December 3, 2023

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2020 Laredoans of the Year: Frontline health care workers

In any normal year, Laredo Morning Times honors one Laredoan on Jan. 1 who has made an especially significant impact on the city. But in a year like 2020, it didn’t seem right to name just one person who has helped the Gateway City through this historic global pandemic when there are thousands of doctors, nurses, technicians, hospital custodians, assisted living caregivers, EMTs and countless others who have worked tirelessly to care for our sick and dying during the COVID-19 pandemic.

Therefore, we are proud to announce that all of our local frontline health care workers are our 2020 Laredoans of the Year for their remarkable service, bravery and efforts to fight an invisible enemy in this difficult time.

COVID-19 has brought unthinkable death and pain to the Laredo community, and health care workers have put patients’ lives before their own in order to save as many as possible. And their dedication to our community’s health extends far beyond the doors of the hospital. Many doctors and nurses who are caring for patients in the COVID units also have to separate themselves from their loved ones so as to limit their exposure to the virus. Following every long 12-hour shift, many frontline workers spend their time in solitude.

Their sacrifice for Laredo will never be forgotten.

LMT recognizes that there are thousands of stories from frontline workers that remain to be told. In the meantime, would like to acknowledge just a few ways they have admirably performed their respective duties below:

A public presence

Dr. Victor Treviño has been Laredo’s health authority for four years. He’s there to guide and lead the public in the event of an outbreak or epidemic, and he can issue quarantine orders to protect the public.

In the past, new viruses like Zika and H1N1 were able to be contained relatively quickly. And absent of an outbreak in the community, a health authority’s job is pretty under the radar.

These days, Treviño can be found three times a week on Facebook Live, briefing local leaders, the media and the community on the status of COVID-19 in the community. He has been omnipresent over the course of this pandemic, a fact that contributes to his ultimate goal of maintaining transparency around the virus.

Keeping the public informed has been their best defense against the virus, he said. He visits Laredo’s three hospitals daily to talk to doctors, nurses and ER staff and get an idea of their workload, which he reports back to the public.

“It’s a 24/7 routine. It doesn’t matter if it’s Sunday, Saturday, night, day, it’s always constant. The phones are always on, and sleeping is sleeping with a phone,” Treviño said. “Illness is present, the virus is present at any time.”

It’s important to keep statistics but even more so to remember that these numbers are in fact people, he said. There are over 500 dead from COVID-19 in Webb County, and each of those deaths likewise represent the loved ones who they left behind.

Treviño admits he carries a weight on his shoulders as the health authority during this crisis but said it’s one he will gladly carry.

“It is different to see all of this in real life, in real time. There is a certain sadness that comes with it. But we have to be strong and we have to continue the fight against this virus,” he said.

One of his most memorable moments in 2020 was the day the first COVID-19 case was confirmed in the community. The Centers for Disease Control and Prevention had not yet released any specific guidelines for the virus, and Laredo City Council called an emergency meeting. There was some hesitation to implement safeguards and shutdowns, but that was the first time local leaders took real action against the virus.

Treviño has also witnessed firsthand how political divisions have crossed into medicine and inhibited their ability to protect the community. This was especially apparent in his efforts to protect the schools from the virus by keeping learning remote via a public health order. The Texas Education Agency ultimately stepped in with its own overriding guidance which changed and varied widely in the weeks leading up to the start of the school year.

“This should be a medical thing. It should be a prevention thing, it should be a public health issue,” Treviño said. “Regretfully, politics got in between. That’s something that came to me as a surprise.”

But in the end, the health authority believes Laredo officials and health care workers have done the best with the resources made available to them.

“I saw the efforts of the health care workers and all of their sacrifices. All of this is very significant,” he said. “… I think we put in a 110% effort to fight this virus, and we could have been much worse.”

Visiting the sick at their homes

Dr. Ricardo Cigarroa couldn’t say how many COVID-19 patients he has treated in the last nine months, but he ventures that it’s in the thousands.

Laredo Medical Center’s COVID ICU director and critical care physician fell ill two to three weeks into the pandemic, and Cigarroa took over management of the COVID unit at the hospital up until he himself contracted the virus in July.

