At least three front-line health care workers have died of COVID-19 in Arizona — two Navajo nurses and a grandfather from Casa Grande who played accordion and cherished his job working in a nursing home.
Hundreds more have fallen ill, living separately from friends and family as they try to recover and return to work, still haunted by images of the patients with COVID-19 they've treated.
SARS-CoV-2, the virus that causes COVID-19, has infected health care workers who were vigilant about wearing protective gear, washing their hands and staying home except for work duties.
"I've never been sick like this in my entire life," said Dr. John Anwar, a 44-year-old physician at a major Phoenix hospital. "The thing that bothered me most was the shortness of breath."
The shortness of breath is also the worst part for 27-year-old Bridget Harrigan, a traveling nurse who is working for Banner Health in Phoenix on a temporary assignment.
Since testing positive for COVID-19 on July 8, she's been treating herself in her hotel room by lying on her stomach a lot, coughing up the "junk" that collects in her lungs and trying to drink lots of fluids and get rest. She's also been taking her temperature frequently and measuring her oxygen saturation level with a pulse oximeter.
Harrigan has no underlying health conditions, is normally athletic and a few days before her positive COVID-19 test had been hiking "pretty intense trails" in Arizona.
"I was hiking six miles, no problem. Now I get winded just staying on my feet more than 10 minutes. I tried to clean my room but can only handle a few minutes at a time," Harrigan said. "The shortness of breath really is just beyond explanation."
At one point, Harrigan's oxygen saturation level got as low as 90. She told herself if it got lower than 90 she'd go to the hospital, which was something she was hoping to avoid.
"I've never seen my oxygen drop below 98 before," she said. "That was frightening."
Shawna Snyder, 41, was a Navy vet and mother
The family of Shawna Snyder, a 41-year-old registered nurse and mother of four, says a higher power must have intervened when she and her eldest son became sick with COVID-19 in the spring.
Shawna, a U.S. Navy vet and member of the Navajo Nation, had no underlying health conditions when she tested positive on April 16, her family said. Her 19-year-old son Joshua Snyder, who had asthma, tested positive about four days later.
Based on Shawna’s knowledge of COVID-19 from her experience as a nurse in Tucson, she worried Joshua would be more affected by the virus because of his underlying health condition, her family said.
Through a spiritual intervention, however, the family believes Shawna was able to take on a bulk of the pain meant for her son.
Joshua recovered within about three weeks. Shawna’s symptoms only worsened, requiring her to be hospitalized for approximately the last two months of her life. She died on July 3 after her lungs collapsed.
“If I were to describe her with one word, I would say she was a very powerful person because powerful can cover so many things — from creating healing, creating humor, creating the very thing she needed to apply herself,” said Ernesto Burbank, her fiance.
“She had the ability to get the best things out of you, like for me, I messed up a lot, but she had the ability to change my life … and she made me more, she made me be a person that I never thought I could be.”
'That last night was a very difficult one'
Shawna and Ernesto grew up on the Navajo Nation and met while attending Chinle High School. Soon after graduating, Shawna enlisted in the United States Navy for 13 years and had her first two children, Joshua Snyder, and Gabriel Franco, who is now 11.
After she completed nursing school at Grand Canyon University, family members said Shawna worked at Banner-University Medical Center South in Tucson.
Her family believes she contracted the virus while working long hours on a hospital floor where COVID-19 patients were being treated.
Shawna was hospitalized in Tucson about a week after testing positive for the virus, Ernesto said. She spent Mother’s Day and birthdays, including her own on June 16, hooked to a ventilator while her family called and sent video messages as often as they could.
“That last night was a very difficult one, she wasn’t responsive … I just sang to her until I couldn’t sing to her no more and we said our prayers, we talked until she drew her last breath,” Ernesto said. “I made promises to her of taking care of the children, making sure they’re raised traditionally.”
The couple had been dating for the past seven years and were planning a traditional Navajo wedding ceremony. Together, they have two children — Naabaahii Burbank, 3, and Isabelle Burbank, 2.
Shawna always wanted a squash blossom necklace but kept putting it off. Before her burial on July 9, her family made it a point to buy her one. But before they could, someone donated $1,000 — the exact amount needed to cover the necklace’s cost.
