This could be how humanity ends: a stealth, highly contagious, mutating airborne virus wafts quickly across the land, wreaking havoc on the health, financial and social well-being of all in its path. The new plague is deliberately ignored by an incompetent leader with magical thinking who denounces the hastily erected policy firewall constructed out of science by local leaders and healthcare experts and fortified by the good grace of strangers.
The connective tissue holding the body of humanity together against the novel coronavirus and the accidental and intentional ignorance feeding it are the first responders, the nurses and doctors, the healthcare assistants, and the frontline workers ensuring the spaces people inhabit are safe.
It may be the nurses working long hours in hospitals, nursing homes, and jails who are among the most brave, battling the regular silent banality of death itself as their patients grasp for a last connection to life against the cacophony of beeping monitors. With each hand they hold, nurses face their own mortality and defend humanity against abject darkness.
Tragically, this was a preventable genocide. President Trump had been warned about the outbreak in January but dismissed the intelligence reports.
On March 3, Angelinos lined up to vote, undisturbed by reports of a new flu-like virus up north but focusing on Joe Biden’s expected blowout of the Super Tuesday election. On March 4, California Gov. Gavin Newsom declared a public health emergency after a 71-year old person died, calling for rigorous hand washing, social distancing and self-quarantining if feeling ill.
By May 6, two months later, there were 1.25 million confirmed U.S. cases, 73,931 deaths; 59,698 confirmed cases of COVID-19 in California, with 2,439 deaths; 28,644 of those positive COVID-19 cases were in Los Angeles County, with 1,367 deaths – 58 new deaths from the day before.
Barbara Ferrer, PhD, MPH, MEd, Director of LA County Department of Public Health during May 5, 2020 news conference
All of these numbers are human beings. This is believed to be an undercount.
More and more, the public has become aware of the quiet courage it takes for nurses and others to venture into the dangerous unknown to fight to keep the virus from spreading.
GLMA, an organization of health professionals advancing LGBTQ equality, just launched a storytelling campaign “to spotlight the stories of LGBTQ healthcare workers on the frontlines who are sacrificing for their patients and communities during the pandemic,” GLMA executive director Hector Vargas tells the Los Angeles Blade. “The goal is to share their heroic stories in and of themselves but also as a means to educate about the need for nondiscrimination laws to protect LGBTQ healthcare providers and the entire community.”
“We know that this is a hard time for everyone, but especially healthcare workers and healthcare workers who belong to the LGBTQ+ community,” GLMA notes on their website. “With nearly half of LGBTQ+ healthcare workers living and working in states where it’s legal to be fired based on sexual orientation or gender identity, GLMA understands why it’s more important than ever to make sure we’re all safe from discrimination on the job.”
GLMA and the Williams Institute determined that 826,000 LGBT people work in the healthcare industry. The percentage of LGBT healthcare workers in states without nondiscrimination protections is 47% (or an estimated 386,000 people).
The Los Angeles Blade interviewed three gay LA-based nurses to share their experiences during this trying time.
Jay-Ar Langcay (Photo courtesy Langcay)
Jay-Ar Langcay, 36, has been a nurse for about 11 years. Since moving to LA from Hawaii in 2010, he has been working as an Emergency Nurse at LA County USC Medical Center, a Level 1 trauma hospital. He also works with the Sheriff’s Department taking care of clinically sick patients from LA County Jail.
Langcay, a COVID-19 survivor, also faced death as a child growing up in the Philippines where he contracted Dengue Fever Stage IV. He contracted COVID-19 at the beginning of March.
“I was not expecting it. I tried my best protecting myself,” he tells the Los Angeles Blade. “The first week was fine — sore throat, fever, headache, body-aches, and loss of sense of taste. The second week added cough, diarrhea and fatigue. The third week, I developed shortness of breath and blood in my sputum. I could hear my lungs gurgling and I couldn’t sleep on my back or sideways. I managed to sleep sitting up and sometimes in a prone position. I was really scared when my color became bright red.
“I got the result of my test on the second week and really got scared, depressed and cried every night while Facetiming my family in Hawaii,” he continues. “I was scared to die alone in my apartment. I always thought, ‘what if I don’t wake up in the morning,’ so I kept my phone beside me all the time. My family’s prayers comforted me all thorough out and my faith got stronger day by day.
“I’ve seen my previous patients who contracted COVID distraught and emotional, on top of all the symptoms they were having and I told them about my story,” Langcay says. “I feel their emotions and uncertainties as I’ve felt before and I know it gives them a little hope and faith that they can survive, as well.”
As of May 6, 168,000 people have survived COVID-19.
Langcay says he experienced different stages, facing his own mortality.
“I felt anxious and depressed experiencing COVID but knowing I’m a healthy person was my key to keeping my hopes high in surviving it,” he says. “But still, seeing and reading the news about the numbers of people who succumbed to the disease made me accept my destiny. Now I say, ‘If it’s my time, it’s my time.’ It’s inevitable.
