Updated: Aug 25, 2020
By Michelle Jung, Communications Editor
Michelle Jung: You may introduce yourself.
Anna Meister: My name is Anna Meister, and I am a dietitian. I'm a Wellesley College graduate from the class of 2002, and I've been working at an outpatient dialysis center, DaVita, which is in New York City in the Bronx.
MJ: What is the situation like for COVID-19 in your area?
AM: New York City has been significantly affected by coronavirus, including where I live in Manhattan and go to work in the Bronx.
MJ: How has your life changed personally and professionally?
AM: My life has changed a lot since then both work and personally. With my son not going to daycare and being at home and my husband working at home and myself — I was taking a leave of absence from March to April when my son's daycare closed because I didn't have anyone to take care of him. Then, I returned to work at the end of April and was not given the choice to work from home remotely. So, I returned to the clinics where I work. We have lost a lot of patients to coronavirus and had hospitalized patients and patients who had to be isolated and treated in a separate facility, which is just for positive patients. And then I had several patients who were still in the hospital. There were also patients who were being tested all the time and it’s just now starting to get back to normal. But it certainly has affected the way we work. We use more protective equipment and I change to working in scrubs, wearing a mask everywhere, sanitizing and washing my hands all the time.
MJ: How much change in workload and demand for your service has there been?
AM: My personal workload hasn't really changed much in terms of patient care. But I did have to help with the screening process of patients and visitors. So, as they enter our clinic, we have to screen them for possible symptoms and check their temperatures and give them masks. I have been participating in that, which has increased my work, plus the added responsibility of helping to disinfect the waiting areas and the common areas. But the patients that I see and follow up on or are about the same.
MJ: How has the pandemic affected the patients you are serving?
AM: Yes, there are patients that, you know, unfortunately did get sick and hospitalized and did not recover. Obviously, those were very affected. And then the patients who did get hospitalized and then recovered slowly were also affected that way. Overall, my patients are more low income, so a lot of them had to rely on the New York City food programs to help get food delivered to their homes. With limited income and not being able to go out to the grocery store as much, if they didn't have a family member who could go for them, it definitely affected them in terms of food access and sometimes their own health due to a lot of co-morbidities and diabetes and things like that.
MJ: So, you said that most of your patients are low income.
AM: Yeah, most of them are, yes, in the Bronx.
MJ: Would you say that they had a tougher time because of the pandemic? How would you say it affected their lives?
AM: I'm not across the board, but some of them had a lot of family support or other support from spouses or partners. A lot of the patients who had limited family support to begin with had a very difficult time because they weren't going out to even get their medications or basic food supplies, and they didn't have the resources as much as other people.
MJ: When the pandemic started to rise within the United States or within New York, what was your biggest concern and what were your patients’ biggest concerns?
AM: One of my biggest concerns was the lack of childcare for my son, since that affected my ability to go back to work and my schedule at work because it made it difficult for me to work a full day. And I had my own anxiety and fears about going back to work as I travel on the subway to work and taking public transportation was an issue (but did end up doing it after spending a few weeks taking Ubers and Lyfts). And then my patients were definitely feeling more isolated. For some of them, and as you said with the issues with food and also their medications, they were used to going to pick up their prescriptions at the pharmacy, and they weren't doing that. And they were just coming to the clinic for their dialysis and going home. It was a definite change of their lifestyle.
MJ: I guess another concern for you would be when you're taking transportation and contacting patients who were infected, and then coming back home and having it affect your family. That must have been tough as you still had to go back to work.
AM: Right, yeah, that was. Yeah, yeah. I first was very hesitant to go back to work, because I feared getting infected myself or affecting my family. Even though I was separating myself from friends and people outside of my home, it was still a difficult decision.
MJ: Has there been any way the pandemic has set back some of your personal or work goals?
AM: I mean I definitely have been looking for a job. And I feel like, yeah, that has definitely been slower and less successful because maybe places aren't hiring right now and some things are still remote. My job search has slowed down, and it's turned my thoughts more to remote work or to private practice because I feel like if things don't change and jobs that are remote are available, then I might switch to that.
MJ: What do you think like a main struggle would be for you as you shift work to remote?
AM: Because a lot of my job is counseling directly with patients and seeing them day to day, I feel like I can be most effective that way, even with wearing face masks. Up until last month, I was wearing a face shield and talking through all that, I still feel like that's effective in person to counsel them rather than remote. But, since I've never really worked remotely, I don't really know. But I feel like telemedicine and Telehealth is a big growing area anyway. So, this just made it more relevant, I think.
MJ: After the pandemic, how do you think your job would change for the dialysis clinic or just as a dietitian?
AM: In general, I think things are moving towards remote and being able to use online video conferencing and such, which we do have for certain for the patients who do dialysis at home. That is a platform that some people use and I think things are going to have to change.
MJ: Definitely, in order to uphold all the social distancing orders.
AM: Yeah. And if you know there's another wave or if something else happens down in future.
