This story has been updated with the most recent confirmed case numbers from the Thomas Jefferson Health District.

Nurses know the vulnerability of their community.

That’s Kellen Squire’s take as an emergency department nurse: That nurses did not sign up to effectively run into battle with no weapons or armor, but know they’ll stay on the front lines and do what’s needed.

“It’s like when they say, ‘Anybody that doesn’t want to be in this mission, you can leave now,’ and nobody leaves — that’s how it’s been,” he said.

Squire, who works at Sentara Martha Jefferson Hospital, said COVID-19 has brought many changes to the day-to-day work of nurses.

“When I decided to become an emergency department nurse I never thought I’d go from Nazis to world-shattering pandemics … but here we are,” he said.

In 2017, Squire, who’s been a nurse since 2011, was among emergency room nurses at both Martha Jefferson and the University of Virginia Medical Center who treated injuries from the Unite the Right rally.

Last month, his team began gearing up to handle COVID-19 patients, and now treats everyone who enters the emergency room as if they may have the disease caused by the novel coronavirus.

Sentara Healthcare has said in statements that it could confirm its organization had “seen patients who tested positive for COVID-19,” but has not specified which locations.

Hospitals in Virginia have largely been reticent to give regular estimates of the numbers of patients being treated for the disease, though UVa official Dr. K. Craig Kent said on Thursday that he estimated roughly 25 people in the Charlottesville area were being treated between the UVa and Martha Jefferson hospitals, which tracks with recent hospitalization information released by the Thomas Jefferson Health District.

As of Saturday afternoon, the district, which includes Charlottesville and Albemarle, Fluvanna, Greene and Nelson counties, was reporting a total of 90 COVID-19 lab-confirmed and clinically diagnosed cases.

Though the area does not yet have an overwhelming number of confirmed cases, it is affected by a dwindling national supply of medical supplies, which experts estimate will be insufficient to manage the outbreak.

One of the biggest initial issues for Squire’s team has been a limited supply of personal protective equipment, he said. Hospitals in the Sentara network are currently accepting equipment donations in an effort to stretch their stock.

Prior to the pandemic, unless someone came into the emergency room with a known serious disease, Squire said he usually only wore gloves.

“You wear gloves appropriately, you’re putting an IV in somebody because you want to be open and accessible,” he said. “One of the big things with wearing masks all the time now is we have a lot of people with hearing problems and a lot of them read lips. So what do you do when you have to wear a mask all the time? Right? We did it less before to be open, a comforting environment for the patients and stuff. And now, obviously, it’s all flipped on its head.”

Squire said the hospital has given care providers information about how to sanitize equipment appropriately so that it is safe to reuse.

“I’m wearing personal protective equipment now that a month ago probably would have at least gotten me written up if not fired,” he said. “... I’ve got a face shield that I reuse, until I can’t anymore, ‘till something happens that it won’t keep me protected.”

Other protocols for procedures, such as breathing treatments for asthma attacks, have also been changed.

“That’s also a good way to spray virus everywhere because they breathe into it and it aerosolized in their lungs, so we don’t do that anymore,” Squire said. “We’re using inhalers with spacers now.”

Now that more Virginians are staying home, he said he feels projections for supply of PPE and bed capacity is looking much better.

The hospital is handling shifting demands as well as it can, he said, and is working tirelessly to keep employees safe.

As much as his work life has changed, Squire said the pandemic has affected his home life as well.

He’s terrified he’s going to bring COVID-19 home and infect his three children, who are 12, 6 and 3 years old.

“I know that kids for the most part, not always, get much milder symptoms, but a lot of people have a misconception ... the mild cases that we’ve heard about, people felt like they’re one step from death,” he said.

The passenger side of Squire’s truck is now a contamination zone, he said, where he leaves his shoes on the floor after work and sprays them with a disinfectant.

“I spray them and leave them in there and they don’t come in the house,” he said. “I get naked in the garage and throw the stuff in the washing machine then immediately go to the shower, so it takes a lot longer to come home than I used to.”

Assuming he has already been exposed, Squire said he’s checking his temperature frequently and, while walking around his house, he’ll “just stop and I’ll smell something” because loss of smell and taste can be an initial symptom of COVID-19.

“The new normal in my house is to lounge around, avoid the kids, take my temperature and then smell stuff, so it’s fun times,” he said.

Despite all the struggles, Squire said the Charlottesville area has a dedicated group of emergency service providers and health care professionals who are as well-prepared as they can be.

“There are a lot of communities that will be much worse off than we are, so I take solace in that and that I have a fantastic group of colleagues both that work in my facility and work in other facilities that will go to the mat for the people here,” he said.

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