MOUNT VERNON – Kim Cullers arrived early to Knox Community Hospital on the morning of Wednesday, Dec. 23.
It was just the third day of COVID-19 vaccination distribution at the facility – only 70 or so employees had received their first Moderna dose at that point – but Cullers was ready to go. She strode confidently into the windowless conference room on the hospital’s first floor, filled out the requisite paperwork and found a seat at one of the room’s two vaccination stations.
The mood in the room was serious, yet jovial. For many, this had been a long time coming. Nine months of loss and uncertainty, and now this: the proverbial light at the end of the tunnel.
Cullers rolled up her right sleeve, and Laura Waters, a staff nurse in the hospital’s internal medicine division, primed the needle.
“There you go,” Waters said, drawing the needle out and wiping Cullers’ upper-arm down with disinfectant.
Waters explained that Cullers might feel temporary soreness in her arm, and that she’d need to wait 15 minutes to see if she’d experience any other immediate medical reactions.
Cullers nodded graciously. She smiled with her eyes, as one does during a pandemic, squinting brightly between her mask and a multi-colored bandana, wrapped tightly around her skull.
“Oh, that’s fine,” she told Waters. “This is nothing.”
Cullers’ pandemic experience has been uniquely trying. A nurse practitioner at KCH’s Urgent Care facility, Cullers served on the front lines for seven months before being diagnosed with cancer in October. She has continued to work in the months since, in between chemotherapy treatments, albeit in a limited capacity (KCH has assigned her lower-acuity patients, and she’s also working fewer hours).
Her family worries about her, she says. But her work has been cathartic – a welcome break from the battles being waged in her own head, during a time of draining isolation. She’s found strength in the opportunity to care for others.
“That’s what I’ve always loved about my job,” Cullers said, “is that it’s never the same. I get to take care of people of all ages and all backgrounds, and that’s what really draws me to it.”
Cullers has worked at Knox Community Hospital for three decades, serving in various roles. A Knox County native, she began working there as an ER nurse in 1990. She’s held various part-time positions since, always staying in touch with the hospital while working in other community roles.
Cullers does not mince words when describing the last three months.
“It’s just been really lonely and isolating,” she said. “It just makes it harder, I think, to get through something like this, without the support of seeing people that you love. But I’m still grateful for everything I have and I’m grateful that I still have a job, and that KCH has been really good to me and tried to keep me in the game, tried to keep me working during this.”
Cullers’ diagnosis put things into perspective, she said. Every day, at this point, feels like a gift.
“I just think that I’m way more grateful for every opportunity I have to still be a part, and it gets me back in connection with people – and I value that a lot more now, just having those connections here,” she said, tears welling in her eyes. “But I’m not scared. I’m just kind of not a scared person. I’m very practical and I’m very careful, and I’m just grateful for everything I have.”
Things are looking up for Cullers. On the day of her initial COVID-19 vaccination, she had one chemotherapy treatment remaining. She called the timing of it all “perfect,” because she still had robust immunity on the day of her shot, which would not have been the case the following week.
And once she receives her second Moderna dose, roughly four weeks after the first, Cullers will be immune from a disease that has killed nearly 10,000 Ohioans since March – and that preys on those with pre-existing conditions and weakened immune systems. Cullers expressed complete confidence in the vaccines currently available, and said her doctors at James Cancer Hospital in Columbus felt the same.
“I’ve gotten the flu shot for 30 straight years, and I just really believe in vaccines ...” Cullers said. “I’ve always tolerated it well, so I have a lot of faith that vaccines do what they’re supposed to do. I’m not at all nervous about getting it. I’m excited to get it. I am ready to get it.”
To Cullers, Dec. 23 represented the beginning of a new chapter. After months of hardship and isolation, she’ll soon be able to live freely again. She envisions 2021 as a year of healing and hope.
“I feel like I can finally take a deep breath and feel like the fear level just goes way down. My confidence level goes up,” she said. “I feel like that this is just the first step to maybe being able to see family and friends again, and to be at work without that extreme anxiety over who’s walking in with COVID.”
