In Episode #5 of Everyday Heroes: A COVID-19 Podcast, we meet Michelle Owen-Clemenson, a nurse who provides valuable information to many people. She talks about her work on the front lines and how to make the best of this strange time.

Transcript

“Memories heal the living. We pray for the living.”

Angela: On May 26, 2020, more and more people in the United States decided to venture outside. Some were being safer than others. At this time, the total number of deaths due to COVID-19 in the United States had just crossed over 100,000. The New York Times reported that the actual count was probably closer to 130,000. We've lost more people to COVID-19 than to ALL wars the United States has fought during the past sixty years. In Colorado, Governor Polis announced that the state's prohibition on downhill skiing has been lifted and that private campsites are now open. With restrictions, restaurants would soon be allowed to let people have dine-in service at 50 percent capacity. This is the context for our fifth episode of Everyday Heroes, a conversation with Michelle Owen-Clemenson, a nurse who provides valuable information to many people.

Angela: We are here with Michelle Owen-Clemenson, and she’s here to talk with me about her experience with COVID-19. I would like to start by just having you give us a quick introduction to let us know a little bit about you.

Michelle: Okay. I'm the person that people call if they have questions about COVID and… Should they be tested? Should they go to the ER? Should they come to the clinic? So I'm kind of that gateway person, and I let people know that they're positive or negative, and I give them advice on what to do and how to protect themselves.

Angela: So before the pandemic really started two becomes something, what was your life like before then?

Michelle: I did patient education, and I explained their disease processes and the tests that they were going to get. And I did a lot of calls to insurance companies and pharmacies for the physicians.

Angela: Then, how have things changed now with COVID-19?

Michelle: Oh, at least half of my day is centered around COVID questions and predicaments. Some days are easier than others. And I get a lot of patients who are very anxious and scared because they've had an exposure or because they're having symptoms. And so I have to get them in to the place where they need to be seen, accordingly.

Angela: What is one of the more challenging aspects of doing this?

Michelle: I have many patients who call, and they demand certain medications because they heard it from our head of state. And I am… Unfortunately, I have to tell them that medication is not able to be used in that way, yet. Because it has not been approved for use in that, unless it's for compassionate use.

Angela: Can you tell me a little bit about what facts versus non-facts are, with regard to COVID-19?

Michelle: It changes weekly. The whole mask thing. I know in the beginning, Fauci and many of our public health officials were saying that masks weren't going to help you. And they were partially right. They don't help the wearer, but they prevent its spread to other people. And this has been proven in other countries such as Austria, where if everyone wears a mask, you have less spread. And trying to help people understand that has been very, very difficult. And a lot of people are just like, “well, I don't have to worry. I'm not in that, in that age group that can get sick”. And that's another one. Everyone can get sick. There are two people under the age of 30 who are fighting for their lives right now in ICU, in the Denver area, and one is on a heart lung bypass because he's so sick. And he didn't even have any preexisting conditions. So that's the other thing, is we can all get it. And as we learn things weekly, new information comes out, but because people are a little bit less open to new information, because it took them a long time to just understand the old information. They're less likely to go with the flow on the new information and the new recommendations. And so that part's a little difficult too.

Angela: Right. What would have to happen for somebody to need to call you? If I'm trying to decide do I need to call or not, how can I make that decision?

Michelle: Wait, we have a corona call line and, you know, I get people to say, “I quit smelling two days ago. Should I get tested?” And we're like, “yeah”. Or you know, “I have diarrhea” or “I'm short of breath” or “I have pink eye”, “My child has a weird rash on their foot”, “I can't breathe. It doesn't feel like asthma. It's different. It's like I just can't breathe”, and I understand that. Heart palpitations is another one. So it's any symptom that isn't your status quo. You just call and make sure that you don't need to be tested. There's lots of testing areas in the Denver area. Some are free, and some are not.

Angela: Okay. Do you recommend that people continue to do a routine visit with their doctor, their yearly physical, that sort of thing?

Michelle: I think they should talk with their provider and see what kind of controls their provider is doing, in the waiting room, in order to keep them safe. Some people, we tell them, “you know, we could do a tele-health visit, let's do that until things get a little bit calmer”, and other people, you know, we bring them in, but we either test them first, or we screen them, and bring them in to a separate waiting room. As far as routine health for… you know, just seeing your regular PCP for a checkup. If you're doing fine, then it's okay just to wait on it a little bit. And I would always just talk with my provider, because there's different things that are going on. Some people need testing for medications and need regular follow-up, and those that need regular follow-up probably should be seen.

Angela: Okay. How is your life changed, either at the office or in your home? What are some things that you're doing differently now than before?

Michelle: I work weekends. I wasn't working weekends for quite a while, and now I'm back to working weekends. And I make sure I'm wearing my mask, and I'm very obsessive with hand sanitizer when I go out in public. I got sick in March, the end of March. And I wrote a will. I never thought I would do that. And I wrote instructions for my kids. Pretty positive I had Corona myself. So it's just making sure that I'm wearing a mask, just to protect my fellow man. Because what if I only had just a bad case of the flu? People can still be carriers and so it's important to wear the mask. And I think that's the biggest thing… is just wearing a mask.

