COVID-19: Voices from the front lines — Hardish Khinda

Popula­tions most vulner­able to COVID-19 infec­tions and compli­ca­tions are older adults — especially those with preex­isting condi­tions. In fact, the CDC reports that 8 out of 10 COVID-19 deaths reported in the U.S. have been adults 65 years or older. Because high-risk popula­tions live closely together in nursing homes and long-term care facil­i­ties, residents are at an even higher risk of being affected by respi­ra­tory pathogens like COVID-19.

Before the first cases of COVID-19 were reported in the U.S., Spokane Veterans Home, a long-term care facility in Spokane, was at the tail end of its ​“upper respi­ra­tory season.” Hardish Khinda, staff devel­op­ment coordi­nator and infec­tion control manager, was already several weeks into monitoring the spread of upper respi­ra­tory infec­tions, quaran­ti­ning infected staff members and residents, and commu­ni­cating daily with Spokane’s local health department.

When COVID-19 cases were first confirmed in Washington state, Hardish’s shifts increased from 8 to 12 hours almost overnight. At one point in March, she didn’t have a day off work for 12 days straight.

“We didn’t fully know what was going on, so we just kept following what the CDC was saying about the coron­avirus and were frequently checking in with our team in Olympia,” she recalls.

To protect her husband and her adult son and daughter at home, Hardish changed her routine; she began washing her clothes and taking a shower immedi­ately upon arriving home after each shift, washed her hands often, and frequently cleaned doorknobs and other high-touch surfaces around the house.

“It’s just a cold,” her husband told her. ​“You’re taking it too seriously.”

In the first week of April, with the help of other nearby facil­i­ties, every resident and staff member of Spokane Veterans Home was tested for COVID-19. Despite following infec­tion preven­tion guide­lines to the letter, like restricting in-person guest visits for residents, screening staff members before they entered the facility and wearing full PPE when providing care to residents, some test results came back positive. In May, after another round of standard testing at the facility and despite her own best efforts, Hardish was diagnosed with COVID-19.

“I was so surprised because I wasn’t having any symptoms when I was tested,” she says. ​“I was a little tired and had occasional headaches, but I just thought it was because I was stressed and working so much.”

Thank­fully, Hardish’s children created a care system for her while she quaran­tined in the family’s guest bedroom for 14 days: preparing and placing her meals outside her door, video chatting with her each day, and making sure she had every­thing she needed to be comfort­able as she continued working from home. Even her husband jumped on board and was tested for COVID-19; he was negative.

“It made isola­tion a lot easier,” she says. ​“I feel bad for other nurses who don’t have family members to take care of them or who are single parents with children to raise while in quarantine.”

Because she has little direct inter­ac­tion with residents in her role, Hardish is unsure if she became infected by a fellow staff member or another method of commu­nity spread. Today (October 2020), family members are only allowed to visit residents in person at end of life, staff are tested weekly and all vendors are tested prior to entering. Hardish also says that unlike other health care facil­i­ties in the area, Spokane Veterans Home has never experi­enced short­ages of PPE.

But what is in short supply, she says, is energy among both staff and residents when there is no end to the pandemic in sight. With residents not being able to see their loved ones and staff feeling fatigued, Hardish says it’s even more impor­tant that nurses remain diligent in keeping patients, and each other, safe.

“I will be the first one dancing when this is all over,” she says. ​“But, in the meantime, wash your hands, wear your PPE and watch out for each other. Let’s work together to see this through to the end.”