Cullers pauses and smiles.
“I can’t wait to travel again,” she adds. “I cannot wait. We haven’t traveled in so long and my husband and I are big travelers, big hikers.
“I’m really just looking forward to just being a part of the world again.”
Cullers’ story may be unique, but her vaccine status is not. As of Friday, KCH had vaccinated 475 frontline workers, according to Interim Marketing Director Lisa Bragg. The hospital received its initial shipment of 500 Moderna doses on Dec. 21, and expects to receive its second shipment in time for follow-up appointments in January.
Knox Public Health has distributed all 300 doses from its initial shipment, Nursing Director Lisa Dudgeon reported Thursday. Initial doses locally have gone to individuals in “Phase 1A” of the state’s vaccination program, which includes frontline health care workers; emergency medical personnel; nursing home residents and staff; group home residents and their caretakers; and medical providers.
In total, 1,355 county residents had received the vaccine as of Monday, according to the Ohio Department of Health. That represents roughly 2 percent of Knox County’s population. Nearly 305,000 Ohio residents had received initial doses of the vaccine by this point, representing 2.5 percent of the state’s census.
Gov. Mike DeWine said last week that Ohio will begin “Phase 1B” of the vaccination process on Jan. 19. This will include residents age 80 and older, living outside of a long-term care facility. This represents roughly 420,000 Ohioans (the state is expecting to receive 100,000 doses that week).
The week of Jan. 25, vaccinations will open up to those age 75 and older; the week of Feb. 1, vaccinations will be available for those age 70 and older; and the week of Feb. 8, vaccinations will open up for those age 65 and older. There are more than 10,000 Knox County residents in these age categories, according to Knox Public Health.
DeWine also indicated that COVID-19 vaccine will be available for school personnel beginning Feb. 1 – providing the school districts commit to going back to full in-person or hybrid learning by March 1. Currently, all school districts in Knox County are operating in-person or hybrid.
Knox County Health Commissioner Julie Miller said she is not sure if KPH will be distributing the vaccine via appointments or mass vaccination clinics. It all depends on how much vaccine is received.
“If shipments continue to be just 100 doses a week, administration will probably be by appointment,” Miller said in a statement. “If larger shipments are received, a drive-thru clinic might be planned.”
Knox Public Health plans to hold a Facebook Live news conference with other community partners on Thursday at 5 p.m. to announce how and when the vaccine will be distributed moving forward.
In the meantime, there remains a small portion of the community that has received its first dose. These are individuals who have seen first-hand the effects of the pandemic, and who have been exposed to its perils on a daily basis.
“It’s pretty exciting, actually, to think there’s a light at the end of the tunnel, even though the tunnel is pretty long,” said Miller, who received her vaccine on Dec. 23 as well (she will help administer the vaccine in Knox County when it becomes available to the general public).
“We’ve still got a lot to do, but it does feel good to have gotten the vaccine and then to see others getting it, so we can protect the community. I’m excited to get the public started. I just hope we can do that quickly.”
Mount Vernon Fire Chief Chad Christopher said his team has been handling an increasing number of COVID-related runs since the second surge began in late October. Some days, MVFD will handle up to 10 coronavirus-related calls, he said, which often involve trips to KCH for emergency treatment.
“We’ve learned from it that you’re pretty much treating everybody as if they have COVID,” he said. “So we’re doing all of our precautions virtually on every run. (That’s) pretty much what it’s come down to, to protect ourselves and protect our patients, is the mask-wearing, the disinfection, the cleaning, and all that (on) every single run, whether it’s COVID or not.”
This workload has worn on his staff, Christopher said. He believes the arrival of the vaccine represents hope for the local first-responder community.
“For the first responders, it’s been a long wait, it seems like, for this vaccine to come – but a wait that is very (much worth it),” said Christopher, who received his initial Moderna dose at KPH on Dec. 23, alongside several of his staff members. “I think it’s gonna kind of hopefully ease the mind of some people, especially for us out on the front line. We’re seeing it every day, with patients … We’ve been affected ourselves at different times.