Her family says she had to be behind the gift. It only solidified their belief Shawna always would be there to take care of them.
“Pretty much everything we tried to do for her, it got taken care of,” Joshua said.
The Navajo Hopi Honor Riders, a nonprofit group that supports military families, provided motorcycle escorts for Shawna's 55-mile funeral procession from the Summit Funeral Home in St. Michaels to her burial site in Tsaile.
Officials with Banner Health confirmed that Snyder was an employee. Citing privacy reasons, officials with the Phoenix-based company said they could not provide additional comment.
In a statement, the company said the health and safety of health care workers is a priority. "We deeply mourn the loss of every colleague and are saddened that so many health care workers around the world have lost their lives to COVID-19," Banner Health spokeswoman Becky Armendariz said.
"We must all do our part to protect those around us, including our health care workers, by exhibiting the behaviors that are proven to help reduce the spread of COVID-19."
Navajo nurse, 57, spoke traditional language
Valrena Singer was one of the most popular nurses at the Kayenta Health Center in the Navajo Nation, her family members say, and social media posts back that up. She was one of the few bilingual nurses at the health center, fluent in Navajo and English.
She died May 30 at age 57. During her funeral procession on June 3, community members lined up along highways 160 and 163 to say goodbye.
Video of the event shows a line of ambulances and fire trucks, sirens turned on, driving slowly behind the hearse carrying Valrena. A banner held up during the procession referred to Valrena as a "medical warrior."
"My sister Valrena never made a big fuss. I don’t think she would have ever guessed she be sent out like this!" Avis Singer posted on Facebook that day.
Avis later told The Arizona Republic that she's one of Valrena's relatives, a "cousin-sister," she said. She said Valrena had been working at the health center in Kayenta for nearly 20 years, loved her job as a registered nurse and had worked in both Utah and Arizona.
"She was able to educate in Navajo and she cared for a lot of patients at the bedside," Avis said. "She was able to comfort them to be at ease to do some of the procedures that they do in the emergency room. She was able to explain to them where they would be transferred if there was a need for higher level of care."
Working in a COVID-19 hot spot
Avis was Valrena's co-worker at the Kayenta Health Center. Avis works in medical records and Valrena was an emergency room nurse, which is where she likely contracted the virus, Avis said.
"Kayenta was one of the major hot spots on the Navajo Nation," Avis said. "We didn't have sufficient PPE. A lot of the workers were not utilizing N95s even though we were coming with contact with COVID-positive patients ... It was just basically a surgical mask and gloves."
Not long after a March 7 religious rally in the Navajo community of Chilchinbeto, cases of COVID-19 began to rapidly rise on the reservation. Chilchinbeto is about 25 miles southeast of Kayenta, and many of those who became ill sought medical treatment at the Kayenta Health Center, where Valrena worked.
Valrena first tested positive for COVID-19 on April 21 and was admitted to San Juan Regional Medical Center in New Mexico on April 28. As her condition deteriorated, she was transferred to Presbyterian Hospital in Albuquerque, where she died, Avis said.
"They did try to do a plasma transplant, but it didn't help in any way," Avis said. "She wasn't coming out of the COVID pneumonia ... She ended up going into kidney failure and had cardiology issues after that. Eventually, they decided to take her off the ventilator."
Navajo Nation President Jonathan Nez acknowledged Valrena in a tweet on the day of her funeral, identifying her as a front-line worker who "dedicated her life to helping others."
"She assisted many COVID-19 patients and sadly passed away from the virus," Nez wrote. "My prayers are with her family, friends, and colleagues."
Officials with the Indian Health Service did not respond to a request for comment on Valrena's death.
Beloved nursing home worker, 60, enjoyed music and family
Mark Daugherty had been a certified nursing assistant for his entire career when he died of COVID-19 on June 19, at age 60.
"He always cared about family, cared for animals. When he was a kid, he made a business for himself taking care of the neighbors' animals," his daughter Stacy Daugherty said. "Being the oldest of four children, he had to help with a lot of that care as well. He always had a caring heart."
