A resurgence in COVID-19 cases is testing the endurance of health care workers who care for the sickest patients, most of whom are unvaccinated.



The latest surge in COVID-19 cases in the U.S. is testing the endurance of health care workers.

NGUYET NGUYEN: You feel like, what am I doing here, where I'm working as hard as I can, and still all of these people are dying?

KELLY: NPR's Jon Hamilton spoke with two critical care doctors at Washington University in St. Louis. Both of them have spent nearly two years now caring for the sickest COVID patients.

JON HAMILTON, BYLINE: Dr. Nguyet Nguyen remembers when COVID first arrived in the intensive care units at Barnes-Jewish Hospital in St. Louis.

NGUYEN: In the early days, we were all very scared because we had no idea what this was.

HAMILTON: Nguyen's colleague, Dr. Tiffany Osborn, says fear was a rational response to this new and deadly disease.

TIFFANY OSBORN: We didn't know how to prevent it, and we didn't know how to treat it. And there were a lot of concerns that many of us had about, can we bring this home to our family?

HAMILTON: So Osborn moved into an RV parked outside her house. She accepted that, but not the way she felt when so many of her patients died. Often, the best Osborn could do was make sure a dying patient's family got to say goodbye over the phone. One of those calls from the ICU still haunts her.

OSBORN: As I turned to leave, you know, I hear this voice come over the phone, this small voice that says, I love you, Grandpa. And all I could do was close the door behind me as I left. You know, it's a very helpless feeling.

HAMILTON: When vaccines began to arrive in late 2020, though, Osborn saw reason for hope.

OSBORN: When you got that vaccine, it was like you could feel the pressure coming off of your shoulders.

HAMILTON: Health care workers could finally protect themselves. And it looked like widespread vaccination would transform the river of critically-ill patients into a trickle. Fast-forward a year, and Dr. Nguyet Nguyen says that hasn't happened.

NGUYEN: Most of the people who come to the ICU are still unvaccinated, and they did not have to be where they ended up being. So it's very frustrating for us to deal with that on a day-to-day basis.

HAMILTON: Nguyen says it's been hard on intensive care nurses and respiratory therapists who provide most of the hands-on care in the ICU. Many have retired early or switched jobs. Nguyen says she understands why.

NGUYEN: We're used to dealing with death, but not at the level that we saw with COVID. And people who are so young and people who - they didn't have to die.

HAMILTON: Osborn says ICU teams are still having to put otherwise healthy, young COVID patients on the last-ditch life-support machines known as ECMO.

OSBORN: We have capacity for around 12 ECMO machines. During our last surge, half of them, at one point, were pregnant women.

HAMILTON: Unvaccinated pregnant women. Nguyen says she wishes that people who still haven't been vaccinated knew more about what happens to COVID patients in an ICU.

NGUYEN: I don't think people understand that for a certain, very unlucky population, COVID is going to kill you, and it's going to kill you a lot faster than you think.

HAMILTON: Nguyen says that for many weary health care professionals, each new wave of COVID-19 has been like a punch in the face.

NGUYEN: So we felt like we were dealing with delta. At least in Missouri, we felt like - that we were over the peak of delta. And then omicron comes rolling in and just knocks everybody down again.

HAMILTON: ICU teams are better prepared than they were at the beginning of the pandemic. They've learned what works to keep COVID patients alive, and there are new drugs arriving that promise to reduce the severity of infections. But Osborn says the nation needs to focus on prevention rather than counting on treatment.

OSBORN: This holiday season is really all about those interactions with the people that we care so much about. And you don't want it to have to be from a hospital bed, with me holding up a telephone so you can talk with your family.

HAMILTON: Jon Hamilton, NPR News.