"It was very scary"

"What happened should not have happened." A doctor from Minneapolis tells how the fight against coronavirus overlaps mass protests after George Floyd's death.

Last weekend in the United States and cities around the world, thousands of protest against police arbitrariness and racism took place. In the United States, these protests have not stopped since the end of May, when in Minneapolis, when the white policeman was detained, African American George Floyd was strangled.

This death led not only to peaceful actions against police violence and racism, but also to the riots: in Minneapolis, after the death of Floyd, dozens of buildings were defeated and burned, shops were plundered, then excitement spread to other cities of the United States.

The pandemic of Coronavirus, which, before the events in Minneapolis, was the main theme of all the world media, lost its place to news about the pogroms and processions of the participants in the Black Lives Matter movement. But if for most inhabitants one of these stories simply changed the other on the front of the newspapers and in the releases of television, then for American doctors, what happened turned into a real "perfect storm": coronavirus did not go away, and the fight against the disease was complicated by the consequences of mass protests. We are talking not only about those who were directly injured during protests, but also people who could become infected with Covid-19 at many thousands of manifestations.

A medical worker returning from the shift welcomes one of the protesters in the center of New York through the glass of the bus, June 4, 2020

A doctor from Minneapolis Tatyana Melnik arrived in the USA from Minsk almost 30 years ago. Now in the state of Minnesota, the largest city of which is Minneapolis, from 500 to 700 new cases of coronavirus infection are fixed daily than in most European countries.

“On Thursday, it became clear that nothing would end quickly. At four in the afternoon, when I worked in the clinic, an indication came - as soon as possible to free all the premises. We tried to give people the opportunity to leave before the transport stopped. The buses and trams stopped at six o’clock in the evening,” Tatyana says about the events of May 28, when the riots reached the peak, and the authorities announced an extreme position and the commandant’s time.

How expected were these events in Minneapolis? How do doctors fighting coronavirus work during them? What is more important - observance of a distance or mass protest? Tatyana Melnik shared her gaze at what was happening with Radio Liberty.

"I volunteered for a virtual covid front"

Tatyana Melnik

- I work at the same university where I received a medical education, this is the University of Minnesota. I work in the clinic with him, this is something like a antenatal clinic. The clinic is located in Minneapolis, and I live in the suburbs. The fact that coronavirus is serious has become clear already in February. When he comes to us, it was a matter of time. In Minnesota, he was brought by a man at the age of about 60, who returned from the trip. At first, the virus was gaining momentum not so fast. When we had a very seriously ill the young man, who was not another 40 years old, he ended up in intensive care, at full life support, including Ecmo , we all realized that he was a virus, he is here in Minnesota, and now he can turn around very, very seriously.

With the advent of coronavirus, my work has changed. I work mainly in an outpatient clinic, not in the hospital. The hospital immediately realized that at least all doctors and constantly working medical staff should be somehow secured. For them, personal protective equipment was allocated. At the same time, in clinics, at first we did not really know what to do. Who is sick, who is dangerous, who is not dangerous? It was difficult to figure out at first, so for any case all the clinics simply clinics and transferred us to telemedicine, with which we used to work so much, that is, answered patient questions, but we could not carry out telephone or even video consultations. Many were transferred to remote work. Many doctors said that they would work from the house, but they simply did not have enough Internet power for such a volume of work, that is, at first it was very, very difficult to maintain this operating mode.

At first we did not really know what to do

In mid-March, we opened a “virtual insolving”-this is a help system when the patient calls the doctors, and they conduct a video with him on some issues. Basically, they were engaged in patients with Symptoms of Covid. I also participated in this work, because I had few patients, and I needed help with a “virtual ambulance”. We can say that I volunteered for a virtual covid front.

Nevertheless, the first time I still had to go to the city center, since we tried to coordinate everything, the joint work of doctors was needed to understand what we were doing with these patients, as we evaluate their condition to do all this at home, there was not enough Internet. When we finally built the normal protocols of our work in the new conditions and determined what we are doing, problems with the Internet were resolved and I began to work in a “virtual ambulance” at home, while still examining some patients in the clinic. There were very few completely “virtual” days, because patients came to the clinic, who was simply impossible to figure out without inspection.

