This story first appeared in the spring issue of USA Triathlon Magazine.
Triathletes know how to cope with race-day disasters. But a pandemic is a calamity of a profound order, and when COVID-19 hit, one sector of the multisport community couldn’t bail out or stay home.
Rather, its doctors, nurses, scientists and healthcare workers surged to the front lines. Among them: aquabike world championship qualifier Mark Hubbard, who leads a lab that runs diagnostic COVID-19 tests; IRONMAN finishers Brittany and Nick Philpot, married ER doctors; and New York City Triathlon medical director and IRONMAN Mark Klion, an orthopedic surgeon who found an unusual role at a hard-hit hospital in the Bronx.
Interviews were conducted April 20-23. Given the hyper-dynamic nature of the crisis, these seven stories offer a snapshot at a time when the virus had already infected 4.3 million people worldwide, put more than 26 million Americans out of work, and killed more than 85,000 on United States soil (updated May 14).
At the time of publishing on usatriathlon.org, more than 112,000 Americans had lost their lives in the pandemic, according to Johns Hopkins University and Medicine. (Updated June 10)
Mark Klion // Age: 58 // Director of Orthopedics, St. Barnabas Hospital in the Bronx, New York
“After the mayor and governor shut down New York, all our elective orthopedic surgeries were canceled. Hospitals were being overrun by Covid-19 patients. [New York City became the epicenter, including the Bronx.] When St. Barnabas was looking to help fill the gaps in coverage, they looked at every service. All hands on deck.
I haven’t taken care of an acute-care patient in 25 years, if not longer, but some of my partners and I had learned that there was a great response in individuals who are not breathing on their own, if you place them prone on their belly for a time while on the ventilator, then flip them back on their back. It increased their ventilation, helped clear their lungs, and improved their chances of surviving. I figured, you know what? A lot of orthopedics requires us to turn a patient over in the operating room. That’s really our expertise. So we started that program at St. Barnabas and we’ve been actively turning patients prone twice a day.
To turn a patient, you need four people minimum. You need a respiratory therapist who controls the ventilator. You need a nurse who watches the lines to make sure they’re intact. You need someone to control the head when you flip the patient over. The majority of patients we’re seeing are obese, so it’s about an eight-person team that comes in. Some patients need to be cleaned as they’re being turned. Some have bed sores so we’ll do wound care. It probably takes about 5-7 minutes to turn a patient. Then you have to make sure the patient stays stable through that procedure – that the oxygen saturation in their blood has remained the same or gotten better. In all, it probably takes about 15-20 minutes per patient to make sure they’re stable enough for us to proceed to the next patient.
We’re probably proning around 10 patients a day. They stay on their stomachs anywhere from 12-16 hours.”
In the middle of all this, Klion, an 11-time Ironman finisher, ran in the Quarantine Backyard Ultra on April 4. Every hour, 2,400 entrants from 55 countries were to run a 4.167-mile loop at home. The last person standing was the winner.
“I said 50 miles is my limit. It took 12 hours. At the end of 50, I was on the treadmill, cranking U2 on my son’s two enormous speakers, got off, and felt great!”
Brittany and Nick Philpot // Ages: 29 and 34 // Emergency room doctors Abbott Northwestern Hospital, Minneapolis, Minnesota
“The ER has been crazy, hectic. We’re seeing more and more COVID, less other issues. I don’t know if that’s because people are quarantining and not having heart attacks, or if they’re too terrified to come to the ER because of COVID and they’re suffering at home — that’s my fear.
From the moment we enter the ER, we put on our face mask and full face shield. You’re not allowed to take it off so communication is difficult; you feel like you’re shouting. We’re all getting so dehydrated because we can’t take our masks off for eight or nine hours.
Another thing that’s really difficult is that the COVID guidelines are changing day by day. I’ll get three, four, five emails a day: new data is saying this or that. We want to know what the public is hearing, too. There’s so much anxiety about missing new information. But there haven’t been a lot of randomized control trials which is typically the data we like to trust.
With Covid-19, we’re seeing other inconsistencies. On paper, a patient’s vital signs can look like a million bucks but clinically, they’re doing poorly. Other times, they look terrible on paper and in front of you, they’re fine. Sometimes people can be doing OK and their oxygen saturation is 75 percent of normal. In a flu patient, if you were 75 percent, you would be in horrible shape.
Prior to COVID, Nick and I were pretty good about keeping work and home life separate. But now, it seems COVID is ruling our conversations and our life.
There are actually a ton of ER docs and nurses who are triathletes. We’re people who crave having a million things going on at once. You know the quote about triathletes never being the fastest swimmer, the fastest biker, or the fastest runner in the world, but kicking [butt] at all three? That’s exactly what an ER doctor is. Whatever gets thrown at you, you make it work.”
Rachel Davenport // Age: 26 // Emergency room nurse, Spotsylvania Regional Medical Center, Fredericksburg, Virginia
Davenport was training for the 2020 ITU Grand Final in Edmonton (CAN) in August before it was canceled. She’s still riding and running, but in lieu of swim training, she’s been working her arms with an $8 stretch band with handles from Walmart.