Cigarroa is a cardiologist but has always devoted part of his practice to internal medicine since Laredo is so underserved in this area. But when the pandemic struck, he decided to close his cardiology clinic and dedicate his practice to COVID until it ended.

“We didn’t know it was going to last this long,” he laughed. “But it’s been absolutely wonderful. We’ve been able to make a difference, and I think it’s what medicine is all about. We took an oath to take care of the sick, and I think this year the sick have been mainly COVID.”

Now his office sees COVID-19 patients from 5-10 p.m. But Cigarroa is still making house calls, as he has since the pandemic started, because so many people fear going to the hospital.

This is a practice he loves. It keeps patients out of Laredo’s packed hospitals, and it brings him back to a centuries-old way of medicine. The pandemic brought home visits back to life, he said.

“You become much more than a physician when you visit patients in their home and they invite you into their home. It’s wonderful. You see the dynamics of the household and how everyone is reacting to COVID, and you become part of their families. It’s really a very beautiful experience,” Cigarroa said.

This has been an extremely tragic year, Cigarroa said, with so much death, misery and prolonged illness. But in the middle of all that, he has been able to see patients recover and regain the twinkle in their eyes and see families reunited.

There have been too few of these moments, but they have been remarkable, he said.

“But I can tell you, the human spirit doesn’t die easily,” Cigarroa added. “Despite the risk of getting COVID, most of our nurses are there every day. And even if they get COVID, they come back afterwards, and that’s a beautiful thing from the frontline side.

“It’s almost like a war. You see so many different things in war, and this is what we’ve seen. We see the death, we see the fates, you see heroes, you see cowards, you see it all. But for the most part, you see tremendous courage from the caretakers.”

Bringing health care outdoors

With the COVID-19 virus finding strength in close-proximity and indoor environments, medical staff have found themselves leaving the comfort of the office for an outdoor clinic to better serve their patients.

While the option was available to shutter one’s practice to avoid infection, doctors around the country chose to open up outdoor clinics to better assess the situation and deliver the care that the community needed. These men and women continued to face the virus head-on while also struggling with the new virus.

The American Academy of Family Physicians stated that outdoor clinics helped relieve stress on emergency departments and made efficient use of staff and PPE while also limiting the spread of infection.

Under the circumstances, planning the clinics was a difficult task that included identifying zones to reduce the risk of infection, transitioning the office’s operations to include the outdoor visits and having the proper workflow and supplies to treat patients, stated the AAFP.

Despite the confusion in the earlier months of the pandemic, Dr. Avelino Alvarez decided to open an outdoor COVID care clinic to provide a safer environment for both patients and staff.

Alvarez set up his office so it would focus specifically on phone consultations and provide care at the outdoor clinic. At the time, doctors were still unsure about how the COVID-19 virus was transmitted, so he set up the outdoor clinic based on his judgment and expertise.

“It worked out fantastic,” Alvarez said. “We were able to reduce the risk of exposure to us (and the) patient, and it turned out that the virus is spread by the respiratory system like most viruses are.”

He said that his choice was a game-changer for him as he could still consult his patients during a time when some doctors retired or stopped seeing patients for fear of COVID. Compounded by not having enough information on the virus, medical staff across the world had to rely on quick thinking and their team to combat the virus.

Alvarez’s own actions resulted in the outdoor COVID clinic and the virtual consultations.

“The patient loved it because they are not close to anyone, it’s just them by themselves,” he said. “We did get really positive feedback from them that they were really grateful.”

Ultimately during this difficult year — especially on the body, the mind and the spirit — Alvarez said all the positive advancements have been due to the grace of God. However, he also commended all the nurses, respiratory therapists, doctors and everyone involved in direct patient care.

When asked about what he believed helped improve the lives of those in need during the pandemic, he said it was simply “to be available.” This means that whether it was in-person, through the phone or through online video streams, being available through multiple means helped the community.

“Utilizing the technology that we have, but availability is key,” Alvarez said. “You have to be available for questions, for your patients; intervene when you have to intervene and treat over the phone, over pictures, over computers. You have to use every source that you have in order to keep them out of the hospitals and keep them healthy.”