- Have you been provided with everything necessary for offline work?

- We quickly completely figured out how to protect doctors who work at an outpatient appointment. At first, there were not so many means of protection, so the doctors switched to shift shifts. In May, CDC (Centers for Disease Control and Prevention, the centers for the control and prevention of diseases under the US Department of Health. - Note. RS) announced that in addition to the mask, it is also necessary to protect the eyes, and we all received shields. In fact, the same means of protection that are used in hospitals are now using in clinics.

"It was scary to see reports from New York"

-With what feelings have you watched all this time at what is happening in New York, a city that has suffered most in the world from Covid-19?

-It was very scary to see reports from New York hospitals and read everything that doctors write in New York. It’s scary not for myself, I understood that I have a risk of getting sick, but not as significant as the doctors of the recovery of the hospital and the doctors of resuscitation. It was scary that we simply could not cope with such a stream. We did not know how to treat them than to help them. We still do not know what to do. We know that they need to be supported, but then we did not know if we had enough at all the capacities of our medical system.

- Is it possible now to say that this power was enough?

- In Minneapolis - yes, of course, enough. We closed the quarantine very early, that is, the wave really did not even reach us. Koronavirus hit New York very much, no one was ready for this there, and they initially had colossal volumes of patients. When we introduced restrictions for large organizations, restaurants, stores, in comparison with the statistics of other states, it became clear that these measures were really working. In our country, the stream of patients simply had no chance to achieve what happened in New York. What will happen now - I'm afraid to even assume.

- The number of patients with coronavirus in Minnesota is declining?

- Now it is quite stable. At first we also had problems with tests. Since there were not enough tests for everyone, we tested mainly those patients who entered the hospitals with suspicion of Covid. We tested the medical staff to prevent further infection. Now we are testing almost all symptomatic patients. We test patients who enter planned operations. Now the directive of our healthcare department has been received - to test even more patients. From what we see, the number of hospitalizations remains more or less stable. This is probably the best indicator in terms of the prevalence of the virus, since we know that the number of positive cases identified is always proportional to testing: the more we test, the more we find them. At a certain stage, of course, we jump into the ceiling, but so far this has not happened yet. The staff reveals approximately 600-800 cases per day, while not a very large number of patients still need hospitalization. We have two large cities-Minneapolis and St. Paul, and another city in the north of the state-Dulut. Minnesota is far from the most populated state, our cities are not large, so we did not initially have much incidence.

Even some nurses had to go on an unpaid vacation

- How good was the quarantine in Minneapolis?

- It turned out that we have enough law -abiding society, at least with regard to organizations. Many companies really closed, so many people were transferred to the remote. Unfortunately, a large number of people lost their jobs because of this. Even with us, some nurses had to go on an unpaid vacation, because the clinic did not have the same volumes for taking patients as before coronavirus. As for individual violations, of course, they were. Someone went fishing with friends, someone went to visit my beloved relatives in another city, because of this we observed an increase in incidence, but not as large as it could be.

"On Thursday, it became clear that nothing would end quickly"

- At that moment, you probably could not imagine what would happen in a very short time. Please tell us what happened in the city after the death of George Floyd and how did it affect the work of doctors?

- The reaction of society was fast enough. The next day, protests and speeches against the police began with the demands to take some measures against the police who participated in the detention, during which George Floyd died. It quickly grew into disorder and looting. Already on Wednesday, May 27, the situation was inflamed to such an extent that fires and robberies began in the city. On Wednesday, no one really closed, there was a hope that all this would end very quickly. But on Thursday it became clear that nothing would end quickly. At about four in the afternoon, when I worked in the clinic, an indication was held - everyone as quickly as possible to free all the premises. We tried to enable people to leave before the transport stopped. The buses stopped at six in the evening, there were no movements in the city and the communications between the cities at all. Trams stopped driving. Therefore, the clinic tried to give everyone the opportunity to leave before the transport stops. On Thursday evening, we realized that the case was gaining momentum. And instead of relaxing on Friday, I came to work. Part of the staff from our department simply could not do this. In case one of the employees cannot come, as a rule, there are freelancers, they try to use those who have cars, try to find someone who comes from the same area, and give others the opportunity to stay at home. The leadership of our organization reported that if someone cannot get to the clinic due to any circumstances, it is necessary to report this so that there is some kind of replacement plan or to help with transport for the opportunity to get to work.

