in the Shenandoah Valley, in Southside, in Southwest Virginia, where do you think those people go for help?

They’re not going to Fairfax. They’re not going to Great Falls. They’re not going to Richmond or Virginia Beach or anywhere else in NOVA or the urban crescent. They come to us. They ask *us* for help.

And for two years, that’s what our community has been doing. Our people have sacrificed. Our emergency services providers and healthcare workers. Our teachers and social workers. Our parents, our children, our entire community has sacrificed and buckled down and held together to support the social safety net both here and across the state. We have been the safety net while the economy has been growing and Virginia has remained the best state for business.

When August Healthcare in Waynesboro was inundated, they called our people.

When Alleghany had nowhere else to send a critical patient, they looked to us.

Rockingham.

Amherst.

Lexington.

Lynchburg.

Farmville.

The legislature in Richmond and folks in Washington, both at the beginning of the pandemic, and right now, have asked community and emergency service providers to hold the line to keep our social safety net intact—and when we begged for help in getting that done, have made sure we have the finest “Canadian Air Support” available to us.

I guess the most frustrating thing of all is that regardless of what they might let on, Chap Petersen, Glenn Youngkin, Jason Miyares and company aren’t stupid. They know the same thing (and probably in far greater detail) that I know: The people of the Commonwealth of Virginia are on the hook for the costs, direct and indirect, of unmitigated spread of the pandemic.

Every travel nurse that has to be hired, at the rate of $5,000 to $10,000 per week? You pay for that.

Every dose of Regeneron or Molnupiravir, to the tune of thousands of dollars a pop? You pay.

The “long COVID” patient who goes on dialysis; the one who has an NSTEMI heart attack; and the 44-year-old mom with no comorbidities that gets acute mesenteric ischemia from a post-COVID clotting cascade, requiring a surgeon to emergently yank a half-foot of small intestine followed by and indefinite ICU stay? That’s you! You pay!

One of the reasons people are convinced they do not want government-run health insurance is because they are convinced they will be waiting forever to get the care they need. You are now waiting eight months on average to see a specialist, and you will certainly be paying for that.

ICUs that are at 128% capacity, that have to go from a 1:1 nurse-to-patient ratio to 1:3? As a patient, you’re still getting charged for 1:1. Same with the ER that has four nurses, a smattering of residents, and 90 patients in it—you’re still getting charged their “ideal staffing ratio” rate, and waiting 14 hours for the privilege.

When the biggest health care chain in the country eliminates their pediatric units in Virginia because of COVID? You’re gonna be paying for all those kids to end up in state hospitals.

Those in elite positions do not have to worry about these same problems. They don’t have charity accounts asking for medical funds. Do you think the governor cares about the health and safety of your kids, when his attend an out-of-state private school where masks are required for student and teacher safety?

When things go bad for the rest of us, these folks are still airily inquiring about why we can’t just eat cake.  

Maybe we’ll luck out and the pandemic really is coming to a close; maybe the Ba2 variant in Europe doesn’t do what delta or omicron did. Maybe we will happen to luck out, and malicious incompetence will dovetail with immunity levels and warmer weather to give us our first breather in forever.

At this point, our safety net has worn thin, our leaders are enabling a burden we cannot support, a loud and privileged minority of people are shouting to get their way (to the detriment of the rest of us), and there is no relief coming.

On the front lines, we’ve done all we can. It’s time for the elected officials to step in and do what is necessary.



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