“Triathlon training has kept me sane. It’s one of the best stress relievers, for sure, because COVID is everywhere — all over social media, the TV news, newspapers — so letting my mind focus on something non-COVID-related is very helpful. It also helps with stamina. I’m on my feet 12 hours straight sometimes — sometimes three days in a row. At the same time, being an ER nurse and knowing how to be flexible has helped me train in the middle of a pandemic when pools are closed and we can’t swim. I also know there’s a risk you take on a ride or a run because if you get injured, you take away [resources] from people who may be in need.”
Ashley Atiyeh // Age: 35 // Emergency room doctor, Jefferson Hospital, Pittsburgh, Pennsylvania
Atiyeh was training for the IRONMAN 70.3 Virginia Blue Ridge (now canceled) when states mandated social distancing and closed non-essential businesses to lower the spike in Covid-19 cases. The executive orders worked, but…“When you flatten the curve, you turn from a sprint triathlon into an Ironman. The race goes on a lot longer. Right now, we’re at like mile 20 of the bike. We’ve got to stay focused and not get lax. I’m spending a full half hour before I leave work disinfecting my badge, pens, phone, bag, shoes, anything that was potentially exposed to the virus during my shift. When I get home, I wipe down the interior of my car, put scrubs in my COVID laundry basket (which also gets disinfected), and immediately shower. As they say in triathlon: control the controllables.”
Macon Fessenden // Age: 28 // Registered nurse, progressive care unit, University of Colorado Hospital, Aurora
I’m a primary nurse in the progressive care unit, which is a step down [in acuity] from the ICU. When Covid-19 patients started going directly to the ICU, the patient population in progressive care dropped to about one-third of the usual. While my friends at my previous job at the North Shore University Hospital in New York were drowning, I was getting called off every shift. It was frustrating.
But now, I’m doing my part. I’ve worked on two of the three Covid-19 ICUs here. We have 150 patients who are positive right now. The number changes every day.
The difference between what I see in the news — that it isn’t really affecting young people — versus what I’m seeing in the hospital? That chasm is vast. In one unit I worked on, there were no patients over age 70 — which is crazy. Young people are getting sick to the point where they need ventilators for two to three times longer than we usually keep people on ventilators. If you’re on a ventilator that long, the probability of surviving is low.
The other day, Colorado announced they were opening some businesses — tattoo parlors, dog groomers and hair salons. They seem very non-essential. I haven’t seen protestors with ‘Free Colorado’ signs, but I did see the photo of the man in Denver, in scrubs and surgical mask, arms crossed, standing in front of protesters in the street... That was taken about six blocks from where I live. It was a potent image. Everyone I know in the medical field was sharing that photo.
Remember, people on the front lines are putting their own lives on the line.
When COVID-19 hit, I was training for an Olympic distance race. I don’t know what I would do if I didn’t have something to train for. I’m very goal-oriented. It helps me get through every day. It gives me purpose on the days I have off. [It also means] I won’t gain the ‘COVID-15.’”
Mark Hubbard // Age: 35 // Lead technologist, Molecular Diagnosis Lab, Hennepin County Medical Center, Minneapolis
“I’ve worked in molecular labs for 13 years. Right now, our lab runs the diagnostic test (not the antibody test) to determine if patients currently have COVID-19.
I don’t administer the tests so I have no patient contact. My job is to get the results back as fast as possible. I took the lead role here in January 2020 so I was just promoted and got thrown into this at the same time. Within two weeks, we tripled our staff from four to 12. I had to train the employees on new acids and understanding of molecular guidelines.
We use chemicals to break apart the virus cells and extract the RNA. We then amplify the extracted RNA, making copies of it to determine how much virus is present and how it’s working or not working.
We have three instruments that can do the extraction process, and six instruments that do the rest. It’s a 3-5 hour process prepping all these samples, then running them in batches of 100. The whole process can take 7-8 hours if everything times out perfectly. Our turnaround times are within 24 hours.
Probably the most unique and interesting thing is that, compared to other viral loads (the amount of virus shed from the body) which might show a few hundred to a few thousand copies in a swab up your nose, with Covid-19, if you’re symptomatic and test positive, that same swab will show 80 million copies of the viral genome. And they’re amplifying much faster because so much more virus is there.
We currently have the capacity to run 1,500 tests a day. Right now we’re probably doing 200-400, so in the last couple weeks we’ve been reaching out to metro area jails, V.A. clinics, and other hospitals as far as Duluth. We have capacity and reagent to do about 100,000 tests — enough for the next three months if we’re at capacity.
It’s highly stressful to bring these tests up fast and stay calm and centered, especially over long hours. The mental endurance [from triathlon training] helps me maintain an even keel and not feel absolutely drained. I can turn around in 12 hours or less and be back to work.”
Sarah Thornton // Age: 40 // Internal medicine and pediatrics doctor, Medstar Georgetown University Hospital, Washington, D.C.
“As a ‘hospitalist,’ I’m in charge of patients that come through the ER or transfer from another hospital. I direct their future treatment. With COVID-19, the big challenge is the unknown and preparing for what you don’t know is coming. Like you would prepare for a race, almost. Our boss isn’t an athlete, but he keeps commenting that COVID is a marathon, not a sprint. It’s true, and triathletes know what it means — knowing you can finish something hard, knowing you have the ability to push yourself when you’re tired, knowing that all the training is going to make us successful in treating our patients and our community. It’s going to take a lot of energy, effort and manpower to get there. Knowing it’s not going to be easy.”