“But the majority of us are staying healthy. So for us to continue to keep helping people on the front lines, this vaccine is another part of that overall system – we’re still hand-washing, wearing a mask, social distancing still, but this is a major piece to that puzzle, to help protect ourselves and protect others.
“It is important. It’s very important for us – for us and the public – to have it, and to know that we’re doing everything we can to be safe.”
Knox Community Hospital CEO Bruce White believes the benefits of getting frontline health care workers vaccinated will be two-fold.
It will not only help prevent staff and patients from contracting and spreading the virus (and White has voiced concerns in recent months about staffing levels at KCH), but it will also boost the morale of KCH’s workforce, which has been running on fumes for the last 10 months as COVID-19 has ripped through the state and county.
In talking with other hospital leaders around the state and country, he said this benefit – boosting morale and preventing burnout – could become crucial for KCH and the community at-large moving forward.
“I was on a call with (the American Hospital Association) the other day and one of the people on the board said this – they said it’s amazing … how it changes the mood among the workforce. They said that it was palpable, how the mood changed,” White said in an interview Dec. 18. “People were feeling much better about their situation.”
White called the vaccine a literal – and figurative – “shot in the arm” for local health care workers, given all they’ve been through recently, and how much of the fight remains.
“You know, COVID fatigue is a real thing. And with everybody on the front lines dealing with it since March, people are mentally tired, even if they don’t admit it to themselves or can’t admit it to themselves because there's no time to draw back anyways,” White said. “This is kind of that first light that says, ‘OK, there is gonna be, somewhere down the road – you know, not too far out – an end to this.’
“What I’m hearing from my colleagues, from their organizations, is that it’s that psychological and emotional kind of shot in the arm. So it’s a shot in the arm for the vaccination against COVID, but it’s also a nice shot in the arm to say, ‘OK, we can see that this truly is not gonna be going on forever.’ And I gotta tell you, that’s really important at this point.”
As the morning of Dec. 23 unfolded, KCH employees of all kinds rolled into that first-floor conference room.
There were doctors, nurses, administrative staff – a true cross-section of the hospital’s coronavirus response, with all of its moving parts, each one just as important as the other.
There was Peg Horn, a nurse in KCH’s cancer care unit, who lives in Jelloway and has worked at the hospital for 43 years.
Horn began working on the medical floor at Mercy Hospital in 1977, at the age of 21, then made her way to the ER. When Mercy and Memorial merged in 1978 to make KCH, she remained on-board, eventually finding an ER position in the new building in 1983. She left for the oncology unit in 1996 and has served there ever since.
In all her time working in Knox County’s hospital system, Horn said she’s never seen anything like the COVID-19 pandemic.
“There’s always some new health issue that we have to contend with. I’d say this is probably one of the bigger ones that I’ve ever seen,” said Horn, who retired in November and now works for KCH part-time.
“I know 100 years ago we had that Spanish Flu, but very few people are still alive today that were alive at that time … And then polio, of course, back in the (1950s), that was a big deal. So this, if it equates to anything like that, we don’t know what the after-effects of this are gonna be, either. That’s still something yet that we’re gonna see and we’ll have to deal with.”
Horn called the vaccine a “godsend,” for both the community and her team.
“It’s kind of a relief to know that we won’t have to be as concerned about possibly passing this onto somebody else or contracting it ourselves. And I know personally, with the family situation, I haven’t been able to see very much of my family because of this. It’s going to help relieve a little bit of that – of course, until they get their vaccine, it’s not gonna be back to normal,” she said.
“But it’s like the beginning of the end of all this. That’s kind of the way I looked at it. And for the gals that I’ve worked with, we know that – they’re concerned about themselves, but they’re also concerned about the patients, too, because we have oncology patients that have immunosuppression that they have to contend with. We don’t want any of them to contract this disease, either.”
There was Layton Shoots, a 25-year-old KCH pharmacist, who said he understood why people might be skeptical of the COVID-19 vaccines (they were developed in record time), but acknowledged that research has shown confidence in their efficacy.
