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December 17, 2020

“This Level of Death, It’s New”—Health Care Workers in Their Own Words

Author Affiliations
  • 1Bloomberg School of Public Health, Johns Hopkins University, Baltimore, Maryland
JAMA Health Forum. 2020;1(12):e201551. doi:10.1001/jamahealthforum.2020.1551

The surge in hospitalizations for coronavirus disease 2019 (COVID-19) around the country has led many physicians and other health care workers to speak out. We created this post directly from the recent words of frontline health care workers and medical administrators in 19 states, with the sources linked to the first word or two of each quote. Their words reflect an unprecedented time for the US health care community in the midst of the pandemic.

This level of death, it’s new. It’s different” (Nashville, Tennessee). “I have seen so many emergent intubations. We’re taking care of very, very sick patients and our patient load just keeps going up” (Omaha, Nebraska). “I’ve done more CPR and seen more people die in the last 2 weeks than I have in my entire career combined” (El Paso, Texas).

We are tired of our beds filling up. We are tired of watching people die. We are also tired of hearing family members say, ‘Isn’t there anything else you can do?’ and for us to say ‘no’” (Colorado Springs, Colorado). “I’ve put an ungodly amount of people in body bags that I was not prepared to do, that I was not prepared to give up on a patient, but there was nothing else we could do and we lost them” (Kingsport, Tennessee).

The beds that we had created for our COVID units, we’ve had to take away non-COVID beds” (Mishawaka, Indiana). “When we talk about limiting surgeries, it’s not like we’re talking about minor things” (Tacoma, Washington). “Strokes are still going to happen, heart attacks are still going to happen, cancer is still going to happen … There’s no one to send help” (Beaver Dam, Wisconsin). “You can’t overwhelm a hospital and expect that care is not going to be compromised as a result” (Yuma, Arizona).

I wish people understood how hard this is on health care workers” (Beaver Dam, Wisconsin). “It can be emotionally exhausting to give so much to your patients and they’re still dying at such a high rate” (Columbus, Ohio).

I’m terrified. It’s engulfing my entire waking moments” (Frederick, Maryland). “I cry a lot” (Kingsport, Tennessee). “We are depressed, disheartened and tired to the bone” (Johnson City, Tennessee). “I find myself telling everyone that others are going through this, you are not weak” (Towson, Maryland).

I’ve had to face down the fear of being exposed without proper [personal protective equipment], and have almost daily conversations with coworkers who go to work every day fearful that this is the day they’ll get sick and take COVID home to their families” (Seattle, Washington).

To protect yourself, you just shut down. You get to the point when you realize that you’ve become a machine … There’s only so many bags you can zip (Altoona, Iowa). “It’s demoralizing and exhausting” (Chicago, Illinois).

Many of you cheered and rang bells and put up signs calling us heroes, and we’re so grateful for that” (Portland, Oregon). “… by fall people are questioning what we’re trying to say” (El Paso, Texas). “Nobody’s clapping anymore” (St Louis, Missouri). “I guess people are tired of being alone or in their homes and want to get out and be social again” (Kingsport, Tennessee).

It’s as if we live in two separate worlds. There’s the world inside the hospital where we see patients coming in gasping for breath, their lungs full of infection, and then there’s the world we see outside of the hospital with people not wearing masks, eating out in restaurants, partying …” (Nashville, Tennessee).

It is so disheartening and demoralizing to leave work and just not see it, to see people gathering and talking about their travel plans, to see people waiting in a line outside a bar to get in when you’re driving home after a horrible day. It’s so upsetting” (Columbia, Missouri).

I do this day in and day out and people are out there doing the wrong thing. People are out there in bars, restaurants, malls—it is crazy—it’s like we work, work, work, work, work and people don’t listen and then they end up in my ICU” (Houston, Texas).

You see on social media people kind of mocking or saying it’s not very serious or comparing it to the flu but, you know, they don’t see what we see every day. They’re not holding the hands of dying people whose family can’t get to them” (Greensboro, North Carolina). “It’s so disheartening to feel that leaders in our government don’t have our backs” (Salt Lake City, Utah). “It kind of feels like we’re just, you know, yelling into the abyss” (Topeka, Kansas).

We here, at the hospital, are no longer the frontlines. We’re the last line of defense” (Columbus, Ohio).

We need community support right now” (Mt Vernon, Ohio). “Right now, we’re asking you to be our heroes and to listen to our call for help again” (Portland, Oregon). “Keep your social distance; wear your mask; wash your hands and avoid going to places where there are a lot of people” (Houston, Texas).

We cannot do this without you” (Hamilton, Montana). “This is the time to double down, not to give up” (Providence, Rhode Island). “If you could just stop one case by wearing a mask or staying home when you didn’t have to go out, it would help us so much … If everybody did that for one person, I think we could stop this” (Kingsport, Tennessee). “They seem like minuscule tasks, but to us they could make the greatest difference” (Marysville, Ohio). “If people can do that, healthcare workers like me will be able to—hopefully rest” (Houston, Texas).

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Article Information

Open Access: This is an open access article distributed under the terms of the CC-BY License.

Corresponding Author: Joshua M. Sharfstein, MD, Bloomberg School of Public Health, Johns Hopkins University, 615 N Wolfe St, Room W1033D, Baltimore, MD 21205 (joshua.sharfstein@jhu.edu).

Conflict of Interest Disclosures: None reported.

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    2 Comments for this article
    The Pain of COVID
    Lisa Simpson, MB, BCh, MPH | AcademyHealth
    Thank you Ms. Veira and Dr. Sharfstein for posting these harrowing voices. This is the pain of COVID. This is the tragedy of our nation, of so many missteps, of the decades-long starvation of public health, of the undermining of trust in our institutions and science.

    To paraphrase Kerr White: "statistics are the faces of people with the tears wiped away." These voices reveal just some of the tears of 310,806 deaths. It has been said that each death affects at least 9 individuals. I think they reach much further - each of us is connected to our
    family and friends and our work colleagues. Each death is a familiar face we no longer casually greet in passing at our local store, the waiter at our favorite restaurant, the cheerful owner of our local dry cleaners (though I have not used one for months).

    I believe we in healthcare can do a better job of effectively communicating evidence and driving healthy choices. Telling the personal stories of COVID is part of that strategy.

    In closing, I am reminded of Jonathan Dunn:

    'Any man’s death diminishes me, because I am involved in Mankind. And therefore never send to know for whom the bell tolls: It tolls for thee'.

    In sadness and deep gratitude to every single healthcare worker,

    Lisa Simpson
    Kenneth Best |
    Excellent article that needs to get into the hands of journalists how. While it's great to share this within the medical community, that's preaching to the choir. Everyone else needs to hear this!