Article in NZZ: "There was a lot of applause during the pandemic, literally. But what comes after that?"

https://www.nzz.ch/schweiz/corona-krise-einzigartige-bilder-aus-der-intensivstation-ld.1565681

Translation with goole Translate, Article Robin Schwarzenbach NZZ

Fabian Fiechter is an intensive care worker in a hospital and a photographer - he was able to capture the corona crisis like no other

Fiechter took photos in the midst of colleagues in protective suits and seriously ill patients. His pictures from the University Hospital Basel also show hope: one of the infected married his long-time partner - after 84 days in the intensive care unit.

Robin Schwarzenbach, Gilles Steinmann; Fabian Fiechter (pictures) 22.07.2020, 5.30 a.m.

March 2020, the corona virus has reached Basel. More and more people with symptoms are being admitted to the university hospital, some of which have to be transferred to the intensive care unit later. People stand in line in front of the preaching church: They want to be tested in the provisional smear center that the hospital has set up in the church.

Intensive care worker Fabian Fiechter wants to capture the crisis - with the camera. Because Fiechter is not only a hospital employee, he has also been working as a freelance photographer for ten years. Works by the 39-year-old German have appeared in “Spiegel”, “Stern” or the “New York Times”. And now Corona.

Fiechter says to himself: This has to be documented. Especially since there are hardly any pictures in the media that authentically show what is happening in German-speaking Switzerland or in German hospitals, as Fiechter says. He makes an application to the media office - and actually gets the green light a few weeks later. The result is impressive images that we publish here in a selection.

Mr. Fiechter, what happens in this photo?

The picture shows a corona patient who has just been turned on his stomach. The change in position is hoped for better ventilation of the lungs. The man is ventilated, there are four colleagues around him, a doctor in the middle and three caregivers. We had formed a group that was on the ward every day to turn patients from back to stomach or vice versa. It takes several people to do this. 

Is the patient conscious?

No, he is in an artificial coma. You have to know that seriously ill corona patients are ventilated with partially very high frequencies. One would hardly tolerate that when awake. Only when the blood values improve can ventilation be gradually reduced.

A lot of staff can be seen in your pictures of the intensive care unit. Do Corona Patients Need More Treatment Than Others?

Yes, this is clearly shown when turning intubated people. This cannot be done alone, especially since these patients are very fragile. The picture above gives a calm impression. In fact, this process is very dynamic until the right position for the next 12 to 16 hours is found. The hoses must remain stable; pressing areas should be avoided, perhaps the mattress must be readjusted. This takes about half an hour each.

Or here, looking through a window into an isolation room. The patient has just been transferred to another area of ​​the intensive care unit and is now being reinstalled. The colleagues in the other unit take over the patient and are informed about his condition.

Are there any scenes that you couldn't or didn't want to take pictures of?

Of course, one wonders which pictures are appropriate and which are not. It is always a tightrope walk. I personally would probably show more photos that may shock others. They don't shock me. I see that every day.

You didn't take any disturbing pictures. Did you restrict yourself?

No, I just took pictures. But I certainly did not select some pictures because patients were recognizable or looked alone in the photo, even though someone was with them. I don't want to convey the wrong picture. Medical lay people often have no idea what we are doing. There are not enough pictures to show what happens in Swiss hospitals or in hospitals in Germany.

The corona virus is a potentially fatal threat; The unsuccessful fight for the lives of patients is part of this in a hospital. Why didn't you catch that? 

I missed it, also for practical reasons. I continued to work in nursing, I couldn't always be with the camera everywhere. My recordings are not complete. There are also no pictures of patients who are better off or of people who have recovered and can happily go home.

What is happening here

This picture was taken in a nurse's night shift, between two and three in the morning. It shows that nursing and photography have a lot in common: both are about exploring closeness and distance, getting to know the other, spending a lot of time together. Nurses spend most of their time with the patient. This creates small stories like the one in this picture - even if it cannot be seen whether the colleague is smiling or whether she is talking well to the patient she is touching. Visual reporting in the corona pandemic has limits. 

Have your colleagues never felt disturbed by you as a photographer at work?

Everyone reacts when a camera is nearby. But if you watch silently for a while, that goes away. Especially when the people photographed have other things to do. 

The hospital staff can hardly be distinguished. All wear hoods, masks, goggles, protective suits and gloves. What do the following two pictures tell us? 

What is it telling you? 

Without thinking too much, I would say: you are showing a doctor. 

The man on the right is a doctor who is concerned with how he can help the patient in front of him. She suffers from severe shortness of breath and must be intubated shortly afterwards. The woman on the left is a colleague from the cleaning service, taken on a normal bed station. I believe that many hospital employees are simply forgotten in the reporting. A hospital is not just made up of doctors and nurses. But here too my work is incomplete. I couldn't take pictures of all the cogs that kept the hospital running, for example the warehouse clerks or the people from the laboratory.

The rooms on the bed station are cleaned every day. When patients are discharged, the entire room is thoroughly cleaned, as can be seen here. Even the walls are rubbed off and disinfected.

An image that clearly expresses the persistence of the corona virus.