Face-to-face with the disease

For the majority of 2020, the COVID-19 pandemic has weighed heavily on the world. The pressure to combat the pandemic has sat squarely on the shoulders of medical staff in Laredo and continues to do so.

And across the country, COVID and ICU units have seen the brunt of the COVID onslaught.

The men and women in those care units face a daily struggle against the virus but still show up each day to do their duty. With medical staff on the frontlines, strong and focused leaders of these units are who take care of ensuring their staff’s safety and well-being while also ensuring the best care for their patients.

Laredo Medical Center Director of the Intensive Care Unit Jupiter Moneda and his team have worked diligently throughout the year to help those that suffer greatly at the hands of the coronavirus.

He said that on a daily basis, he makes his rounds throughout the ICU to ensure everyone has the proper PPE, and he conducts the orientations of all the new nurses from different states in the LMC COVID-19 care procedures.

Even when he tested positive for COVID-19 and was required to be sidelined for two weeks from work, he continued to call into the ICU to coordinate the continued efforts and provide moral support until he returned to work.

“For at least four weeks, I was at least able to work from home combing the unit, giving out diagrams, making the schedules for the nurses, making assignments if needed, attending the administrations meetings,” Moneda said. “And that’s helped me to keep this ICU afloat and able to handle those large cases of COVID-19.”

With new nurses coming into the hospital from around the country, he ensures that his orientations bring them up to speed in order to continue the smooth operations of the ICU.

With patient safety a priority for Moneda, he and the rest of the staff at the LMC ICU have worked diligently on providing thorough treatment and life-saving care.

Nurses assisting the ill

Around the world, the primary and long revered frontline workers during the pandemic have been nurses.

The Texas Nurses Association stated that nurses will often be dealing with challenges and undesirable outcomes during disasters. These include lack of staff, supplies and other utilities. During the COVID-19 pandemic, nurses have fought against misinformation, dwindling numbers due to infections and a lack of PPE.

However, the TNA also states that nurses will often be compelled by their duty to care for others while they balance to care for themselves.

It is this tenacity and determination that has allowed the world to continue forward, and despite the fatigue and fear they may have, nurses around the country and Laredo persevere.

Soledad Montes was recognized nationally for her dedication and commitment to the care of her patients after volunteering early this year to work in the COVID ICU.

“We are so proud of Soledad for putting Laredo Medical Center and our city on the map by winning this distinguished award,” said Interim CEO Jorge Leal, FACHE. “We are honored to know that one of our frontline health care heroes represents the best of the best among our nation’s nursing professionals.”

With countless nurses and medical staff helping the community each day, Montes was nationally recognized by the World Health Organization for the lengths she had gone to amid the pandemic.

Despite receiving the recognition, Montes also credits her team and LMC for part of the recognition as she worked with them to save lives.

“I can’t avoid feeling frustrated, expressing my grief and strong sense of powerlessness about suffering and loss of life. Despite this, I still found a deep meaning in my experience in the COVID area,” Montes said. “It made me proud of myself and of my team for the courage and potential to overcome these difficulties.”

She has been a part of the medical community for 20 years and said that she has always been motivated by helping others.

“In the face of the virus challenges, I still have to show great strength and perseverance,” Montes said.

Additionally, Patricia De La Garza, an employee health nurse, has also worked diligently this whole year.

“My role is to provide not only the routine employee screenings but also coordinate COVID-19 symptoms and random testing, contact tracing, give advice to our employees about COVID-19 and return to work,” she said. “I also handle reporting and work together with Infection Prevention, our Quality Department and the City of Laredo Health Department.”

De La Garza added that despite the situation, there is hope. It can be seen in the new vaccines which have been distributed and administered to health care workers around the world.

“Sometimes being a good listener and showing empathy can soothe an illness. This pandemic not only brings pain, but it also brings something more powerful. That is fear,” she said. “By constantly following up with our co-workers’ conditions, we wanted to show them that we care for them as we care for a member of our own family.”