Angela: Yeah. That's been a huge change for me as well. Do you have any idea about how long it will take and how much longer we’ll have to social distance?

Michelle: I believe that coronavirus will be around for quite a while because it's going to be more of an endemic, which means it's not going away for a while. The type of virus that it is, which is an RNA type of virus, it's a little bit more difficult to make a vaccine for. It's very similar to HIV, which we do not have a vaccine for yet. And we started distancing and isolating, back in the beginning, to protect our hospitals from surges and not being able to care for people. And now, we're more about distancing and isolating to protect those people who are unable to protect themselves, either due to immunity issues, or because their health is frail, or they are elderly. When we get large groups of people together, such as what they did at the Lake of the Ozarks, there will be local outbreaks, and there'll be more people placed at risk.

Michelle: We need to be able to take advantage of the lull moments during the virus to, yes socialize, but do it… Wear our masks and to distance, you know, not be very close to people who aren't within our own households. Because it just poses such a risk. They've done a lot of studies and they found that the more people that you interact with on a daily basis, the more likely you are to either get Corona or be one of the carriers. And I don't think that people truly understand the asymptomatic carriers or those people who are not exhibiting symptoms in the beginning, but they do later on. And it's in the beginning of that virus when you're the most infected, and you're spreading it to everybody, and that's where the mask comes in and it's also where a distancing comes in.

Michelle: I feel that if people truly understood that asymptomatic carrier, they might take a little bit more cautions. I have spoken to those people, and I let them know, “Hey, I'm sorry to tell you this, but you have coronavirus. This is what you must do.” And they tell me, “You're kidding. I run six miles a day, and I'm a vegetarian and I haven't really had any exposure. What do you mean I have coronavirus?” And it's like “You do. I'm sorry. You really do.” And so it's those people who we call the super carriers because they were just fine and because of the fact they feel fine, they may even be taking risks that they shouldn't be taking: not washing their hands as often, not wearing their masks because, “Hey, I feel fine.” And so that's one of the biggest issues, just making sure that we continue distancing until either we do have the vaccine or we have herd immunity.

Angela: Are there any stories that you would like to share in terms of specific people that you've spoken with?

Michelle: I can't sway them to either come in or to do what they need to do, because they're just too scared. And those ones kind of haunt me when I go to bed at night, because there has been one patient who was too scared and he died. And so, you know, as nurses, we do everything we can to make sure that they're protecting themselves, and they’re getting medical attention when it's obvious they need it… either their oxygen level is really low, or their ability to talk is very minimal. And I can hear their breath sounds over the phone. Those people are very difficult to sway. You know, it's usually your male person who is an avid watcher of the news, and gosh darn it, he's not going to allow us to scare him, and he's going to do things his way. And so, those ones are difficult.

Angela: Do you feel that there are some countries that have done very well with the approach they're taking to dealing with the situation?

Michelle: Oh, absolutely. I mean, all you have to do is look at Canada, and there's also Austria. There's several countries that have done better. They took precautions sooner. They swabbed everybody. We didn't swab people and we're still… We're doing a lot of swabbing, but we're still having issues getting in the supplies that we need, whether it's the actual swabs or the reagent solution that we need to be able to run the swabs. We didn't do as well as we should have.

Angela: How did the tests actually work? Is it just one type of test?

Michelle: The basic test that everyone's doing, it's called a PCR. It's a Polymerase Chain Reaction, and it's a swab that goes, it goes all the way into the back of your nose. It feels like a little brain biopsy, and you need to swirl it for a good two seconds, which is very long, if you think about it. And then it goes into a reagent solution, which is ran off of a special machine, and it usually takes about 24 hours. The tests that they did that were kind of almost like a pregnancy tests, where it was positive or negative, they threw those out because those were only 50% accurate. And most PCR tests now are 80% and above with accuracy. And the reason it can be as low as 80%, it depends on the person doing during the testing. Did they get back far enough? Did the actual patient have enough of the RNA within their nose, or are they a person that has it more in their lungs or their throat? That's the other issue: not everyone has a lot of it up here.

Michelle: And we do have antibody testing, which has been a big, big argument right now. I'm told that there's a couple of places, including ours, that you can pretty much say, “yes, you've had it”, or “yes, you have it currently”. But there's still a lot of issues as to whether or not the patient themselves had made enough of the antibody. Because not everyone creates those antibodies. And we also don't know how long the antibodies stay. So, those patients who are coming to us who are saying, “You know, I traveled back in January. I got sicker than a dog when I got back home in February, and I want tested,” and it comes back nothing. And they said, “well, it's so weird because I could have sworn I had it. I had all of the symptoms.” And I'm not saying that they didn't have it, I'm just saying we just don’t have the antibodies. As we learn, we adjust. We make adjustments with every everything we learn.

Angela: Is there anything else that you would like to share with us before we call it a call it good?

Michelle: I've pretty much pounded it in that I want people to wear their masks when they’re in public, and then just maintain social distance. I find that I have people who want to explain things to me, and they get up… you know, it's just natural to want to get close so that, you know, you're being listened to. And I’m backing up.

Angela: Thank you so much for doing this, Michelle. I really appreciate you taking the time. Thank you.

Michelle: Thank you.