View of the center of Minneapolis from the clinic window in which Tatyana Melnik works, May 29, 2020

On Friday, the clinic was closed, and very quickly. In the morning we had patients, but then they told us: "That's it, leave." We closed the hospital, only patients could go there, and they had to have good evidence that they needed medical care. In fact, only a car of the urgent worked for us, women came, who began to give birth, who was absolutely nowhere to go. And our staff came. There were difficulties, because they also blocked the entrances to the city, many had to either leave earlier, or come to work earlier. Several people remained to spend the night in the hospital, because they simply could not leave.

- Were there those who suffered from unrest among these patients?

-I know that at least two hospitals-this is a large hospital in St. Paul and a very large hospital in Minneapolis-were almost completely re-profiled that day to help those who suffered during them.

- What was more difficult for the medical system and doctors - the arrival of coronavirus to the city or sudden mass protests, fires, and clashes of demonstrators with the police?

- For the medical system, it was difficult that the riots and protests came at the same moment when Covid already existed. Usually such events do not continue for a long time. Yes, for several days it is possible to enter patients with injuries, but then everything calms down. We know what needs to be done, each hospital has a plan for the receipt of mass victims, this plan simply opens, and we begin to follow it. Such planning is in almost all hospitals of the United States. As for Covid, we thought that it may end quickly, but it turned out to be a very long -term siege. We do not see the end of this yet. From the point of view of the medical system, given that we were not covered with such a wave as New York covered, to compare these two phenomena-the mass intake of the victims in the process of something and such a long-term siege of Covid is very difficult. When all this is overlapping, it becomes a huge catastrophe in itself.

When all this is overlapped, it becomes a huge disaster

-Have you personally in a situation of serious danger because of this? Was someone from your colleagues-doctors suffered in the epicenter of riots?

-I do not think that I was in any danger, because at that time I was far enough from all this. Nobody was injured from my colleagues, and I am very happy about this fact! Several of my colleagues do not live so far from the places affected by riots, and they said that the night, of course, they had sleepless, but everything worked out.

- When you watch the picture on TV, it seems that all Minneapolis was on fire, everything burns, everything is defeated. How was the case in reality? How significant part of the city was affected by these events and were there areas where everything was relatively calm?

- I think that there were very few such places. Almost everyone felt the tension, and no one knew where it would go further. There are areas that have suffered very much. On some streets there was not a single whole glass. One of the central streets of the city needs enormous restoration work. Some buildings are completely lost. A very large building, which was built for residents with low incomes, burned to the ground and is not subject to restoration. Many stores closed, they are clogged with plywood. Not the whole city burned out, certain parts of it burned. There were many small fires that were much easier to extinguish, since there was no crowd. Where it burned out to the ground, usually a crowd stood and did not even allow the police and firefighters to drive there to extinguish it.

"This is a death that should not have happened"

- How did you personally hurt you with the death of George Floyd? Working in the clinic, you probably faced a variety of representatives of society - both white, black, and rich, and poor. What position did you take in what is happening-a detached observer or your sympathy on someone else's side?

- I could not fully view the video where Floyd dies. Working in medicine, I, unfortunately, lost a fairly large number of patients. Many of them were dying in my eyes, we did everything possible and just could not do anything. The situation when a person, already chained into handcuffs and lying on the ground, dies in the process of detention, simply could not leave me indifferent. This is a death that should not have happened. Therefore, it is very difficult for me as a doctor to remain an observer in this situation. No matter how much the detained man was, he did not deserve such an attitude, did not deserve such death, so it is very difficult. What happened should not have happened. One of the tasks of the doctor is to prevent death that should not happen. It’s hard to look at how this happens, on the video, and in the hands of those people who should protect order and protect us.

Derek Shovin, a policeman accused of murder of George Floyd

“Could you assume that something like this would happen in Minneapolis?” Were there any prerequisites for this? Have you encountered yourself or your patients with police violence?