Helping other communities

Hospitals across the U.S. and the world have been experiencing hardships unlike any other amid the COVID-19 pandemic.

With the close proximity nurses and patients share and how the virus is transmitted through the respiratory system, hospitals are losing nurses while they recover or pass away.

As a result, traveling nurses have helped bolster the staff at hospitals to ensure quality care for all the patients.

According to the American Traveler, a traveling nurse website, traveling nurses are sought out during seasonal shortages or critical needs in certain specialties.

With how the pandemic has affected the U.S., struggling hospitals have found support from nurses who leave their home and families for the greater good.

As a retired nurse with 23 years of experience in the early months of the pandemic, Luis Decker returned to the field this year to help at the Hackensack Meridian Health Hospital as a traveling nurse.

As a Laredo-born nurse, he joined the team in New Jersey as it was a severe COVID-19 hotspot. With over 7,000 deaths in the state in May, he renewed his license and began anxiously waiting for his 13 weeks to begin.

“When I first got here, it was the real deal here,” Decker said. “I’m grateful Laredo wasn’t hit like it is here.”

When reaching New Jersey, he was assigned to a nursing rehab center for patients that was already outfitted with professional staff, risk minimizing protocols and a stock of PPE. However, there was a high chance he would see the devastation first-hand, and he did by his fourth shift.

One of his patients, an elderly woman, died of COVID as he stood with her.

“It was difficult to see; I knew to expect it, but I wasn’t prepared to experience it,” Decker said. “I was with her when she took her last breath. She wasn’t alone.”

Still, Decker continued to help throughout the pandemic and fulfilled his time in New Jersey.

“It was surreal. It’s like a warzone without the war,” he said. “The streets were completely dead in New Jersey.”

Decker and so many other nurses have worked tirelessly in hospitals to not only help patients get better but also stand by their sides in their final moments.

Researching a cure

More than 400 Laredoans participated in the Moderna vaccine trials in 2020. They received either a placebo or the vaccine, and 28 days later a second dose. Then for two years, participants will report any symptoms and if they’ve been exposed to COVID-19 or tested positive for the virus.

It’s a long process to prevent further mortality and help create herd immunity for the world. And thanks to these 400 participants and 30,000 others in the U.S., this vaccine is now being distributed across the country.

Dr. Milton Haber was approached by Moderna to conduct this trial this summer. Historically, Latino and Black populations are underrepresented in vaccine trials. And especially considering that people of these ethnicities face disproportionate odds of dying from COVID-19, Moderna needed their participation in the trials. Laredo, being 95% Latino, was a perfect choice.

Haber is one of 89 physicians in the U.S. to become a principle investigator for this clinical trial.

“I said, ‘Damn right I’ll get involved,’” Haber said. “I immediately was accepted into doing the COVID trials, and it’s been an incredible experience — probably the greatest thing I’ve ever done in my life. Because it has changed my life, but it also changed thousands of lives in Laredo.”

Haber believes that having Laredoans participate in the trials will encourage more to take the vaccine, thereby preventing further mortality in the area.

He said the Moderna trial was extremely well-organized, well-structured and a lot of work. He and his team follow these 400 patients every day, documenting every phone call, email and text message, and reporting it back to Moderna daily.

“There was a really good feeling behind it all. And we still have a long way to go. We still have a lot of research to do,” he said. “But it’s fun. It’s a learning experience. You’re talking and having meetings with the best virologists and investigators in the world. It’s a humbling experience.”

Going directly to the patient

With hospitals struggling during the pandemic and health professionals spread thin, some have continued to help patients with at-home visits.

For many, visits to multiple patients at their homes is the norm. For others, taking care of one patient has been a vastly different experience that may have resulted in a stronger bond between medical professional and patient.

Jennifer Ann Garza, Private Duty Licensed Vocational Nurse, said that her role during the pandemic has been to care for her patient throughout the day and night. She said that with so much time spent, she sees her patient as family and works even harder to ensure both of their safety.

Each day, Garza monitors her patients for any signs of symptoms and makes sure that social distancing guidelines are followed. Aside from the usual LVN duties and the COVID safety guidelines, Garza also looks out for the safety of her patient’s family.

