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Surge Advice From 1 Of The Early Hospitals To Battle COVID-19

STEVE INSKEEP, HOST:

News of the vaccine is balanced by news of hospitals reaching their capacity. For some hospitals, it can feel like a return to the early days of the pandemic, and there may be lessons from those early days. Will Stone spent some time at Harborview Medical Center in Seattle, which was one of the first places to confront the outbreak in the United States.

WILL STONE, BYLINE: After a spring, summer and fall on the COVID ICU, Roseate Scott knows what to expect when she heads into a patient's room. The routine of cinching her plastic gown, of pulling the white hood over her long black hair, of securing the awkward hose hooked up to her waist. But Scott says some parts of the job are never routine.

ROSEATE SCOTT: When they're on their belly, laying down with all the tubes and drains and all these extra lines hanging off of them, and it takes about four to five people to manually flip them over, you know. So things like that - it feels intense every time. It doesn't matter how many times you've done it.

STONE: Scott is a respiratory therapist at Harborview. It's the large public hospital run by the University of Washington. This ICU is more streamlined now. People know the right protocols after nearly a year of practice.

SCOTT: It's still busy and chaotic. There's a lot going on. There's constant in and out of the rooms. But I would say it's a lot more controlled.

STONE: Back in the spring, the hospital was busy with COVID patients, but Scott says it never got as bad as somewhere like New York City. But now Washington state is seeing more cases than ever before, and ICU beds are already growing scarce.

SCOTT: That's the fear I have personally - is overwhelming the resources, using up all the staff, and the numbers are still going to go up.

STONE: This apprehension lingers on the edge of most conversations in this hospital wing. ICU nurse Whisty Taylor remembers treating patients in April when the virus was so new and scary.

WHISTY TAYLOR: One of our nurses came in and was sick and was intubated on our floor. That's really when it hit - that could be any of us.

STONE: Luckily, that nurse survived, and Taylor says it helps that they know this disease better. But nursing itself hasn't quite felt the same.

TAYLOR: These people are in the rooms for months. The only interaction they have is with us, with mask, eyewear, plastic. And they're sedated.

STONE: COVID patients in the hospital are faring better these days. Some of that is treatment, knowing how to manage them. And there are a few drugs that can help. But...

RANDALL CURTIS: They're not magic bullets. People are not jumping out of bed and saying, great, I feel great; I'd like to go home now.

STONE: That's Dr. Randall Curtis, who's the attending physician here. He says other than some medications, like a steroid that improves survival slightly, doctors don't have many more tools than back in February.

CURTIS: The biggest difference is that we have a better sense of what to expect. We haven't had a, you know, great breakthrough.

STONE: However, the hospital has learned how to keep staff, even those who aren't involved in patient care, from getting infected at work. Stacy Van Essen, a nurse on the COVID floor, says in the spring surge, nurses were delegated all kinds of tasks.

STACY VAN ESSEN: We mopped the floors, and we took the laundry out and made the beds, plus taking care of people who are extremely, extremely sick.

STONE: That's not the case anymore, and it goes a long way in freeing up staff. But Vanessa Makarewicz, who's in charge of infection prevention and control, says some problems still haven't gone away.

VANESSA MAKAREWICZ: Our biggest obstacles continue to be our PPE. It's something that definitely keeps myself awake at night.

STONE: Standing next to Makarewicz is Dr. John Lynch, the associate medical director at the hospital.

JOHN LYNCH: We've learned an enormous amount.

STONE: But he says the counterweight to all of this experience is exhaustion.

LYNCH: This is a crisis that's been going on for almost a year. That's not the way humans are built to work. We're definitely feeling the strain here. And this is the very beginning, to be honest.

STONE: Lynch says during the first wave, Seattle was able to recruit nurses from all over to help. That's unlikely to happen this time around, with so many hospitals under pressure. Back on the COVID ICU, Taryn Escuriex, the nurse manager, says there's also all that emotional and physical exhaustion of caring for patients, and even the small ways to decompress are fraught.

TARYN ESCURIEX: All of the staff can't even really eat lunch together anymore because no one can be too close to one another without their masks on. And so just even debriefing about a case or the day with your co-workers has become difficult.

STONE: The hardest thing about this next surge, she says, is not knowing just how much worse it will get.

For NPR News, I'm Will Stone.

(SOUNDBITE OF SON'S "VERUM") Transcript provided by NPR, Copyright NPR.

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