“I feel like I have the knowledge base to make an informed decision on if I want to get it or not,” Shoots said. “I feel like it was an easy choice to get it.”
Shoots said the vaccination process feels like an active step in the right direction.
“It’s just the first step of having a means to an end for everything. It’s just like the first step of an active solution, instead of a bunch of defensive things …” he said. “It’ll be awhile before everybody can get it, but health care workers, long-term care facilities, things like that, it’ll be helpful for all those (populations) in the beginning.”
And there was Jamie Ladd, a nurse in KCH’s progressive care unit, who took selfies and posed for pictures following her shot that day.
Ladd said she planned to post the pictures on Facebook. She wanted to set an example for friends and family – to convey that she felt confident taking the vaccine, and to encourage others to do the same when it’s their turn.
“We just want everybody to get vaccinated, so we can just go back to life …” she said. “A lot of people are like, ‘I’m not getting that,’ and I’m like, ‘We’ve gotten every other vaccine. Why do you not have polio? That’s why. We don’t have polio because we got vaccinated for it.’ So hopefully people get it.”
Ladd called the last 10 months “chaotic” – particularly during the latest surge, which has tested KCH from a staffing standpoint. During this time, Ladd said 50 percent of her unit’s patients have had COVID-19.
“It’s stressful … Because now it’s not just patients, it’s our staff,” Ladd said. “So now not only our staff, but some of our doctors, even some of our physicians are getting it … This is a small hospital; we don’t have more than one.”
Ladd spoke candidly about her experience working on the front lines this winter. While many of KCH’s COVID-19 patients survive and are successfully discharged, some are not so lucky. She said her unit has seen more “codes” – instances where hospital staff are called to revive a patient who has stopped breathing – in the last month than she can recall in her two years working there.
“People have to get intubated, and that’s very real …” Ladd said. “And that is dangerous – it’s life-threatening, obviously. We’re trying to keep people alive, and that is scary. And when they’re COVID patients, there’s a lot of danger to the staff in the room because it’s an emergency situation. We may not have all the proper PPE going into the room because if somebody’s not breathing, but we need to (respond).”
Ladd, who lives in Richland County, works for KCH part-time. She was called to pick up additional shifts in August because of rising staff infections, and her workload has remained steady ever since. The hospital’s COVID-19 census has also increased substantially during that time.
“Once August and September hit, people started getting sick, and now we have admission after admission after admission,” she said. “I mean, there are times when this hospital is holding patients in the ER, waiting for beds. And we’re literally – when I say literally, we’re literally discharging a patient, cleaning the room stat, and bringing another patient up.
“It’s very real. There’s a lot of people who are very sick – some not as bad as others, but they can get there quickly. They’re unstable.”
With hospitals maintaining a no-visitor policy for safety reasons, Ladd said nurses are now charged with keeping patients’ families informed about their status. That can become taxing, Ladd said, particularly when a patient’s health worsens over time.
“Not only are we doing our jobs, but now we’re managing all the family by phone calls,” Ladd said. “You know, some of these family members will call six, seven times a day. They’re scared.
“But nurses are being pulled from their jobs to make phone calls. We have to, because we’ve gotta inform the family. And when somebody codes and you have to intubate them and their family's not here, that’s a hard phone call to make. But you do it.”
These stressors have weighed on Ladd and her co-workers. By the time she arrived for her initial COVID-19 shot on Dec. 23, just after 9 a.m., her unit had already experienced one “code” call that day.
But Ladd believes there is hope. She seemed thrilled to receive her first vaccine dose, and said that if enough people in the general public get theirs, pressure will eventually lessen on the local health care system.
Given the way COVID-19 has spread throughout Ohio in recent months, Ladd said most people locally have begun to understand the seriousness of the virus, having seen it up-close. The next step, she said, will be translating that experience into action. Ladd is cautiously optimistic.
“I think now, people are more understanding of the real threat that COVID is,” she said. “Hopefully that means people will get vaccinated. I’m scared that people won’t.”