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Nevada County doctor helps COVID-19 patients in Italy

Lorraine Jewett
Special to The Union

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The Nonprofit: Samaritan’s Purse

The Name: After sharing the story of the Good Samaritan, Jesus said “Go and do likewise.” For more than 40 years, Samaritan’s Purse has helped the world’s poor, sick, and suffering by providing food, medicine, and other assistance

Website: http://www.samaritanspurse.org

Phone: 828-262-1980

Address: PO Box 3000, Boone, NC 28607

While the coronavirus pandemic left Nevada County relatively unscathed, a Nevada City doctor treated hundreds of desperately ill COVID-19 patients at the height of the outbreak in Italy.

“The issue is the curve wasn’t flattened,” said Dr. Mark Agness. “It was a Matterhorn. There was a huge surge in cases.”

Agness is an emergency room physician at Rideout Hospital in Marysville. He was deployed to Italy in March with Samaritan’s Purse, a nonprofit with which Agness has volunteered since 2017.

The 60-year-old doctor spent a month working at a field hospital in Cremona, the capital of a northern Italian province in the Lombardy region. Agness worked in the field hospital’s Intensive Care Unit 12 hours each night for 28 of the 30 days he was in country.

“The Italian people were utterly overwhelmed when the virus hit,” Agness said. “The city was filled with the sound of ambulances day and night.”

Cremona’s regional hospital had 600 beds, and 500 were already filled with COVID-19 patients. It would have been quickly overwhelmed by the influx of COVID-19 patients if not for the overflow valve offered by the Samaritan’s Purse field hospital and its 68 beds, including 10 in the ICU.

“In the ICU, our patients were very sick,” said Agness. “A number of them did die and that was hard. Death, unfortunately, is a part of COVID that you can’t ignore. It’s a complex disease, and we were trying any number of therapeutics without much success.”

Yet the medical team remained undaunted and made important breakthroughs.

“We discovered patients had a propensity to clotting, and they clotted too much and in the wrong places such as lungs and kidneys,” said Agness. “We learned to become aggressive with blood thinners.”

Agness said the strategic use of ventilators also evolved over time.

“An important takeaway that the U.S. needs to be aware of is keeping patients off ventilators as much as possible and using high flows of oxygen or non-invasive ventilation,” Agness said. “There is a controversy with that approach, due to the fear of spreading the aerosolized virus. Some hospitals are dead-set against non-invasive ventilation. But in terms of patient outcomes, those struggling need to be given every opportunity to stay off ventilators. Once on a ventilator, it’s difficult to get them off and for them to survive.”

CHANGE OF PLANS

Just before he shipped off to Italy, Agness and his wife Melisa, a radiologist, were preparing to embark on a medical mission trip to Ethiopia with Samaritan’s Purse. Then the coronavirus sent the world into a tailspin.

“It was clear Ethiopia was closing down,” recalled Agness. “We might be able to get in, but we weren’t sure we could get out.”

At about the same time, the Italian government requested support for the regional hospital in Cremona. Samaritan’s Purse loaded jet aircraft with hospital tents, supporting equipment, a generator-driven pharmacy, X-ray unit, and other essentials such as Personal Protective Equipment. The nonprofit’s building team established a field hospital in the parking lot across from the regional hospital.

It took just 72 hours.

Agness joined the field hospital’s staff March 20 and worked there until April 23. He joined Samaritan’s Purse volunteers from across the United States, Canada, and Australia. Agness was one of three doctors assigned to the ICU. Another four doctors staffed medical wards. There were also two dozen nurses and Emergency Medical Technicians, administrative support staff, plus the building and maintenance team.

At the same time Samaritan’s Purse was establishing the field hospital in Italy, it was doing the same in New York City. For more than 40 years, the faith-based nonprofit has provided medical assistance and other resources to ameliorate disease outbreaks and other crises.

“Samaritan’s Purse has responded to these types of disasters many times before, such as the Ebola outbreak in the Congo,” said Agness. “So they know how to quickly deploy a field hospital. There are already established procedures for donning and doffing PPE. They have a stockpile of everything they need, including ventilators, which we brought with us.”

Agness suffered no ill heath while spending a month in the epicenter of Italy’s coronavirus outbreak. Only one of the 100 Samaritan’s Purse volunteers became sick during the two-month mission.

Local businesses and citizens provided Samaritan’s Purse volunteers with places to stay, a chef to prepare meals, and a virtual welcome mat with a real-life feel.

“Over Easter, we received truckloads of their traditional Easter cake and great big chocolate Easter eggs the size of footballs,” said Agness. “There was chocolate everywhere.”

Agness said the Italian people were gracious and grateful despite the ongoing tragedy of the pandemic.

“The Italians got gob-smacked by this disease in part because of who they are,” Agness said. “They love life. There is lots of hugging and kissing and little social distancing. There were patients who had no business getting better, but they did. There were wonderful reunions and it was extremely gratifying.

“It was also a ‘perfect storm,’ and a hard lesson to learn,” he added.

Lorraine Jewett is a freelance writer who lives in Nevada County. She can be reached at LorraineJewettWrites@gmail.com.


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