“I thought of all the good things I’ve done to others — I thought of the bad ones, as well,” he says. “And I thought of ‘what if I only given a second life and this is it.’ But I also thought of my family and friends and they are not ready to let me go.”
Finally, Langcay says, confronting his own mortality “made me think of what my real purpose in life is and if I already served my purpose here on earth. Recognizing and accepting my impending mortality in a way gave me the strength and faith to overcome COVID-19.”
Harold Sarmiento (Photo courtesy Sarmiento)
Harold Sarmiento is an infectious disease nurse practitioner at Kaiser Permanente Los Angeles Medical Center. He is also an assistant clinical professor and preceptor for advanced practice nursing students at California State University and UCLA School of Nursing where in 2016 he earned an MSN and is now a doctoral student. Sarmiento was an adult-gerontology primary care/HIV nurse practitioner at AIDS Healthcare Foundation in Beverly Hills and before that, worked as a critical care RN at Keck Medicine of USC and USC Medical Center.
“When I was growing up, my mother, who is a retired midwife, used to take me with her to work at the community health center. Sometimes, in the middle of the night, I’d accompany her while she helped pregnant women deliver their babies at their own homes,” Sarmiento tells the LA Blade. “I also had a younger brother who suffered from cerebral palsy. I was helping my family care for him at home when I was not in school – at night and during the weekends. Unfortunately, he passed away at the age of 5. These experiences fueled me to get into this field.”
Sarmiento is particularly sensitive to being a gay nurse. “Being a first-generation immigrant and a member of the LGBTQ community myself, I can relate to my patients’ struggles – lack of compassionate, culturally sensitive care from their healthcare providers, stigma and discrimination from the society, lack of access to healthcare insurance, cultural and language barriers, lack of education, poverty, homelessness, mental issues, substance abuse, etc,” he says. “Seeing and caring for the LGBTQ population opened-up my eyes to the disparities in our health care system. It breaks my heart to see how the LGBTQ community is disproportionately affected by HIV/AIDS, even these days. I am here, trying to make an impact on the lives of my own community.”
He has seen how COVID-19 has caused a “spike in fear and stigma” that feels familiar to people living with HIV/AIDS.
“Although we don’t have enough information if people with HIV have higher risk of contracting COVID-19, we know that patients with HIV who are immunocompromised (those with low CD4 cell count), patients who are not on antiretroviral medications and older patients with other underlying medical conditions, have higher risk of getting very sick with COVID-19,” Sarmiento says.
“It has been very challenging lately. My patients are scared to go to the clinic for their follow up, to get their lab works done or even to pick up their medications at the pharmacy,” he says. “I totally understand — they don’t want to contract coronavirus and we want to protect them from potential harm, as well. So, for almost two months now, we’ve been using telemedicine in our clinic. We also provide them an extra supply of their medications, as well, free delivery.”
Sarmiento is in charge of the Pre-Exposure Prophylaxis (PrEP) program and has noticed some patients are taking a break.
“Their fear of contracting COVID-19 has lessened their sexual activity,” he says. “Fewer people are hooking up because of the ‘Stay at Home’ orders. People are quarantined and staying at home with their partners, thus they have more time to be intimate and have sex.”
However, “despite social distancing, there are still people who are contracting HIV and STDs. And unfortunately, a rising number of my patients have lost their jobs due to the crisis. They have also lost their health insurance, adding even more stress,” he says.
“As COVID-19 spreads, it exposed not only the challenges in our healthcare system but also the inequity especially among us – the underserved, marginalized members of our community,” Sarmiento says. “As an LGBTQ+ community, let us not be further stigmatized by COVID-19. Please help raise awareness without increasing fear by sharing accurate evidence-based information. Let science guide us. Please practice social distancing, wear a mask and wash your hands often. Spread love, kindness and help each other during this very difficult time.”
Santiago Mandi (Photo courtesy Mandi)
Nursing runs in Santiago Mandi’s family. “I knew that my mother found joy in her occupation so when I was young, I believed that nursing was a great career. It wasn’t until I began to volunteer at the hospital in Seattle, Washington that I knew it was what I wanted to do,” Mandi, 38, tells the LA Blade. He graduated from nursing school in 2004 and has worked at hospitals in St. Louis, New York City, Boston, and now Los Angeles, where he’s lived for seven years.
“I am employed at UCLA Ronald Reagan Medical Center in the Coronary Care Unit, Cardiac Intensive Care,” he says. “The pandemic has quickly changed the processes the hospital has implemented when admitting patients into the hospital and how procedures are done. The staff is regularly updated on policy changes when it comes to caring for patients with COVID-19 and how healthcare workers protect themselves.”