- For me personally, meeting with the police is not very pleasant, but do not pose a danger, since I fit into the white majority, I am a white woman. When the police detain me, I have no thoughts that something like this will happen to me in the hands of the police. For this, I need to freeze something completely unbearable-for example, to pull out a weapon, which, by the way, I do not have, and begin to swing them right in front of the police officer. As for my colleagues and patients, yes: I mainly fly women, and women from the African American community told me that they were forced to explain to their sons how to behave with the police so that they would not advent the same as George Floyd. In the United States, there were already several cases to the death of Floyd, by which it could be assumed that something so sooner or later would happen. Filando Castile was killed in his own car, this is an African American who worked in a school canteen and did nothing remarkable in order to be shot right in his own car, he did not warn the policeman that there was a weapon in his car, which, in principle, must be done when meeting with the police so that it was not a surprise for them. But the policeman, obviously, was very scared and considered it necessary to use force. In this case, the policeman was justified .

July 7, 2016, a protest in New York demanding a fair punishment for a policeman who shot Filalando Castile

A few years later, a white woman shot a white woman in Minneapolis, while the policeman was convicted of murder and received a term of 12 years, and a 20 million compensation was paid to the family of this woman. Now that George Floyd's death occurred, after these two cases and after several cases that occurred in other states, the situation was simply in the balance of the explosion. I could not assume that this would happen in Minnesota that this would happen on my state, but I could assume, given everything that was already happening in the country, that another such incident would end with a rebellion.

- What is the situation in Minneapolis now? Does the commandant’s hour apply, does it apply to doctors? Are troops introduced into the city?

- At the moment, the commandant hour is preserved. Initially, he was from 8 p.m. to 6 in the morning. Then it became a little calmer, and the curfew was made from 10 pm to 4 in the morning. On the doctors and the staff that is necessary to provide first aid, the commandant hour does not apply, but at the same time it is necessary to have a badge with you, that you are really a doctor, a nurse, a nurse and go on business, a certain hospital. The National Guard was mobilized in Minnesota, and it was they who patrolled along with the police of Minneapolis and St. Pola. Naturally, everything is impossible to patrol, all the same, the number of people in the national guard and the police remains quite small, so they mostly try not to allow the accumulation of large crowds. I know that many residents organize Neighborhood Watch , this is the self -organization of people in the field when they simply monitor the situation - and if strangers appear, this is immediately reported to the police, and they try to talk with these people, to find out who they are and what they do in one or another area. The protests continue, but there are no such colossal riots as a few days ago.

National Guard cars before entering the hospital in Minneapolis

- The other day, an open letter of American doctors and medical experts was published, who stated that they did not condemn the protests participating in the protest, and only called not to go out for demonstrations without a mask and in case of poor health. This letter caused a contradictory reaction: how so, the doctors were for quarantine because of the coronavirus, and now they are actually not opposed to people to gather thousands on the streets. Do you, as a doctor, feel some kind of contradiction between the need to observe quarantine and the desire of people to go to many thousands of demonstrations?

-Naturally, there are no contradictions: in the States, with a very, old time, speaking for civil rights of the population is considered a very serious matter. Can I advise residents to protest? No. But at the same time, I can understand their desire to express my opinion with the help of such protests. Therefore, my task as a doctor here is to try to give some advice, how they can protect themselves, given the situation with coronavirus. I myself am going to participate in protest, which is organized specifically for medical workers, because we see with our own eyes what is happening with our patients, including patients from black communities who have tremendous health problems. At the same time, yes, all participants in our action were told without mandatory to be in masks and be from each other at a distance of two meters.

"The African American community suffered stronger"

- Was the inequality of the incidence of certain groups of the population by Covid noticeable?

- Yes, the African American community suffered stronger, and this is due to many factors. Many in it work at those works where the risk of infection with coronavirus is very high. These are catering enterprises, this is work in the nursing homes, which are very many here and which have suffered greatly from the virus. This is work on cleaning enterprises and offices. At first, we tried to protect doctors and nurses in hospitals, then we tried to protect the medical staff that works in clinics. We lacked personal protective equipment for all people who worked at high -risk, and these people were not only doctors, but also those people who work every day for fairly low -paid work. It was quite difficult to provide everyone with personal protective equipment in places as the same McDonald's. At the beginning of the epidemic, we still did not know that these people would be associated with increased risk, we did not even think about it. As it turned out later, we did not think about it in vain, because they were sick very, very often. The percentage of the African American population among sick people is much higher than their percentage among the total population, even in our state, is about two times.

