Fighting COVID-19 in Italy with Care & Prayer

Strange New World

Unzipping the heavy white tent flap and stepping into the inflated dome feels immediately alien, foreign – an unsettled sense, which is only heightened by a hoard of machines with their coloured blinking lights and blaring alarms and bulbous tubes running from their boxy structures into human mouths and noses. Crisscrossed layers of medical tape secure the tubes snaking down throats into lungs that have become so riddled with infection that they cannot function without oxygen being forced into them.

Chests, many of them already frail and fragile, mechanically rise and fall with each methodical pump of their attached ventilators. Some patients stir with more awareness, gazing through half-lidded eyes at the gowned and goggled and gloved beings swirling around their bedsides. One wonders where the patients’ thoughts have taken them, if they understand what has happened, why they have landed in the middle of this bizarre scene that should belong only in a science fiction movie. Here, they are fighting for their lives in a Samaritan’s Purse field hospital, set up in a heavy-duty vinyl tent in a car park in northern Italy.

During the end of February, the city hospital in Cremona was quickly overwhelmed by a deluge of COVID-19 patients being admitted from Italy’s hard-hit Lombardy region. The hospital had no choice but to dedicate 500 of its 600 beds solely to the treatment of those impacted by the virus. Medical staff were fatigued and falling ill themselves, while an overflow of patients on gurneys lined the lobbies, hallways, and spare corners of the hospital.

“It’s like a bomb,” said Dr. Angelo Pan.

Pan is an infectious disease specialist at Cremona Hospital. In 1984, he treated the second patient in Italy to be diagnosed with AIDS. Though the two diseases are quite different, he said the frustrations of trying to treat an unknown virus are the same.

“You don’t know how to manage it and you try to use different drugs and you hope they will work. It’s frustrating, definitely.”

“When I am at home alone, sometimes I cry,” said Paolo, an ICU nurse at Cremona Hospital. “Most of us, we are scared.”

Walking through the city hospital’s hallways, the huffing of ventilators seems vastly out of place coming from rooms decorated with benign murals of smiling mothers and children playing. Some patients sit with clear plastic bubbles over their heads, the inflatable containers that are filled with concentrated oxygen to help them breathe easier giving the impression the wearer is on the verge of a deep-sea dive. Other patients are turned onto their stomachs, pronated to help relieve the pressure on their lungs.

Tears well in the eyes of Paolo Merli, an ICU nurse at Cremona Hospital. He can’t find the words to describe the emotional battle that he has faced each day for more than a month, as he struggles to care for his patients while living in constant fear that he will bring the deadly virus back to infect his loved ones at home.

Clelia Roncaglio, a fellow nurse for two years, echoes those fears, yet humbly deflects credit for her hard work to the seasoned co-workers who are battling the disease alongside her. Sometimes, she said, her only strength comes from being able to care for people she knows, so she can update their families on their condition.

“There is some light in the dark, but it’s really, really small,” Clelia said.

“We have to be their family, even the patients we don’t know,” said Clelia, an ICU nurse at Cremona Hospital.

Writing their names on their personal protective equipment is one way to break the barrier it creates between medical staff and patient.

As terrible and ravaging as this disease is, perhaps the most devastating effect is the isolation left in its wake. Due to its highly infectious nature, friends and families are prohibited from visiting hospitalized loved ones, even in the event of a death.

Everyone is asked to do their part to prevent the rapid spread by staying home. There are no social gatherings. No handshakes. No hugs. Streets and squares are eerily quiet in the midday sun. The silence is often and only broken by the haunting sounds of ambulance sirens.

A Bright Light

In mid-March, it seemed as though northern Italy would be consumed by the tidal wave of coronavirus patients and deaths. Though the disease had spread throughout much of the world at that point, a higher percentage of coronavirus patients were dying in Italy than anywhere else. Italians felt abandoned, adrift in a vast ocean with no lifeboat in sight.