MJ: For the dialysis clinic, what are ways in which your work field is trying to prepare for a possible second wave or future waves coming up?
AM: There was a lot of support for healthcare workers so that we learned and developed over the past few months to protect everybody— so just learning how to try to continue our work while using the proper protective equipment and being able to screen and test the patients, keeping the patients who are likely to infect other people away from others. I think that there was a lot learned and implemented that did work. But, I'm sure there's room for improvement because there were some of my co-workers who did get sick and the beginning and maybe weren't either following everything strictly enough or they just didn't have the adequate protection that we later learned was crucial. Yeah, everything was so new.
MJ: Amongst your colleagues and family, how are you communicating real-time on health updates about the pandemic?
AM: Well, my company sends out a bi-weekly email to everybody with constant updates, because things have changed one week where we are testing patients this way and another week, we're doing it differently. Or, one week where we're not all wearing face shields. Then the next week we had to, there were two constant updates regarding how we would stay safe and treat patients. Then, we are always updating the patience to when new things are implemented. We have to inform them through emails and text messages from the company. As the staff of the clinic, we educate them. As a dietitian, I provide resources for how to get food during the pandemic, how to make sure you get your medications in order to keep them out of the hospital. My coworkers are also well-informed and we all have to take certain training that explain the mask wearing and disposal of equipment, etc. Then, guidance on what to do when you're out in public or at home. So yeah, we're constantly getting updated and we went and gave information to our team and also asked to spread that to the communities that we live in.
MJ: When we're watching CNN or any news sources, we don't hear much about the role of dietitians in COVID-19, so could you elaborate more on the role of dietitians during the pandemic and why they are essential to this fight right now.
AM: For some of my colleagues who are working in hospitals, I know that they saw a lot of patients who are positive and we still had to do our job of just assessing them, counseling them on various therapeutic diets, and a lot of them who were unfortunately on ventilators or a respirator or having breathing complications had to be tube fed. So, there were a lot of dietitians who were crucial to make sure those patients were given tube feeding. My regular counseling work sort of took a backseat because I felt like I just came back to work and I wanted to make sure that everybody was able just to get food. And it was less about like, oh, are you eating low salt. A lot of their diets were not so good. They were just trying to get whatever food they could get. Whether that was through government programs or just going to the closest thing that was open like a fast food place or a deli and getting that. So, I was able to be less effective in that, but I just tried to make sure that they were able to afford some food. As things got a little better and things started to open up, then I was able to get back to trying to emphasize how to prepare healthy meals and cook more often. But still, a lot of my patients are not there. Still not cooking and doing regular grocery shopping.
MJ: With increase in healthy food products, like vegetables and fruits, in price and the wipeout of products in grocery stores, do you think that was also a huge factor for some of your patients to not be able to get access to healthier food sources?
AM: It was more that they just were not going outside in public as much. They feared going to the grocery stores, and the restaurants that they would go to were closed. I mean, Chinese take-out or McDonald's were still open, but that was still a change in their usual routine. And people were just more mentally stressed and afraid, so they were just doing whatever they felt comfortable and easy to do. And for some of them, their aids weren't coming or helping them, so I think it was a combination of factors.
MJ: For government food programs, what were some nutritional plans or organization plans that the program lacked?
AM: Some of them went to food pantries or soup kitchens and I think a lot of them just did not have the capacity to keep going, during the pandemic. I'm not sure where they are now because there are other organizations helping out but some of my patients just called like the 311 number and anyone could get meals delivered to their homes. They also had school meals for everybody that you could pick up at school, so I think some of my patients did that. And then there are a lot of them who get the snap cards and food stamps so they still got those, so they could use them at the grocery store, but I think there were fewer resources available to them.
MJ: It definitely has been difficult on governmental programs because I know there was an increase of people going to fruit pantries.
AM: Right, exactly. There was more demand because people lost their jobs and stuff.
MJ: There has been some news about COVID-19 patients not being able to sense taste. What are your thoughts on that? Is it true, from your experience?
AM: Yeah, definitely, from what I've heard from the doctors who I work with and just word-of-mouth. Yeah, it's definitely that it was a common prominent symptom for a lot of patients that that's what happened.
MJ: Once your patients recovered, were they able to like taste food afterwards?
AM: Yeah, nobody complained. Nobody mentioned to me having that symptom. They definitely did lose weight. I know that a lot of them came back from the hospital having lost weight because they weren't eating well. But then it just took time for them to get their appetite back, but I'm not sure if they still had taste issues.
MJ: What are ways in which students or higher-paid workers are able to provide access for those who are dependent on food programs or are in need of help to the access of food as they are on the lower income side?
AM: I provided flyers about calling for free meals or going to public schools for free meals and then just educating them about the resources available. And also, even for mental health and hotlines and things that came up for all the anxiety and stress that people were going through during this because the pandemic certainly affected everything about their life. I think it's depressing because a lot of them are isolating themselves and not socializing. I just try to provide whatever resources I could find and try to share that.