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Dr. Rebekah Sensenig, Infectious Disease Specialist, Riverside Health System
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Dr. Rebekah Sensenig wears a medical mask that is effective for people that have already been diagnosed with the Coronavirus.
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The earliest Sensenig thinks a vaccine will be ready is the spring, and at first it will be limited to populations such as the elderly and health care workers.
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Sensenig believes there’s a way to go about life without hiding under a rock, simply by being cautious, wearing masks, social distancing, limiting large groups and encouraging contact tracing.
It was sometime in January that Dr. Rebekah Sensenig heard about a new virus from China. The warning came in an email from the chief medical officer at Riverside Regional Medical Center, where Sensenig is an infectious diseases physician. The email warned about a coronavirus that was starting to make itself known.
Sensenig tried to be optimistic, hoping the email was the last anyone would hear of the coronavirus. But deep down, she didn’t think it would be.
“This is going to get bad very quickly,” she told her husband.
At the time, no one realized just how bad it would get. That the virus would end up bringing an entire country—really, the world—to a standstill, shuttering businesses, closing schools, putting people out of jobs … and killing people. Hundreds of thousands of people. That it would become a pandemic.
One of the first things that struck Sensenig, an osteopathic physician who began her career in the Air Force, was how quickly this coronavirus began to spread. It didn’t seem to be as fatal as quickly as SARS and MERS, both illnesses caused by other coronaviruses. Both of those worked fast, killing before the virus had time to spread. COVID-19, as the illness was designated, appeared to be a spreader.
The first case hit Virginia on March 7, when a Marine at Fort Belvoir tested positive. At the time, public health officials said the risk was low. Wash your hands, health officials advised. Use hand sanitizer, cover your coughs, and stay away from sick people.
Within three days, the number of cases in Virginia grew to eight. By March 11, there were nine. Meanwhile, more than 1,000 people across the country were infected. On March 12, with 17 cases in Virginia, the governor declared a state of emergency. The following day, there were 30 cases.
By mid-March, COVID reached Hampton Roads. A James City County man died. Schools started closing. People were told to avoid social gatherings of more than 10 people. “I want every Virginian to hear this message,” Gov. Ralph Northam said. “It is up to us to act responsibly.”
On March 20, Newport News registered its first case, according to the Virginia Department of Health.
“From the beginning, it wasn’t an ‘Oh, no, here we go,’” Sensenig recalled. It was a ‘How bad is it going to be?’”
Americans were told to shelter in place to “flatten the curve” and keep hospitals from being overwhelmed. Virginia doctors watched as COVID devastated states such as Washington, New York and New Jersey. Sensenig credits Virginia being spared the worst of it thanks to the governor shutting the state down fairly quickly.
Initially, it was not too bad in Hampton Roads. The staff at Riverside weren’t overly busy, with one or two COVID patients here or there.
In fact, it was almost eerily quiet. Because of the coronavirus, there weren’t as many people coming into the hospital. Elective surgeries were cancelled. From March through May, the hospital never neared capacity as a result of COVID cases.
The anxiety, however, was high. “Our biggest fear was bringing it home to our families,” said Sensenig, who has three boys with her husband, an emergency room physician at another hospital. “People didn’t want to play with our kids, because they knew we were going to the hospital.”
In May, though, as cases in Virginia topped 20,000, there were outbreaks at the chicken plants on the Eastern Shore. With the few hospitals there quickly overwhelmed, some patients needed to go elsewhere. But ground transportation was tricky because patients were on oxygen, and the oxygen could run out en route.
At one point, medical helicopters were flying multiple patients a day from the Eastern Shore to Hampton Roads. Some went to Norfolk and Virginia Beach. Some went to Newport News.
“They were pretty sick, certainly in the beginning,” Sensenig said. “They were very, very ill patients. People were sick.”
And yes, there were deaths. Still, the COVID peak didn’t hit Hampton Roads until after the Fourth of July—right about the time things started to open back up across the state.