Then, on 17th March, a DC-8 cargo plane emblazoned with the words “Helping in Jesus’ Name” landed near Milan, carrying more than 20 tonnes of critical relief supplies and a team of Samaritan’s Purse disaster assistance response specialists. With them, they brought hope.

The Italian Air Force quickly unloaded the plane, then transported the supplies to the parking lot of Cremona Hospital. It was all-hands-on-deck, as a team of Samaritan’s Purse doctors, nurses, lab and biomedical technicians, hygiene specialists, and other support staff were joined by Italian soldiers and civil protection volunteers to erect a working field hospital in about 36 hours.

Officials from the city, Cremona Hospital, and the Lombardy region joined Samaritan’s Purse staff on 20th March to mark the 68-bed field hospital’s opening.

“You are the first bright light in our dark sky,” said Giulio Gallera, the Lombardy Region Minister of Health.

Giulio Gallera, the Lombardy Region Minister of Health

The mayor of Cremona, Gianluca Galimberti, thanks Samaritan’s Purse for bringing an emergency field hospital to his city.

Ambulances soon began pulling through the field hospital gates.

“That is the only sound you hear during the lockdown—ambulances and helicopters,” said Davide Cominetti, a translator at the field hospital. “It is terrifying because you do not know if it is your mother or your brother on that ambulance or helicopter—it is devastating.”

Patients are delivered in various states, their procession like a strange parade that no one asked for. Some walk on their own, clutching small armfuls of personal items they managed to gather before leaving their homes. Others are already attached to ventilators or oxygen, riding on gurneys or in wheelchairs.

One by one, they disappear into the tents, delivered into the waiting arms of the doctors and nurses who have travelled thousands of miles to demonstrate the love of Jesus Christ through their care.

Jason, a chaplain with the Billy Graham Evangelistic Association – which works closely with Samaritan’s Purse during disaster responses – watches as a patient is moved to the ICU.

Becoming Hands & Feet of Christ

Each layer of the personal protective equipment donned by Samaritan’s Purse doctors and nurses before caring for the sick seems to erase another bit of their humanity: Rubber boots. Gloves. Gown. Mask. Hair net. Goggles. Second pair of gloves.

Finally, all that remains visible are their eyes, peering through fogged goggles or chlorine-spotted face shields. Becoming invisible as individuals, they rely on these layers to shield them from the invisible threat of coronavirus.

Still, each day the staff pray that somehow their patients will feel how much they are loved by them and by God.

“I pray that patients see Jesus in us,” said ICU nurse Shannon Wood.

Inside the wards, compassion and care is packed into each small, intentional gesture. Nurses clasp a set of nervous fingers, stroke a tense shoulder, or brush fevered hair from a wrinkled forehead. Staff bow their heads when a patient requests prayer. And each one still smiles, the grins seen not on upturned mouths, but in every set of eyes.

“We are covered in PPE and all they can see is my eyes,” Shannon said, “I pray that I’m able to love on these patients…and just hold their hand while they are anxious, and that they’re able to see Jesus.”

The Shadow of Night

Many evenings as they exit a city bus, the night shift is greeted by a small sea of grinning faces; the day shift’s earnest applause from varied pairs of freshly washed hands seems a determined attempt to carry these newcomers through their long twilight vigils. But as the sun creeps toward the horizon, the mid-March temperatures in northern Italy begin to drop, and these fresh new faces are ushered in alongside a biting cold.

Each step of the care extended by the day shift is mirrored by the night, only now with an extra shiver or two as the doctors and nurses rush in short-sleeved scrubs to don their PPE and begin doling out medicine alongside mercy.

Taking a break, however necessary, comes with a side dish of dread. They must not rush, must not miss a step. But after each layer of PPE removed, they must rinse their hands in a gush of freezing chlorine water, a precaution taken to prevent spreading any viral particles that may be hitching a ride.

“Jesus said ‘Come, follow Me.’ And where would Jesus go? He would go exactly where it’s the darkest, where it’s the hardest,” said Stephanie Morales, a physician assistant working on the night shift.