Many in the African American community work where the risk of infection with coronavirus is very high

-Did the mass protests brought, which began after the death of George Floyd, to the surge of new hospitalizations with Covid-19 or to an increase in the number of identified carriers of the virus?

- Now it’s too early to talk about it, since it all began not so long ago. After some time, we can see a surge. The incubation period of coronavirus is about 5-7 days, that is, soon we should see a larger number of infected, and we, of course, will observe statistics. For about 7 days, the course of the disease takes the course of hospitalization, that is, the growth of new revenues to the hospitals and, perhaps, we will even see death after about a few weeks. I have no doubt that among the protesters will be infected. Already now in the Virtual Eallest Eallest there are patients who were in protests and feel symptoms, it is quite difficult to avoid infection in such a crowd. In addition, unfortunately, we had sick and infected paramedics and firefighters. Among these riots, it was very difficult for them to navigate, dispatchers tried to collect information on calls, if there were infected ones, but they could not always get reliable data. People call in a panic, they need help right now, and they do not even think that they can endure those who come to them to provide this help. Therefore, many came without personal protective equipment to the house where someone was sick.

Black Lives Matter movement in Vienna, Austria, June 4, 2020

"We must learn to listen to each other"

-Did you think that in this situation, when one overlapped the other, just quit and leave somewhere far away?

-Of course, I wanted to escape somewhere in the Antarctic, where coronavirus has not yet been found, but it is also impossible to run to life infinity. To escape is, in general, the first reaction, but far from the best. This is one of the classic reactions that our very, very old area of the brain tells us. Unfortunately, it is far from gone to such a reaction. Therefore, you have to turn on the mind and think: Okay, it seems, will not work out, because everywhere there will be its problems. It remains to fight. How? Power techniques against the virus do not work very much. It is also difficult to use power against unrest, because this can lead to victims. Just freeze and wait until everything passes past me is also not the best option, because it may not pass by, but go through me. I have to think what I can do in this situation personally. And the feeling that I can really help someone in a difficult situation in which a person was in connection with the virus or in connection with protests, this is probably the best reaction.

I wanted to escape to Antarctic

- What feelings do you experience from what is happening as a person who came from another country and lives here for a long time?

- It hurts. The fact that we have lost so many people is very painful. I can’t separate my personal reaction from the doctor’s reaction, I look at the number of deaths-and I am just very, very bitter. I understand that we could do something in this situation, but for some reason this did not happen. If we do not take out the lessons from this, if we meet the next pandemic in about the same way ... This is a matter of time, in fact, this is a common occurrence-when something crawls out of some bowels, so that then we can’t find any trace at all, where it came from, how it came, how it came. Pandemia is one of the fairly frequent phenomena, in the last century there were several of them, and we were also not ready for this. Very disappointing. It is also a shame for the fact that the scientific world, unfortunately, completely collapsed, the quality of the work that went along the coronavirus left much to be desired. We still have no sensible approach to the outpatient treatment of Covid. We approximately know what needs to be done in hospitals, but we do not know what works for patients who only get sick, how can we help them so that they do not need to go to the hospital and be on the artificial respiration apparatus.

As for the riots, I will honestly say that it was very scary. There was a feeling that all this would come to our clinic. The police were absent, it was generally not clear what was happening and why. After some time, I had to simply turn off my emotions. Reacting in a state of emotions is a normal reaction, but it is impossible to remain in the same emotional intensitance endlessly, you need to turn on the head and analyze. For me, the main question was: why is this at all? Why do I understand that the United States seems to be a country of equal rights, but at the same time, some people who, in principle, are quite a lot, my patients tell me that the rights, in principle, are not the same for everyone? Instead of telling them: “You are wrong, everyone, in fact, is fine, it’s just such incomprehensible”, I try to understand them, I try to hear their story. Пока мы не научимся слушать друг друга и делать что-то в этой связи, помогать друг другу, Америке будет очень тяжело, – сказала Татьяна Мельник в интервью Радио Свобода.