First Responders of St. John’s Community of Metro Detroit Lead COVID-19 Battle

Kurjian worked directly with COVID patients. Residents typically work as a team; 2 residents and an attending physician, seeing 15-18 patients at a time. When the pandemic broke out, all teams became COVID teams. His day started at 7 a.m., signing out the night residents, then doing rounds with his attending, interviews and making sure imaging studies were getting out. Patients were waiting for several days while they were being treated. The ICU was busy as well. Typically older patients had a lot of medical problems and they didn’t do as well. Kurjian shared they did the best they could. Kurjian added he feels that the majority of people that they could save, they did save. He added that the local community in Livonia has been great. Restaurants have been donating lunch, water bottles, cookies, and so on to the health care workers. Fr. Aren Jebejian also reached out to him.

Kurjian believes that there will in fact be a second wave of Covid. It would be great to get a vaccine – there are promising studies with an antiviral agent called remdesivir, but studies are limited. He added that the lockdown has been effective and they saw drops in cases a couple weeks ago, which made their job easier. With fewer cases, they are better able to care of patients. In reference to the lockdown, Kurjian states, “I would lose my mind too” (from having to stay at home), but that people should be more open to continue lockdown because we don’t know what the fall is going to look like. We need to get some data and more time to make the right choices.

Dr. Rita Akaraz-Avedissian works at St. Joseph’s in Ann Arbor and St. Mary-Mercy in Livonia. Most of her COVID involvement has been at St. Mary-Mercy. When it started, it wasn’t that many cases, but soon they were slammed and they were out of room in the ICU, and out of ventilators and personal protection equipment, as was also the case in many other hospitals. She states that everyone in the southeast Michigan area was in the same boat.

Akaraz-Avedissian’s life has significantly changed. She has a whole different process for how she gets up and goes home, including decontamination, before seeing family, because she has two children, Armen, 6, and Aren, 3. She has been working 10-12 hour days, with patients that are confirmed or suspected to have coronavirus. Many patients have died.

Akaraz-Avedissian said that typically in her field she might lose 2 people a month, but during the pandemic people have been dying almost daily. St. Mary’s was the hardest hit hospital outside of Detroit proper, she said. They had to reorganize how they operated in the hospital. “Everything changed about how we practiced medicine. For the first month or month and a half I wouldn’t even let the kids hug me. I haven’t seen my 92-year-old grandmother since March.”

Akaraz-Avedissian stated at the time of the interview (on June 24) that “we are seeing a spike right now, it’s controlled but hopefully it doesn’t get worse.” She predicted that things will continue this way until there is a vaccine and/or the people gain herd immunity. Herd immunity happens when enough of the general population, around 70 percent, becomes immune through vaccination or previous infection. At that point most people can’t pass it or get it.

Until that time, we will be dealing with these disease surges, she said.

The treatment has also been difficult as this disease was previously unknown. “We are learning as we go,” she said, and recommended practices were changing weekly or daily. She added that the medical profession was looking to Italy for the most accurate data as the data being given out by China may not be entirely truthful. In the beginning there was a lot of response from the community in terms of donating PPE. Women were sewing masks, restaurants were donating food, but a lot of that has fizzled out. Akaraz-Avedissian wanted to debunk some of the conspiracy theories she has seen circulating about this virus. For example, physicians do not “get paid more by listing COVID as the cause of death.” Such conspiracy theories are incredibly frustrating to doctors like Akaraz-Avedissian because they are risking their lives to take care of patients. It is physically exhausting but also mentally exhausting, because people are dying left and right, she said.

Amanda Banks is a hardworking nurse who has a less direct, yet critical role in the battle against COVID. She has an MSN (Masters’ of Science in Nursing) and her title at Beaumont Hospital in Royal Oak is “Operational Improvement Black Belt.” She works on the administrative side of the hospital’s operations. When the pandemic started she was immediately brought in to be a part of the emergency response center, which is a crisis management team for Beaumont. They conducted all changes that needed to take place, such as allocation of resources, overseeing the labor pool, etc. They also had to make sure all exits were covered with screeners and everyone had hand sanitizer and masks. Another task was to allocate unit as to who would take care of patients. Everyone was scared, she says, and it was her department whose job it was to help ease everyone and make them feel confident in their role.