“When patients come into the Emergency Room, they are automatically tested for COVID-19,” he continues. “It’s been taking only a few hours for the results to come back. All patients going for surgery are retested for COVID-19. If there is a suspicion a patient has contracted COVID-19, staff members have clear protocols on what steps need to be taken.”
Mandi says there have been many changes since March on how to handle patients with COVID-19, “but that’s expected since the CDC’s guidelines to properly take care of these patients has been evolving.Thankfully UCLA has been quick to adapt to the latest guidelines recommended by the CDC.”
“Currently we have enough supplies to protect ourselves,” he says. “Supplies have definitely become limited and rationed strategically, but if I need a mask or a gown to wear over my scrubs when I enter a room of a patient who is being tested for COVID-19, the hospital provides me with what is needed. Every day I enter the hospital, my temperature is checked and I am given a basic surgical mask since the hospital has employees wearing masks throughout the hospital. If, for some reason, my mask needs changing, I know I can get a replacement without difficulties.”
However, Mandi says, “I do hear of other hospitals that do not have this luxury and it’s frightening. I can’t imagine taking care of a patient with COVID-19 and not having the necessary supplies that is needed to protect yourself. I know that I am lucky to be working at UCLA, which has more resources than many healthcare facilities in the neighborhood. UCLA Medical Center has been preparing for the surge that thankfully has not yet happened due to the hard work of everyone in the city.”
Mandi echoes signs held by healthcare workers begging community members to try to stop the novel coronavirus pandemic by please following guidelines for everyone’s safety, especially as cities in LA County start to slowly re-open.
“I hope the LGBTQ community can continue social distancing and regular hand washing as we move forward and lift the city’s restrictions,” Mandi says. “As the weather gets warmer, the community will be out and about enjoying sunshine and take part in more gatherings. But we need to continue to be mindful that COVID-19 is still around and can still transmitted to one another.”
Testing for COVID-19 is increasingly becoming available, so if you think you have symptoms or want to be tested for peace of mind, visit https://covid19.lacounty.gov/testing/.
“Thank you to our amazing healthcare workers, who are on the front lines of our fight against COVID-19. We are so incredibly grateful for your efforts and sacrifice, and you are a key reason we are getting through this pandemic,” Wiener said in a statement to the LA Blade. “Thank you for taking such good care of those in the LGBTQ community who may have some reservations about entering the healthcare system. We appreciate you and will never forget the sacrifices you’ve made.”
“Nurses, along with other health workers, are on the front line, battling the deadly virus each day. We thank for them for their heroic efforts and for continuing to care for people living with HIV,” says the Los Angeles County Commission on HIV.
“APLA Health was founded to fight a deadly virus and today we see ourselves out in front combatting another,” said Craig E. Thompson, CEO of APLA Health. “The dedicated staff at all of our health centers have stepped up to the challenges that COVID-19 has presented us and I am immensely proud of all the hard work they have put in during the last few months. They have put in long hours, adopted new technologies and continually been there to provide the essential services our community relies on to stay healthy and well. Our frontline staff have and will always be integral in the care of our community.”
“Nurses and all other front line workers at the [Los Angeles LGBT] Center and similar organizations have been providing critical and life-saving services for decades as we have navigated the HIV/AIDS pandemic and now Covid-19. Throughout, they have been courageous and compassionate, even in the face of personal danger and tremendous loss. The world is now seeing the true value of all those who come to work every day, from medical professionals to grocery store clerks, to help us all get through this new reality. They are all to be commended, valued, and made visible on this National Nurses Day,” says Darrel Cummings, Chief of Staff, Los Angeles LGBT Center.
“In ordinary times, the nearly four-hundred nurses and related nursing staff working for AHF in our healthcare centers both here and around the world as well as those nurses working as case managers for us serve as a linchpin and lifeline in the delivery of lifesaving care for our patients. Each deserves our profound recognition and thanks—not only on National Nurses Day—but every day that they step forward to fulfill their duties,” said AIDS Healthcare Foundation President Michael Weinstein. “And today, even more so, during these times of heightened anxiety and both profound and routine medical need amid the coronavirus pandemic. On behalf of all of AHF, I could not be more proud to see how these professionals have risen to the challenge or more thankful for the dedication these exceptional care providers continue to demonstrate in measures large and small each day.”
“Our siblings who are part of our LGBTQ community and who are not often recognized, The TransLatin@ Coalition wants to acknowledge your existence and dedication to support all people in need. We also want to specially appreciate all of those health care workers who we partner with and those who are warriors on behalf of Trans, Gender Non-Conforming and Intersex (TGI) people. Thank you for helping us live and survive through this horrible global pandemic and always. Much love and appreciation,” Bamby Salcedo, President/CEO, The TransLatin@ Coalition.
“Team APAIT sends big virtual hugs and thumbs up to all first responders and essential workers for keeping our communities safe,” says Jury Candelario, MSW, APAIT.