Mark was the prime caregiver for his younger brother Marlin, who needs help with daily tasks like bathing, said Stacy, who is now caring for Marlin.
The Casa Grande father of five and grandfather of 15 loved his job at the Oasis Pavilion Nursing and Rehabilitation Center, where he often played his accordion and sang for residents. He'd been playing the instrument since he was a child growing up in West Virginia, where his family had its own gospel music band. His favorite song was "Wings of a Dove."
"He was someone we loved dearly. He was a good man," Oasis nursing home administrator Kenneth Opara said.
"His heart was truly for the patients here at Oasis," Amber Moore, the facility's director of nurses, said in a statement.
Mark moved to Casa Grande with his family when he was 18. His dad had arthritis, and the climate for his condition was better in Arizona, Stacy said.
"They were actually on their way to Tucson, and they stopped here for a rest, fell in love and just stayed in Casa Grande," she said.
In addition to the accordion, Mark played the piano, the banjo and harmonica. He was also an artist who loved to paint landscapes and was an active participant in community theater in Casa Grande. His favorite role was playing a government agent in a 2019 performance of the musical "Kilroy Was Here," Stacy said.
Stacy and her father used to play the card game Uno for hours at his favorite Casa Grande hangouts — IHOP, Denny's and Olive Garden. He also liked to spend time at Cracker Barrel, which is where Stacy works.
When he died, his children and widow, Kim, held a funeral service for him at the New Beginnings Church of the Nazarene, which they livestreamed for friends and family. His two white marble accordions, his banjo, harmonica and his cowboy hat sat at the front of the church.
When they heard about Mark's death, the staff at Olive Garden gave Stacy a menu signed with individual messages of condolence.
'He kept gasping for air'
Stacy isn't sure where her father contracted the new coronavirus, which causes COVID-19. The nursing home where he worked had at least 12 deaths related to COVID-19, 34 resident infections and 14 staff members who have been infected, according to federal data released in June and updated July 3.
"As we all know, COVID-19 is widespread throughout the community so it is impossible to say where Mark contracted the virus from," Moore said in her statement.
Stacy said her dad was vigilant about wearing a mask and made sure his family members wore them, too. Mark had a heart condition and often got severe migraine headaches but wanted to keep working, even with the threat of COVID-19, his daughter said.
"It's the Daugherty pride. We push ourselves through everything," she said. "He definitely is my hero. He kept working even knowing there was a high-risk factor for him. I think he wouldn't have had it any other way. Those people needed him."
Stacy can't recall exactly when her father got sick but estimates it began in March. At first, he started to feel rundown and a little dizzy. Then he started feeling cold all the time. He had two COVID-19 tests, and both were negative. But he didn't feel good. He mentioned that his chest was hurting and he had a bad cough.
He was no longer able to have coffee at his daughter's house, which was something they regularly did together, three or four times per week. He also was no longer able to go to work.
Officials at Oasis say Mark's last day of work was May 13. He called in sick on May 19 and went to the hospital that day, Oasis officials said.
He was discharged home, but Mark's health continued to decline. A few days later, he went back to the hospital.
"He was in bed for about two days and then was finally able to call me and asked me to take him to the hospital. He didn't look good. He was pale. He kept gasping for air. It was bad," Stacy said.
Stacy was not allowed to go into the hospital with her father. Because of visitor restrictions, the day she dropped him off was the last time she saw him in person. Her father tested positive for COVID-19 at the hospital and eventually was placed on a ventilator. He was also diagnosed with chronic obstructive pulmonary disease.
Mark's health continued to get worse. After several weeks in the hospital, with the family's consent, medical providers unhooked the ventilator on June 19. Stacy said her younger brother was with her father when he died.
"If it wasn't for COVID, he'd still be here," she said.
Physician, 44, did 'everything by the book' but still got sick
Anwar, the Phoenix physician, tested positive for COVID-19 on June 14. His symptoms included a sore throat and a cough. At first, he thought it was allergies, but then the symptoms progressed to severe body aches, including headaches, and fatigue. At one point, he was sleeping 20 hours per day.
Anwar knew from experience what COVID-19 looked like because his job as a hospitalist includes admitting patients who have tested positive. At the same time, as his suspicions were confirmed with a positive test result, he was baffled at how he could have contracted the virus.