Yes - with the restriction that rooms are always cleaned so thoroughly when discharged patients have had an infectious disease or multi-resistant germs. But the protective clothing of the colleagues is emblematic of the pandemic, as is the logistics behind it. The processes in a hospital are extremely complex, especially in a pandemic.

In what way?

Several bed areas were completely converted into isolation stations that could only be entered with protective clothing. Usually, this only happens with a few areas or individual rooms, such as flu waves. But in the crowd? In 20 years as a nurse, I have never seen half the intensive care unit blocked due to one and the same virus. At peak times, we had 17 corona patients in the intensive care unit plus about 50 more throughout the house. There were also suspicious cases that also had to be isolated. The more patients you have, the more complex the procedure. The teams inside and outside of these zones were dependent on one another, for example if medication from outside was needed in the isolated area. Therefore, I believe that the cleaning staff or the nursing assistants who do all the logistics in-house are extremely important.

Have you never had doubts whether the operation would withstand the stress?

We were well prepared as personnel resources were moved to where they were needed because of Corona. My workload was also increased. We coped well with the crisis - but only because non-urgent operations were shut down and politicians made the right decisions: what would have happened if the Basel Carnival had taken place in early March. . .?

What does this picture stand for?

For the fact that a rich country like Switzerland can also be affected by a shortage of resources.

Have you never had concerns that you could infect yourself - and others?

I would be lying if I said: "It leaves you cold there and the virus doesn't bother me." However, fear is a bad advisor. You have to concentrate: when putting on, when taking off protective clothing; before entering an isolated room when you leave it. Is everything hygienically correct? Is the mask in place, are the goggles in place, is the smock still complete? If you spend eight hours with Corona patients, a lot can happen.

And after work?

My neighbor is in her eighties and often wants to talk to me. I always take a step back. Sometimes it's strange feelings that you take home with you. At the height of the crisis, I isolated myself more than I probably would have if I hadn't worked in a hospital.

You had yourself tested at Easter.

Yes, I had flu symptoms.

Was that uncomfortable - until you found out that you didn't have Corona?

Since I didn't have a fever, it wasn't that bad. And it happened very quickly. I was in the smear center in the Preacher Church that was there at the time, and the next day I got the result. The pictures from the church are from mid-April. I would have liked to take photos of people queuing on the street at the beginning of the pandemic to be tested. But I still had no approval from the media office or the hospital's corona task force, which can be seen in the next picture at one of their late meetings. 

You spoke of little stories that you want to tell. Is there a moment in the hospital that you particularly remember? 

Yes, when I found out that a patient and his long-time partner are getting married on our ward. 

A corona patient marries in hospital? 

Yes, that was a very moving moment. 

How was that possible? 

The visiting rules were relaxed because the patient was no longer contagious. There were also a few relatives there. The registrar was allowed to go to the patient's bed. When he said yes, he stooped to understand him clearly. The man could hardly speak.

This patient is the only one who can be seen in her pictures. How did that happen?

I introduced myself to him and his partner, and he agreed that I would photograph him and that the pictures would also be published. He had been in intensive care for 84 days and still had to be ventilated. The man was flown out a day later. He had had to wait a long time for a place in a rehab clinic.

What triggered this encounter in you?

I was very happy for them. But of course it's sad to see that someone suffers so much from the late effects of this disease and is still struggling with it. The conversations with him were very interesting. I think he thinks it's good that the population knows that Covid-19 is very bad for him.

The image of the wedding ceremony also conveys hope. 

Naturally. That touched the whole team. That also gives you strength. The colleagues who looked after the man were also there at the wedding, behind a window. At such moments it becomes clear that we do not treat diseases, we treat people.

What did you learn as a nurse in that time?

We have to be humble and thankful that we have been able to help most patients so well; that things didn't go as badly as in Ticino or in other countries. Because our health care also has limits. But I have respect for what may come in the further course of the pandemic.

And as a photographer?

I am glad that I was able to document the corona crisis. The nursing profession is clearly underrepresented in public perception. There was a lot of applause during the pandemic, literally. But what comes after that? We always have a lot to do, we are often at our limits. Many leave the profession. Society should discuss this fundamentally. 

R. Sc. On April 10, 2020, 98 percent of the beds in the intensive care units of the local hospitals were occupied. More than half of these were for Covid 19 patients. Since then, occupancy has been declining continuously, as figures from the Swiss Society for Intensive Care Medicine (SGI) from last week show. In mid-June, corona patients accounted for only 3 percent of the intensive care. Three quarters of the available beds were for patients with other diseases. The SGI sees itself confirmed in an earlier assessment that the capacities "were sufficient at all times to treat all critically ill patients". However, there were significant regional differences. Intensive care units in Ticino and in the Lake Geneva region were the most busy, as SGI wrote in a statement. According to the SGI, the fact that the hospitals were not overloaded is partly due to the fact that resources for doctors and nurses were increased significantly in some cases. On the other hand, the ban on unnecessary interventions and therapies from mid-March had made a significant contribution towards overcoming the high point of the pandemic to date.