ecdysis: When COVID-19 Strikes

It has been 13 weeks since I first started my job as a community health nurse at Rush University Medical Center. Specially, I got hired to be a part of a core team of COVID nurses to go out into the community to test at-risk and underserved congregate populations. Since August, my world has been composed of testing and doing public health surveillance at long-care term facilities, homeless encampments/shelters, substance abuse centers, domestic abuse shelters, detainee centers, among other congregate settings. Certainly, there are moments when I lay in bed, not wanting to go to work and not wanting to create another label, input data into RedCap, and swab another fidgety and anxious person. Recently, however, my myopic vision regarding testing and surveillance was greatly jolted and I am slowly beginning to realize that the work that my team and I are doing is crucial as a form of public intervention and social justice.

For me, this week was a catalyst in expanding my perspective for a variety of reasons. First, my team and I (and a group of volunteer medical residents/students and nursing students) were assigned by the Chicago Department of Public Health to go test at a homeless shelter five minutes from where I live in North Lawndale. The minute we stepped into the shelter, something deep inside of me realized that this was an environment that very few chose to willingly venture into, and that the people who did step inside were those that fell under the category of outcast. I sat in the tension of swabbing person after person, locking eyes with individual after individual and reckoning with my own discomfort of being in that sort of setting and wanting to leave while also realizing that I had much to learn as a healthcare provider. I may have appeared externally to be doing a public service by testing this population, but I realized in that moment that my internal disposition was contradictory and that my heart was pretty distant from the heart of God. Indeed, it's slowly dawning on me that the opportunity that the Lord has given me to step into different spaces and brush shoulders with different populations must be done so with his heart. This is what initially motivated me to apply to nursing school, and this is what must continue to motivate my decision to serve the underserved. I desire to see the Lord in places and in people that society has forgotten.

In addition to testing at the aforementioned homeless shelter, a group of us also were assigned by CDPH to go to a detainee center to test approximately 800 detainees with the help of the UIC COVID team. Prior to testing the detainees, we were given some context by the in-house infectious disease doctor regarding the jail. Important to note is that a jail is different than a prison in that it is a place where individuals are detained pre-trial. Even more important to note is that 95% of detainees are there for non-violent offenses and that 42% are not convicted of the offense they were jailed for. The infectious disease doctor went on to inform us that the police department is quite separate from the sheriff's department and that the police department continues to unnecessarily arrest individuals at a rate that continues to overwhelm the holding facility. This, along with the reality that courts are closed due to the pandemic, has resulted in an upsurge in this particular jail that has ultimately resulted in a petri-like environment that was the cause of a huge COVID outbreak (around 900) back in April. I found the following article https://www.healthaffairs.org/doi/full/10.1377/hlthaff.2020.00652 (sorry for not knowing how to hyperlink and for being too lazy to google a how to) interesting in that it "suggests that cycling people through Cook County Jail alone is associated with 15.7 percent of all documented COVID-19 cases in Illinois and 15.9 percent of all documented cases in Chicago as of April 19, 2020". Additionally, it is safe to say that the disproportionate intensity of policing and incarceration in black and brown neighborhoods is very much a factor in the disparate COVID cases in these communities. The individuals that are placed in this jail are susceptible to getting COVID and for spreading the virus back to their home communities upon discharge. Indeed, in the wake of a roaring pandemic, it is even more urgent and vital that the police department reexamines its reasons for initial arrest and existing incarceration policies.

On the second day of testing, my team and I stationed ourselves just outside of the double-tiered cells. There was one moment in particular that made me sit in silence and gaze at the scenario in front of me. Here we were, fully gowned up in PPE, going from door to door, swabbing the detainees who resided within each cell. It was a chilling scene, this moment where the unseen were for a brief second, seen. I was very much aware that this was a visual snapshot that I would carry with me forever.

Is this a lot to sit with? Yes. It is. And yet, as I sat in the division testing the detainees, I realized that I must reckon with what is before me. I realize that the neighborhood I have lived in for these past five years is victim to mass incarceration and that it is futile to separately categorize where I live and where I work. Systemic racism is insidious because it does not simply involve one aspect of society - it is an interconnected web that intentionally disadvantages and harms black and brown communities on multiple levels. The injustices that always existed prior to COVID rise to heightened levels to became even more destructive in the wake of the pandemic. As a community health nurse, these realities urgently demand that I serve humbly and take into account the stories and histories of the communities I interact with. I realize that knowledge is power, and that there is a certain responsibility that comes with knowing. May I step into new opportunities to advocate for my community here on the Westside of Chicago. May I diligently label/RedCap/swab away, with the knowledge that my work is for a cause that is beyond my full comprehension.

Lastly, I would also like to note that the long list of judges that was on your ballot in this year's election is actually pretty important. It is the court and the judges that sit in those courts that determine certain policies that influence whether or not a person must be detained in a holding cell (versus being on house arrest, etc.). Also, I found this article a revealing spotlight on the voices of detainees: https://southsideweekly.com/not-getting-no-treatment-cook-county-jail-covid/