As covid-19 patients fill hospitals, health-care workers fight fear and exhaustion: ‘Here we go again’
This intensive care unit went down to zero patients with covid-19. But once the delta variant hit, they've seen a return of patients with the virus. (Whitney Shefte/The Washington Post)
By Antonio Olivo and Rachel Chason
The man in his 60s could no longer breathe on his own, so the doctor, respiratory therapist and nurses worked together, snaking an oxygen tube into his windpipe. That day in late July marked the first time they had intubated a covid-19 patient in weeks.
As they did so, the medical professionals exchanged silent looks: They knew what they were seeing was the beginning of a third surge of coronavirus patients in the Washington region.
“It was surreal,” said Kanak Patel, the director of critical care medicine at Luminis Health Doctors Community Medical Center in Lanham, Md. “We all knew: Here we go again.”
Nearly two months later, the surge continues, driven by the highly transmissible delta variant and affecting mostly unvaccinated people, including the man that staff at Doctors intubated that day.
Health-care workers say in some ways, this phase has been the hardest yet.
Earlier this summer, it looked like the widespread availability of vaccines might mean the coronavirus pandemic was behind them. Now, those on health-care’s front lines share a hardening view toward the delta variant’s biggest target: the willingly unprotected.
The workers are baffled over how, after so much pain and death, there is still even a debate over whether to get vaccinated or wear a mask in public. Their patience is wearing thin, they say. And as they toil in stifling plastic protective gear, or glance down the growing lists of new patients to contact, exhaustion has settled in. Many have quit, Patel said, or are thinking about it.
“Empathy fatigue,” he said, “is a real thing.”
There have been more than 23,000 deaths in D.C., Maryland and Virginia since the first was reported on March 14, 2020. Health-care workers are now in their 19th month on the front lines. Here are some of their stories.
The vaccinator
Tiana Satchell, a nurse, worked at the Six Flags mass vaccination site in Prince George’s County, Md. (Michael Robinson Chavez/The Washington Post)
After months of putting coronavirus vaccine shots in arms, Tiana Satchell thought she had done her part to help end the pandemic.
Her time working at Six Flags America, Maryland’s largest vaccination site, had been the proudest of her nursing career.
“People wonder their whole lives whether they make a difference … now I feel like I have," Satchell told The Washington Post on July 10, the final day of operation at the theme park site in Prince George’s County.
Officials closed most of the state’s mass vaccination sites during the summer after realizing that waning demand meant they were no longer needed. But Satchell and the other Six Flags staff had focused on the positive during the closing days: More than 342,000 people vaccinated. It was the most of any site in Maryland.
When the final shot was administered, Satchell and the other nurses danced, cheered and snapped pictures.
“I thought we were good,” she said. “I was on cloud nine.”
A few weeks later, she was spending time with her daughter and infant granddaughter when she started seeing more news about the delta variant in the D.C. region.
She felt a sense of dread — and doubt.
Satchell, a contract nurse, had seen the pandemic from a few angles, including working in nursing homes filled with covid-19 patients during the first and second waves.
When she started working at Six Flags in April, she said she felt filled with purpose, especially when she was administering shots for children.
“I hope I can see my friends now,” she remembers them telling her. “I hope I can have a normal school year."
Satchell has been praying for those children recently, fearful their plans will be thwarted by the rising case numbers.
The group chats she has with fellow nurses, she said, have been blowing up lately with people frustrated by the rising case numbers asking the same question: “What is going on?”
The Paramedic
Virginia Beach EMS Captain Randy Rudder has seen the toll the delta variant has taken on front line health workers. (Whitney Shefte/The Washington Post)
It’s always the stifling plastic protective gear that Pete Gonzalez dreads when his Virginia Beach paramedic unit goes out on a call.
Twice now, he has been convinced that he was going into cardiac arrest under all that equipment, his body suffocating in the summer heat beneath a respirator, plastic cap, plastic gown and gloves, while helping to treat a patient they believed had covid-19. Gonzalez, 53, has lost nearly 60 pounds since the pandemic started, most of it water weight from sweating beneath the plastic.
Like his colleagues, Gonzalez can feel his patience wearing thin as hospital transports related to the disease skyrocket, while the number of people getting vaccinated in the city feels stagnant. Nearly 40 percent of the city’s 450,000 residents have yet to receive even one vaccine dose.
In late July, an average of one covid patient per day was being hospitalized in Virginia Beach, according to the state Health Department. Now, that figure is up to almost 14 per day. Meanwhile, 911 calls from houses with covid patients tripled between June and July, and then went up nearly 400 percent in August to 204. Meanwhile, 17 rescue workers at Virginia Beach’s Department of Emergency Medical Services have been infected, presumably while working, the department said.
“It can drive you crazy,” Gonzalez said.
He has been a paramedic since 2001. The years of experience have taught him to keep those feelings to himself while out on a call.
Gonzalez reminds his younger colleagues — and himself — that it’s their duty to treat whomever they encounter without judgment, be it heroin addicts, drunk drivers or the unvaccinated.
“Everyone is making their choice to do something that’s not wise,” Gonzalez said he tells his colleagues. “We’ve done this, so don’t let it take the wind out of your sails.”
The contact tracers
Kandace Haney, left, and Lauren Owensby work for the Loudoun County Health Department in Virginia. Haney is a contact tracer. Owensby is a case investigator. (Michael Robinson Chavez/The Washington Post)
The names of people to call are stacking up — hour after hour of conversations that need to be had to rein in what is now a full-blown coronavirus surge in Loudoun County, Va.
Lauren Owensby, a county case investigator working from her home, is back to putting in 55 to 60 hours a week after the early summer lull in cases that allowed her enough time off to travel with her family to Hawaii.
Now, she’s upstairs in her office into the evenings, offering a calm, reassuring voice to people who have recently tested positive for the coronavirus and are nervous and unsure about what to do next.
Ideally, those conversations would happen within 24 hours of the test result, so arrangements could be made for the person to isolate and so a contact tracer can alert those who were around them.
But many Washington-region health departments, such as Loudoun’s, cut back on their contact tracing staffs during the lull, thinking the slowdown would last. Now, Loudoun is averaging about 72 new cases per day, compared with one or two in early July, and the staff members who remain are at their limits.
“There aren’t enough hours in the day, to be honest,” Owensby said, during a recent break. “The overall feeling is disconcerting and overwhelming.”
Contact tracer Kandace Haney says people are mostly grateful to hear from her. She’s helped an anxious single mother find government aid to cover expenses while in quarantine and has patiently answered questions from children who may have been infected. Haney, who is legally blind, had difficulty finding work before the pandemic due to her condition — but contact tracing has been perfect for her.
Lately, there has been a rising drumbeat of worry in those conversations. Where Haney was just making a handful of calls per day in early July, she now talks to as many as 20 people every day.
The higher volume has made Haney feel more vulnerable, her world again diminishing. She went out often when cases were low, including a family trip to New York.
Now, she mostly stays home.
“For me, I feel that’s been the safest thing to do at this point,” she said. “I don’t want to get covid.”