I recently came across a photo of myself in late December 2020 getting my first dose of a Covid-19 vaccine. I was ecstatic. Many of my colleagues posted similar images. Even though we were all wearing masks, no one could miss the smiles on our faces. This vaccine was the hope we’d been waiting for. In that moment of jubilation, I could not imagine the tragedy to come.
In the hospital in Tampa where I work as a hospitalist, the daily number of Covid-19 patients held steady in the 20s between January 2021 and July. While some of those patients were incredibly sick, and some died, the work felt doable after the crushing summer surge in 2020.
Then everything changed. Beginning in late July, the number of Covid-19 patients we are caring for has skyrocketed. The hospital went from fewer than 20 patients with active Covid-19 to more than 200 today. When the two floors of our Global Emerging Disease Institute quickly filled with Covid-19 patients, we scrambled to convert other areas of the hospital to treat them. The inpatient rehabilitation facility was closed and reopened as a Covid-19 unit. Every three to five days another unit was emptied to make room for the Covid-19 patients flooding the hospital’s emergency department.
I haven’t said anything about what’s going on with #COVID here in FL bc I haven’t had the words to describe it. The truth is we’re caring for 3x the number of patients we had last summer. 12 of our floors have been converted to covid units. We are stretched to the breaking point. pic.twitter.com/MyZVmIuaUE
— Jennifer Caputo-Seidler, MD (@jennifermcaputo) August 21, 2021
As I write this, 13 of the hospital’s wards are now dedicated to caring for people with Covid-19.
It’s not just the number of patients that’s worse this time around. They are also sicker. I’ve gotten used to seeing a patient during morning rounds on minimal supplemental oxygen who ends up in the ICU before the day is over. I cared for one patient who, in 24 hours, went from being on a small amount of supplemental oxygen — 4 liters — to being on a ventilator. When even maximal ventilator support couldn’t provide him with the oxygen he needed, I called his wife and told her I didn’t think he would make it. She broke down on the phone and asked if we could arrange a call for their 9-year-old son to say goodbye to his dad.
I made eight similar phone calls that day.
Having many patients who require a lot of oxygen congregated in specific areas of the hospital froze some of the oxygen supply lines. Who knew? So backup oxygen tanks must be delivered to every Covid-19 floor when the oxygen flow drops below what is needed.
While the hospital has plenty of ventilators to meet the growing number of people who need them, there aren’t always enough qualified physicians available to perform the delicate intubation procedure needed to connect a patient to the machine. It’s easy to go online and look at hospital or ICU capacity statistics and see that open beds are available. But those numbers don’t account for the health care workers needed to care for the patients in those beds. An ICU bed cannot save a life. It takes a team of doctors, nurses, respiratory therapists, pharmacists, environmental services workers, and others. And we are stretched too thin.
All of us have been showing up for 18 months, caring for people with this disease, risking our health and risking exposing our families to it. We’re exhausted, physically and emotionally. We’re traumatized by the phone calls we must make telling families their loved one isn’t going to make it.
For me, the most devastating part of this surge is that it didn’t have to happen. The hope that I and other health care workers felt when Covid-19 vaccines arrived was real. Vaccines have since become easy to get — at the corner pharmacy, pop-up vaccination center, on the job, and elsewhere — which makes it unfathomable that nearly all of my current Covid-19 patients haven’t been vaccinated.
Vaccines save lives and reduce the risk of serious illness and hospitalization. In the face of this surge of Covid-19-related hospitalizations and deaths, I can’t understand why some people still don’t want to get vaccinated against a virus that is killing their family members, friends, and neighbors. Their decisions have pushed the health care system, and me and my colleagues who will care for them when they get Covid-19, to the breaking point.
Jennifer Caputo-Seidler is a hospitalist on the Covid-19 unit at Tampa General Hospital and an assistant professor of medicine at the University of South Florida.