“You are not just caring for the patient. You also have to think of who else is in there, who else has been exposed,” she said. “It’s definitely more responsibilities now as we are taking more precaution now for the safety of the patient.”

With these extra precautions, Garza said she adheres strictly to the safety guidelines and avoids traveling out for unnecessary reasons. This helps protect her well-being as well as that of her patients, but it is at the cost of not seeing her family.

“This is tough, but I am grateful that my immediate family has been safe from the virus,” she said.

As added protection, she has received her vaccine but will continue to be cautious as the country moves toward vaccinating the general public in 2021.

“I just want things to get back to normal,” she said. “I think it’s going to be good for our elderly patients and health care professionals.”

Shining a light on COVID

The war against COVID has been fought by many nurses and doctors who have sacrificed their own health and the health of their family.

While the end may be in sight as the vaccine is expected to roll out to the general public by June according to Laredo health officials, COVID has affected members of hospital staff here and across the country. Still, they continue to fight for the good of the community.

In April, Dr. Jaime Pinero, an ER doctor at Laredo Medical Center and Clear Choice ER, tested positive for COVID-19 during a time when information was still very scarce.

After caring for COVID-19 patients, Pinero developed a sore throat and fever.

After confirming he had COVID-19, he went into quarantine and the Laredo community lost a powerful ally against COVID-19 for the duration of his quarantine. However, he did not stay silent. Pinero later shared a video warning other about the impact the virus would have on the community.

Even when he was afflicted, Pinero continued to work for the community. And throughout the year, he has continued to provide insight regarding the virus through the “Laredo Contra COVID 19” Facebook group, the same platform used for his first informational video during his quarantine.

In a Dec. 27 video, Pinero educated the community on the use and improper use of steroids and antibiotics. Additionally, in the middle of the November COVID-19 spike, he begged for the community to avoid going out to bars and hot spots.

Leading during a crisis

Through the continued efforts of hospital staff, the pandemic has been fought daily.

At the Laredo Medical Center, leaders of their departments see new information and new cases every day. For all of 2020, they have weathered the storm and have implemented protocols to ensure the safety of their team and the patients.

Hospital leadership not only understands the issues of their patients but the needs of their staff as well.

LMC Director of Women’s Services Laura Uribe said that over the course of the year, she has learned to live with precaution as a result of the difficult days.

“I also rely on my faith and truly believe we will prevail in this difficult time,” Uribe said. “On a more personal level, I have enrolled in graduate school this year in order to stay busy at home.”

On the day-to-day basis, she opened the Obstetricians and Gynecologists COVID Unit to provide guidelines and help maternity patients.

“In the Women’s Services units, we continue to strive to make the necessary adjustments in order to observe the latest recommendations from organizations such as the CDC, American College of Obstetricians and Gynecologists, and the American Academy of Pediatrics in order to provide the best care possible,” she said.

To better address the issues of maternity patients, she keeps herself informed about OB COVID cases and educating the patients and staff about up-to-date recommendations by the Laredo Health Authority and the CDC.

Alejandra Gonzalez was the LMC Director of 2C Telemetry and State but transitioned into the position of FEMA State Disaster Coordinator in September. Aside from handling staff needs, she also deals with the state and finds way to receive additional help for the hospital.

“As we started battling this pandemic, we received so much support from local entities with warm meals and small gifts, but above all, so much prayers to keep us safe,” Gonzalez said. “COVID-19 hit home for me as I lost family members to this disease, but I was never alone as there was always someone to reach out to.”

As for the critical emergencies, Amber Hernandez, LMC’s Director of Emergency Services, said she has seen a lot of tragedy. Even during the pandemic, accidents and unexpected conditions still occur, Hernandez said. However, she continues to fulfill her duty to care for those in the ED.

“This entails preparing processes to better treat our patients, ensuring staff have all the resources required to safely care for patients and assisting in staffing,” Hernandez said. “I lead the front door to the hospital, and I have to express how proud I am of every one of my staff members. Their bravery, dedication and sacrifices are admirable.”

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