Banks stated that personally things have been challenging. She has been strongly practicing social distancing, and continues to support local businesses and restaurants but only in the form of take-out. She always wears a mask in public, and keeps her hands clean. She believes in being extremely careful not just for her protection but because she works in a hospital. She was happy to be asked to be part of the healthcare professionals’ committee to assist with the reopening of St. John’s Armenian Church. She has been volunteering to work any shift needed at the hospital, days, afternoons, and midnights for about 3 and a half months. And, as stated, she has helped to manage logistics, operation, documentation, and planning during crisis management.

Banks stated that she has seen a lot of support for healthcare workers. There is even a mental health hotline for healthcare workers to help them deal with a sort of PTSD from what they’ve experienced, as well as financial assistance programs for people that have been furloughed. She applauded St. John’s “Sirov Jash” program as well as stores that are giving out masks and have hand sanitizing stations. Banks says that there will continue to be waves of this disease until a vaccine comes out. She stated that it is something we are going to have to live with, while we continue to work together as a community.

Lynne Kojamanian is a nurse practitioner at Beaumont Hospital in Royal Oak and works in critical care. Her position is as a member of a team that responds to anything critical in the hospital, and they are there acting on behalf of the physician. In mid-March she was placed on a COVID unit where they were intubating patients. At first, they weren’t really thinking about masks other than for patient care, she says. Later wearing masks everywhere became the recommendation. The surge at Beaumont was so fast and furious that nobody knew what was happening at the time, Kojamanian stated. More than 30 nurses, a dozen practitioners and some residents also got the virus. The hospital was taken over by the pandemic, with something like 600 COVID patients at one time.

Kojamanian was taking care of critical care patients and three weeks later she came down with COVID herself, and her husband also contracted the virus and was doing worse than her. The couple was sick for about 12 days. Kojamanian stated that the virus “is very weird” because her son and daughter were both in the house taking care of them, yet they did not get the sick nor did they get antibodies. When asked how the virus affects a person, she stated “both of us thought we were going to die,” and that it took her about 4 weeks to get back to something like normal. She stated that people don’t realize the side effects. She is a member of a Facebook group for COVID survivors and people report hair loss, joint pain, shortness of breath, some fogginess in the brain, and other side effects. Kojamanian says that she herself is experiencing joint pain as well as fatigue. She still doesn’t have her sense of smell back and only 50% of her sense of taste. “It’s ten times worse than pneumonia, and zaps every bit of energy out of your body,” she says. On the positive side she said that the community rallied together behind health care workers, with local restaurants sending food to the nurses on all different floors. She stresses that mitigation with masks is important, and hopes for a vaccine, or for people to develop herd immunity. “It’s a beast of a virus, and is mindboggling,” she concluded.

Anahit Movsesyan, recently former chairwoman of the St. John’s Armenian Church Youth Organization of America (ACYOA), returned from graduate school in Cleveland and is now a physician’s assistant and works in hospital medicine service at Ascension Providence Hospital. She stated that she was in a unique situation because she had newly graduated and was looking for a job when the pandemic hit. She was part of a team taking care of hospitalized COVID patients and continues with that today.

She noted, “Before I started working, I was starting to get really worried about COVID numbers in Michigan. It wasn’t until I began to work with these patients that I realized COVID is bigger than us and there is still so much we don’t know going forward.”

Movsesyan works the night shift with a team of PAs. They are the hospitalist team on nights along with 1-2 hospitalist physicians covering the hospital calls as well as admissions. She admits 5-6 patients on a busy night. She states that “I’ve been lucky to work with such a supportive and hard-working team.”

On a personal level, Movsesyan added that she feels COVID has not affected her as much because she is a young professional, but she has done her part to be careful coming home after the hospital and making sure not to expose others further due to the nature of her job. “Some days are more difficult than others,” she says. “It is definitely difficult to see so many patients being admitted with COVID continue to have worsening progression of their illness, and at times not even making it out of the hospital. This takes a mental toll on healthcare professionals, myself included, working in these environments.” On a positive note, family and friends have been extremely supporting, constantly checking in to see how she is doing. The Farm Grill, the restaurant owned and operated by her mother, Hasmik Movsesyan’s, has not only fed her but provided catering to her colleagues.

Movsesyan seemed cautiously optimistic about the future. She stated: “In all honesty, it is hard to predict what will happen, and we’re figuring it out as we go. I can definitely say we’ve had a significant decrease in COVID cases, and Michigan did a wonderful job in preventing further hospitalizations/deaths. I know the medical/scientific community will learn from all of this and we will continue to be more innovative going forward.”