On the last morning of February 2020, South Korea awakened to the news that Daegu had the largest number of COVID-19 cases outside of China and the city didn’t have enough medical personnel to cope with surging infections.
Kang Jeong-hwa heard the news while going to work, and it haunted her the rest of the day. By the evening, she decided to act; she would plunge herself into the crisis.
“Why you, among all people, mom?” asked her daughter, who had hurriedly returned from Hong Kong, where she was studying. “What if you get infected?”
Kang had no answer to calm her family’s fears. They beseeched her to reconsider but her sense of duty was steadfast. She told herself that she simply had to be where she was needed the most. “I am a nurse.”
Two days later, Kang arrived in Daegu, its streets eerily empty all day and night, blaring with ambulance sirens. At Yeungnam University Hospital, she started her two-week stint in a special ward for COVID-19 patients. It had negative air pressure to contain droplets of the coronavirus. At the end of the two weeks, she extended her service to six weeks; she just couldn’t leave the “war zone” without seeing any patient recover and go home.
Before finally leaving Daegu, she tested positive on the last day of her own two-week quarantine and was hospitalized for a month. Now, she is back to her position as head nurse of Design Hospital in Jeonju, but she is a so-called “long hauler” among COVID-19 survivors, those with lingering, long-term symptoms. After nearly a year, she has yet to fully recover her sense of smell.
Kang was one of the 3,959 nurses who responded to the Korean Nurses Association’s call for volunteers last March and April. At the time, Daegu accounted for half of the nation’s total cases.
In January this year, the association published a collection of the nurses’ memories of those critical days. The 262-page book, titled “COVID-19 Heroes Nurse the Republic of Korea,” offers a vivid glimpse of the situations at hospitals overflowing with patients at the early stage of the pandemic. The narratives, written by those who had daily, hands-on contact with patients, are intimate and heartrending.
All of the nurses say they felt dread, burnout and distress from relentless workloads, as well as “a sense of guilt” for causing pain to patients when giving care. Also palpable is a shared ethical dilemma in forcing patients to die alone; their family members and friends were not allowed to say goodbye to prevent COVID-19 from spreading.
For most nurses, the challenges began with functioning with personal protective equipment, not to mention overcoming the fear of possible infection.
“It’s not easy to look after 20 patients even in ordinary times. Then, looking after so many patients on each shift while wearing PPE with PAPR (powered air purifying respirator) was something far beyond imagination,” one nurse wrote. “With the goggles fogging, it was hard to see the syringe needle. It was so difficult to locate the vein because I’d had no experience in giving intravenous injections with my hands covered in two layers of gloves. Sweat ceaselessly ran down inside my PPE, often burning my eyes.
“Hospital regulations told us to minimize contact with patients. But how could I turn away from a patient who was trembling with fear? I spent increasingly more time calming down patients while wearing my heavy protective gear.”
Another nurse wrote, “Korea has refined its infectious disease policy based on our experience with MERS (Middle East Respiratory Syndrome), which is being implemented in fighting with COVID-19. Nonetheless, when there weren’t sufficient supplies of PPE, when defective products were spotted among Level D PPE, when we had to reuse disposable PAPR masks, we all prayed earnestly that in the wake of this pandemic, improvements will surely be made to our nursing work environment.”
Nurses are highly vulnerable to infections because they work in close contact with patients. Korea Disease Control and Prevention Agency statistics on the initial COVID-19 wave last spring have 133 infected health care workers, of whom 77 were nurses, 33 were nursing assistants and 10 were doctors.
As for means of transmission, 67 cases occurred during general treatment, 10 while treating COVID-19 patients, four at screening stations and 52 in cluster outbreaks.
The International Council of Nurses, a federation of some 130 national nurses’ associations, has been vocal about “unacceptable inequalities” of COVID-19 exposure on the nursing profession, as well as women in general.
In a message dated March 17, Annette Kennedy, president of the ICN, said, “As we look back on the past year of the pandemic, we can call after call for protection, decent pay and acceptable working conditions for this 90 percent female workforce being ignored by governments and policy makers all over the world.
“Women, and especially nurses, have shouldered the majority of the care of the ill and dying, along with increased child care, yet we see rates of violence and abuse against women are on the rise, and nurses are continuing to put their lives at risk for a low-paid, undervalued job. I am also concerned about the impending exodus from the profession of nurses who have been traumatized by caring for patients with COVID-19.”
According to a study based on reports from 37 countries, as of Aug. 15, 2020, COVID-19 had infected some 300,000 health care workers and killed more than 2,500 health care workers.
In Korea, the relevant statistics available are extremely scarce and belated. However, considering the number of infection cases, which continues to hover around several hundred with no signs of decreasing, health care workers throughout the country must still be toiling under immense pressure. True, the most harrowing images of the pandemic have receded, but we must not forget the sacrifices of health care workers as front-line warriors protecting us from the prolonged danger.
Lee Kyong-hee is a former editor-in-chief of The Korea Herald. She is currently editor-in-chief of Koreana, a quarterly magazine of Korean culture and arts published by the Korea Foundation. -- Ed.