“It made sense,” Sensenig said. “I think people had quarantine fatigue. People wanted to get out and see friends, and they did. We saw the peak after that.”
Each week, a member of the medical staff was assigned to the COVID ward at Riverside. There were often volunteers —people wanted to do all they could. But there was a lot of confusion about the virus, a lot of unknowns. Stories of what was happening at hospitals in other parts of the country kept pouring in, and it was enough to scare anyone.
For the staff, days began suiting up in full PPE gear and ended in exhaustion.
At Riverside, patients got IVs with extra-long tubing, so nurses could dispense medication from doorways. Nurses held up iPads to terrified
patients so they could talk to loved ones. There were tears all around. Staff spent extra time with patients starved for interaction, trying to provide comfort. Some staff contracted COVID themselves.
“We didn’t know how it was transmitted, so there was always this underlying fear,” Sensenig said. “There was a day the CDC changed [the believed transmission method] in one day. The honest truth is no one was really sure.”
Testing has been a constant source of frustration. Early on, it was hard to get a test even in the hospital unless approved by the health department. Turnaround took two weeks. Some patients were simply told to go home, rest and report if they got worse. And although testing is better now, it’s still not perfect.
Treatment, however, is better. That was not always the case. Early on, Remdesivir, an antiviral medication that can help lessen recovery time, was only available for compassionate use. Doctors would use it on patients who could best benefit. It’s readily available now, but there is still no cure.
The antibody cocktail given to President Trump when he had COVID is experimental and not easily accessible. Common treatments are Remdesivir, dexamethasone (a steroid) and anticoagulants, because there appear to be clotting issues.
“We don’t have a miracle yet,” Sensenig said. Overall, however, COVID patients seem to have fewer symptoms, and people seem to be pulling through better than they were early on. But that doesn’t mean anyone should let down their guard and think the danger has passed, Sensenig warned. What’s unique about COVID is that it’s not just a respiratory illness: “To watch a relatively young person go from being mildly short of breath on admission to requiring mechanical ventilation and dialysis with multi-organ failure without being able to successfully intervene causes a helpless feeling we are not used to having.
“There are people still dying from it,” she said. That said, Sensenig believes there’s a way to go about life without hiding under a rock, simply by being cautious, wearing masks, social distancing, limiting large groups and encouraging contact tracing. If precautions are taken, she also doesn’t think there’s a reason for kids not to go back to school. Her own children—ages 6, 8 and 10 —started returning to school in York County in October.
“The problem with keeping kids out of school is we’re failing to see that public health is not just freedom from the virus,” Sensenig said. “It encompasses their emotional health, their educational health. Keeping these kids out of school is causing significant harm to them.”
There has been a marked decrease in abuse reports since COVID began, along with an increase in cases of depression, anxiety and even suicides, she said.
With safety measures in place, such as frequent hand washing and wearing masks, the risk to students and teachers in schools is minimal, Sensenig said. Children who get the virus generally tolerate it well, she added.
“I understand [teachers’] fears, because I was there, too,” she said. “But I think it can be done safely.”
Going forward, there are still unknowns. The earliest Sensenig thinks a vaccine will be ready is the spring, and at first it will be limited to populations such as the elderly and health care workers. Also, flu season is almost here, and no one is sure what complications that could cause, although looking at the southern hemisphere, which already had its fall and winter, flu cases were down, she said.
If Sensenig could send a message, it would be simply, “Don’t quit.” If anything, she said, the pandemic has already shown how communities— including the medical community—can come together, how family time is so important and how people can persevere through hard times.
“It’s going to take some time, and honestly caring for each other,” she said. “It will certainly change us. But perhaps there will be some good changes. We will be kinder, we will be more patient and we will be more focused on what is truly important in life.”
Kim O’Brien Root is on the hunt to find the most comfortable and stylish face masks out there and has already amassed an impressive collection.