Through the Valleys

The nights and days of this fight are full of emotional highs and deep lows, perhaps never more accentuated than the day the first patient to improve and leave the ICU was fully discharged.

Cheers and applause erupted from medical and support staff as Francesco walked out of his general care ward and made his way along the fence line delineating the hot zone from the clean zone to a waiting vehicle. Already emotional, he couldn’t stop the tears as he recognised his best friend from childhood, who had arranged to transport him home as a surprise. His friend – decked out in full PPE – fell to his knees, crying, as the pair high-fived with gloved hands.

Minutes after Francesco’s ride departed, a non-descript white van pulled in to take its place, there to transport the body of a patient who succumbed to the disease.

“Sometimes we walk patients to the footsteps of heaven, and sometimes we walk patients to the front of our tent to see the sunshine for the first time in many days,” Shannon said.

Francesco waves to his well-wishers as he is discharged. “I couldn’t imagine so many people praying for me,” he said, “for all this love around me.”

Francesco high fives his best friend from childhood, who surprised him by arriving to transport him home. “When he arrives, oh, we’ll have a party!”

One month after opening, the field hospital had treated over 260 patients, and seven ICU patients had been extubated and discharged. A note from a former patient hangs in one of the male wards:

“Giorgio just called to stay he is doing well at home. He is reading his Bible. He misses you.”

When patients improve enough to be discharged, waves of encouragement ripple throughout the tents, like a small feather landing on a pond’s surface. The late afternoon air is often filled with the joyful celebrations that accompany patient processions from the tents to their transport.

As he prepared to leave, Massimo’s joy and gratitude was infectious. Throwing his hands in the air, he brought them again and again to his heart – a gesture that transcended any language barriers between him and the staff.

“You have a special place in my heart. I will remember you in my prayers,” said 91-year-old Claudio, pictured below, with his nurses Savannah and Alyssa.

Working in Faith

“I can do all things through Christ who gives me strength.”

“Cast your cares on the Lord, and He will sustain you.”

“She is clothed in strength and dignity, and she laughs without fear of the future.”

As they wage war against the little-known virus attacking their patients, the doctors and nurses serving with Samaritan’s Purse often turn to Bible verses when they feel overwhelmed. They rely on their faith to sustain them, from the midst of chaos when a patient is coding in the ICU to the midnight hours that stretch on through the cold nights. Many say it is a privilege to be asked to pray with and for their patients.

“Asking them, ‘Is there anything I can do to pray for you?’ A lot of times they’re like, ‘Yes!’ and they’ll give you specific things…and you can just see, many of them are about to cry,” said Stephanie Morales. “You’ll sometimes be checking their oxygen and their heart rate, and their heart rate will be up. They’re so anxious, and then we’re praying, and you see that thing just come down.”

Hope In The Storm

One month after opening, on a sunny late afternoon, a month after the field hospital opened, the plaintive strains of a violin soared like a prayer high above the cross-bearing tents. Bedraggled staff emerged below, straining their ears and eyes, searching for the source of the musical cry.

Ten stories high, a woman in a red dress swayed on the rooftop in time with her music, closing her eyes as she coaxed the notes from each string. Lena Yokoyama played for the besieged–the Cremona Hospital, the Samaritan’s Purse field hospital, the city, the country, the world.

“It was like a cry out to God,” said physician assistant Stephanie Morales, “like an appeal to heaven.”

“As hard as it was, watching people die from this disease without family or friends to comfort them…[her playing] gave me a peace that we loved our patients to the very end,” said nurse Kelly Sites. “It made me feel completely connected to the people of Cremona.”

A patient embraces her nurses and translators as she is discharged from the SP field hospital in Cremona.

Lena’s music stretched from rooftop to rooftop, a melodious thread that seemed to connect everyone in a resolute battle to beat this brutal virus.

And as the last notes dissolved like a sigh, God breathed new breath into the lungs of those still in the midst of the fight.