As COVID-19 Inundates Hospitals, Staff Is 'Emotionally Pulverized'

NPR's Mary Louise talk with Dr. Aharon Sareli of Memorial Healthcare System in Florida and Dr. Adriano Goffi of Altus Lumberton Hospital in Texas about how COVID-19 surges are affecting their staffs.

Transcript

MARY LOUISE KELLY, HOST:

Some businesses make it obvious when they're maxed out - the shuttered box office window with sold out pasted across it or that no vacancy sign lit up on a motel. Well, from the outside, you would have no way of knowing the intensive care units at Memorial Health Care System in south Florida are full; inside, different story. They are beyond full with COVID patients, overwhelmingly unvaccinated ones.

AHARON SARELI: We've converted conference rooms and cafeterias, offices, ultrasound rooms into units that house patients with beds and monitors.

KELLY: That's Dr. Aharon Sareli, chief of critical care. Over in Texas, Dr. Adriano Goffi is in a similar bind. He is the medical director for Altus Lumberton Hospital.

ADRIANO GOFFI: Non-COVID patients in a hallway. Our triage room has effectively become multiple bed patients that we're using for non-COVID patients because we can't mix them.

KELLY: It's a rural hospital with an emergency room but no ICU. In normal times, serious cases get transferred to bigger hospitals. But right now those ICUs are full, too.

GOFFI: We have to continue to keep getting more and more creative. And also the staffing - our own nurses are developing COVID symptoms, vaccinated or not. They pop positive, and they are out of the system for a few days. So even these areas that we're able to provide an open - sometimes we have to close them down.

KELLY: We brought these doctors together to try to glimpse what is happening behind closed doors at hospitals in two states where the health care system is at the breaking point.

Dr. Goffi, when you're treating a COVID patient who needs the ICU, who needs a ventilator and you're calling and no ICU will take them, what is that conversation? Your nurses are calling hospitals all day, trying to find a bed. And they say what?

GOFFI: Well, so we did not have a way to have, like, a waiting list. So we had to hire - we average around five secretaries calling hospital by hospital by hospital and even calling the same ones. It's almost like you just get lucky that a bed opened up and you were on the phone with them. And we're calling thousands of places a day. We've literally air flown somebody from Lumberton to North Dakota to Tennessee just because those were the only beds available.

KELLY: Have you had people die while waiting?

GOFFI: Yes, we have. It's very difficult, and it takes a big toll on us, even my family here because you come home and there's no way not to take that home.

SARELI: Yeah. I think that's such an important point. The amount of death that healthcare professionals are seeing on a daily basis is so many orders of magnitude higher than anything we could have ever imagined. Working in critical care, we deal with death on a regular basis but not in these quantities and not this regularly. And the staff has just been emotionally pulverized is the only way that I can describe it.

KELLY: Emotionally pulverized. Yeah. Dr. Goffi.

GOFFI: I think that's one of the best ways to put it. And, you know, the other part, the other component that really is difficult for us as physicians is as we're caring for these patients - you know, there's the other side, which - these are mostly unvaccinated. You have a lot of vaccinated individuals come into my emergency room, for instance. And they're non-COVID-related issues such as a heart attack.

KELLY: I was going to ask.

GOFFI: And...

KELLY: What does all this mean? If I have a heart attack and I need to come to your hospital for urgent care and...

GOFFI: Exactly. And that's...

KELLY: ...There's huge - yeah, please.

GOFFI: And it's very difficult for us as physicians because we have a certain amount of things that we pride ourselves in the United States of being able to do. You come in with a heart attack, and we can get you the treatment that's lifesaving within 90 minutes. Now they're waiting three, four or five days. And it's not just the heart attack patients. It's cancer patients that need a biopsy. And I think that's very important to understand that people need to get vaccinated also to prevent others from having serious complications of other illnesses.

KELLY: Is there a discussion underway at either of your hospitals over prioritizing, over, if resources are finite, who deserves the bed?

SARELI: Yeah. I think that is a discussion that no physician in a first world country ever wants to be part of. We are committed to providing care to both our COVID populations and non-COVID populations. And as physicians, we are always going to do the best that we can with the resources at hand. But there's no question that in modern history, health care system in south Florida and, I'm sure, in the rest of the country has never been under so much pressure for such a long period of time.

Our society and all of us have our part to play. And we all have to get vaccinated because as you said, there is an impact not only on the people that have COVID but on every one of us. Every one of us is going to need health care at some point in our lives. And having the system so overburdened, we are going to pay the price. And we are paying the price.

KELLY: Both of you have mentioned the vast majority of the COVID cases coming in are unvaccinated people. What are those conversations like when you see somebody come in, they need urgent care, it's critical and you think, this was so preventable?

SARELI: You know, the only real word that comes to mind is tragic. It is an absolute tragic conversation to have with patients before they get intubated when you know it's too late, when you know that they've missed that opportunity not to have had their lives devastated by this virus. And you know that when they land up on mechanical ventilation, the overwhelming chances are that they're going to die. And we then have an intimate relationship with their family members. No one dies in the ICU from COVID in a short period of time. It takes weeks and months. Every day I speak to their families. I hear their kids in the background, and it's very hard to explain to someone who's not there the magnitude of the tragedy.

KELLY: Dr. Goffi.

GOFFI: This has probably been the most difficult part of my career. You're going through residency and seeing other areas of medicine like NICU, where there's some sad cases there. This one's really tough because I'm not upset with patients because a lot of it is the misinformation that Dr. Sareli is mentioning. It's getting information from all the wrong places. And I think that's the part that hurts the most - is that they feel that they're educated on this subject, and they're not because it's coming from Facebook or a variety of avenues that is just not real.

SARELI: Can I say one other thing? Can I share one other piece that we didn't get to today? You know, I just wanted to mention that one of the challenges of this last delta wave compared to the last summer, when we were hit by a massive surge as well, is that last summer everyone seemed to be in the battle against COVID together. It's almost like the world was holding its breath.

And I think one of the challenges with this surge is that if you're in the hospital, if you're a physician, if you're a health care giver or if you're a patient that is seriously ill or dying from COVID, you're in it and you're faced by what we've been talking about. But for the rest of the community, if you step outside of even Florida hospitals, life goes on. People are driving around. People are in the streets. People are going on about their lives. And I think that we've almost become numb as a community to what COVID is doing to those patients that chose not to become vaccinated and are now paying the price.

KELLY: We've been speaking with Dr. Aharon Sareli of Memorial Health Care in south Florida and Dr. Adriano Goffi of Altus Lumberton Hospital in Texas. Thanks to you both.

SARELI: Thank you very much.

GOFFI: Thank you.

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