"It did not make sense. I protected myself really well," Anwar said. "I did everything by the book ... How it happened, I cannot pinpoint."
He wore full personal protective equipment when seeing patients, including an N95 or P100 mask, facial shield, gloves and a body covering. Working in a hospital, however, is a higher-risk situation, even with all the right protection, Anwar said. And PPE and masks are not a 100% guarantee.
Working in a hospital is a much higher-risk situation than walking through a store, he emphasized.
After about 15 days of "severe illness," Anwar is now feeling better and he is working remotely, via telemedicine. He still has a "very mild cough," and his hospital wants him to wait until his symptoms are completely gone.
The hardest part for Anwar has been self-isolating from his family, particularly his 4-year-old daughter, who does not understand when she tries running to him, hoping for a hug, and he has to tell her to stop. They need to maintain distance. He's living in a separate area of his house, and so far neither his wife nor his daughter has become ill.
His wife leaves food at the door of the room where Anwar is staying, and he only eats from paper cups and paper plates. Though he's on the mend now, Anwar said that for a while he worried he would die from COVID-19.
"I will never forget this in my entire life," he said.
'The bottom line is, it's not the flu,' says nurse, 27
When news of the coronavirus first hit the media earlier this year, Harrigan, a Banner Health travel nurse whose home base is Texas, was initially annoyed by the hype. She knew how many people in the U.S. die from the flu each year, and the attention on COVID-19 seemed overblown.
Harrigan's initial doubts have vanished. The flu in the U.S. this past season caused an estimated 24,000 to 62,000 deaths, the Centers for Disease Control and Prevention says. As of Thursday, COVID-19 was known to have killed 143,204 Americans, including 3,063 people in Arizona, data from Johns Hopkins University and the Arizona Department of Health Services show.
"The bottom line is, it's not the flu. And the scariest thing is that it hits everyone a little differently," she said.
“Lost on the Frontline,” a collaboration between Kaiser Health News and The Guardian, as of Thursday had identified 836 U.S. health care workers who likely died of COVID-19 after helping patients during the pandemic.
Harrigan, 27, was at work on July 7 when, within about 90 minutes, it became clear that she was not well.
Her symptoms included fever, shortness of breath and a cough she's still trying to shake. She'd been feeling a bit rundown on the weekend but it was nothing like the way she felt that day at work.
"It came on pretty fast, and I immediately went from work to the (Arizona State) Fairgrounds and got swabbed," Harrigan said. "They are prioritizing health care workers, so they fast-tracked the results."
Harrigan found out the next day that she was positive. During the first few days of her illness, she was terrified, she said.
"I really would not have been able to hold a phone conversation a week ago," she said on July 17. "It hits everyone a little differently. The range of symptoms is so vast beyond the CDC website. I never lost my sense of smell or taste, and I know other people who only had that symptom."
More than a week into her illness, she developed congestion and "overwhelming fatigue."
Before her stint caring for COVID-19 patients in Phoenix, she treated COVID-19 patients in Denver and in New York City, where she worked in the COVID-19 ICU at hard-hit Elmhurst Hospital in Queens.
Like Anwar, Harrigan isn't certain where she contracted the virus but suspects that since she works with COVID-19 patients daily, it was likely she got it from them. However, she's also noticed a more lax attitude to wearing masks and physical distancing in Arizona than she saw when she was out in public in New York City.
She's hoping to go back to work soon but needs to stay away at least 10 days, plus prove she's free of symptoms, including free of fever for three consecutive days.
"What I experienced with COVID is nowhere near what I've seen at its worst and I still felt so terrible, especially those first few days," she said.
"I am definitely talking to my hospital's program for recovered COVID patients to donate plasma. So, that's what I am going to be doing next."
Do you know of an Arizona health worker on the front lines who has died from COVID-19? Contact health care reporter Stephanie Innes at Stephanie.Innes@gannett.com or at 602-444-8369. Follow her on Twitter @stephanieinnes.
Reach the reporter at chelsea.curtis@arizonarepublic.com or follow her on Twitter @curtis_chels.
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