From The Front Line: A Doctor's Perspective On The Pandemic
Colorado is currently experiencing the highest number of COVID-19 hospitalizations since the pandemic began. This is causing concern for state officials, who have warned we could exceed our hospital capacity this winter. We spoke with Dr. Jane Jenab, a physician working in Colorado and New Mexico, who has been dealing with the pandemic firsthand.
These interview highlights have been lightly edited for length and clarity.
Erin O’Toole: How would you describe the current conditions in hospitals across the Mountain West? What are you seeing?
Dr. Jane Jenab: We have seen an exponential growth in COVID-positive cases, which is translating into higher emergency room visits for COVID patients and higher hospitalizations. We are unfortunately anticipating that we're going to have an enormous surge of hospitalizations in the coming weeks and months, which very possibly will exceed the number of beds and or staff that we have available in order to care for COVID patients.
How does the current situation compare to what you saw back in March or April?
I think in March and April we were worried about the same thing, where there were a lot more unknowns at that time. We do know more about how to treat patients and we are seeing a decline in the percentage of deaths of hospitalized patients due to our further understanding of the virus. But I think back in March and April, we did a pretty good job of getting the word out, asking people to social distance and to stay home. And we were able, in a sense, to flatten that curve.
Unfortunately, the volumes that we're seeing now, the number of cases that we're seeing now, is far exceeding what we saw earlier. And it is not just in places like New York or Washington. It's now hit the Midwest. And we're seeing nationwide increases with a very serious concern because of, again, this exponential growth. We're seeing over 180,000 new positive cases in a day. And usually hospitalizations and deaths lag a few weeks behind the initial diagnosis. So we're anticipating we're going to see huge volumes hitting our health care systems.
Initially, you could see a curve and you could think about flattening that curve. Now it just looks like an upward trajectory. It doesn’t seem possible to flatten that.
That is my concern. I'm very worried that we may be beyond the ability to flatten this and we're simply going to be overwhelmed with cases. I think part of that is that people are experiencing something that we're calling COVID fatigue, which is that they're tired of this. They're tired of not being able to resume normal life. They're tired of not being able to see their loved ones. They're tired of not being able to go to a movie or go to dinner with friends and family.
And we're also seeing, unfortunately, a large percentage of the population who is still thinking that this is in some way a hoax, and are not believing that masks can help slow the spread of something that they don't believe in in the first place. So we're seeing a dichotomy between people who are really trying to do the right thing, trying to be safe, thinking of their fellow Americans — and folks who are simply refusing to do the simple things that could potentially slow this down.
I'm curious about frontline health care workers who themselves have underlying conditions like asthma or diabetes. They would be at higher risk for potentially contracting a more serious case of COVID-19 themselves. How does this impact their work?
I'm actually one of those people. I have asthma and I'm overweight, so I am in a higher risk category. You know, it varies from person to person. In places where accommodations can be made, some people who are at higher risk are doing more clerical work and not doing as much direct patient contact. Some people have simply quit health care altogether. Some people, like myself, are still working in high-risk areas and feeling almost as if we're playing a game of Russian roulette, where we don't really know when we're going to get it. But the odds are that at some point we are going to get it. And potentially it could be life-threatening.
It depends on your comfort with risk and, you know — some of us feel that we have an obligation to be there. Unfortunately, we're seeing health care workers fall. We're seeing deaths every week of E.R. physicians and other doctors, nurses, respiratory therapists, techs, EMTs, medics. It is heartbreaking to watch these people who have dedicated their lives to health care fall, die, in the care of others. And these are not people that are easily replaced. These are folks who have spent years and often decades learning about health care and honing their skills to take care of people. And once they're out of the equation, that is a huge loss to the nation, to our ability to care for our fellow Americans. Those folks are essentially irreplaceable.
Back in March you spoke with our colleague, Leigh Paterson, about concerns with hospitals getting enough personal protective equipment to keep health care workers safe. Is that a concern now?
You know, you would think that almost a year out from knowing about this virus, that we would have kicked things into high gear from a production standpoint and we would make sure that every health care worker in the U.S. has sufficient PPE. And unfortunately, that's just not the case.
I'm still talking to friends and colleagues who are given one N95 mask to use for two weeks. This is supposed to be a one-time use mask when you are exposed to somebody who potentially has an infectious disease like COVID-19 — and these folks are asked to wear it over and over and over and over again. And we know that the mask does not work as well as it should when it is reused. It's an enormous source of frustration for health care workers.
And no matter how many times we raise the alarm, not only about PPE, but about simple things that people can do to help to slow the spread of COVID, it seems like folks are not listening. It's like screaming into the void.
What about staffing? Is there a concern that hospitals in our area might not have enough staff to support patient need?
Very, very, very concerning. We were in a nursing shortage nationwide already before COVID hit. And now that COVID is here, not only do we have, again, folks who have had to leave the workforce, either because they have gotten ill or because they have family members that have gotten ill and they need to leave to take care of them, or they have small children at home and they need to be there to help with schooling. But we have this surge in patients and it doesn't matter how many hospital beds you have, if you don't have the staff who know how to care for critically ill patients, then it doesn't matter if you have a bed.
So, we are in desperate need of nursing staff, respiratory therapists and physicians. You know, you talk to the nurses who are getting inundated with recruitment calls and emails offering them enormous amounts of money to go to places that are hit hard by COVID. If those nurses go there, then where they were working before is now down a nurse — and the volumes are surging across the country. There's just not enough staff to meet the need.
What do you want Coloradans to know right now about the virus, and the impact that it’s having on health care workers?
We are absolutely exhausted. We are going into work every day, risking our lives. Seeing volumes out of control, knowing that there were ways to control this and to slow it down and feeling profoundly demoralized by the fact that as a state, as a nation, we could be doing a lot more to keep each other safe and a lot of us are not doing that.
A lot of us are. A lot of us are not getting together for Thanksgiving. A lot of us are wearing our masks. A lot of us are avoiding public situations. But there is a huge percentage of people out there who are not, and we would beg you to make the small sacrifices that could make such a profound difference and could save so many lives, including the lives of people that you love.
This conversation is part of KUNC’s Colorado Edition for Nov. 18. You can find the full episode here.