A year after vaccines arrived, surge of COVID cases triggers more of the tough phone calls
A guy on five is crashing. He’s being rushed upstairs in a bed to the intensive care unit at AHN Forbes Hospital in Monroeville, where 11 of 20 patients are all suffering from the same disease. ¶ Oxygen hisses under the man’s mask. Doctors and nurses crowd around the patient in the intensive care unit, where he is quickly sedated and connected to a breathing machine in what may be his last conscious moments. ¶ COVID-19 is killing him.
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Medical staff looks over the chest x-ray of a patient being treated for COVID-19 in the intensive care unit at Forbes Hospital in Monroeville. (Alexandra Wimley/Post-Gazette)
“He’s pretty sick right now,” a nurse tells a family member on the phone, a sliding glass door away from the medical team working in a hurried ballet. “We’re giving him all the support we can. We had to move him to the ICU. Is all that OK with you?”
A year ago, when the COVID-19 pandemic was still adolescent, the biggest fears were for people in their 60s and 70s and older. Vaccines went first to nursing homes.
But nearly two years in, the pandemic has shown that no one is immune. The critically ill patient at AHN Forbes is in his mid-40s and otherwise healthy.
He is not vaccinated.
He is also not the youngest COVID-19 patient in the ICU on that day: A few doors away is a woman in her early 30s. Across the hall is a man a few years older.
Neither of those patients is vaccinated; neither is getting better.
It’s two weeks before Christmas, and AHN Forbes opens another 17-bed unit to absorb a crush of COVID-19 patients as the hospital bulges with the highest number of patients infected with the coronavirus in Allegheny Health Network’s 14-hospital system. In that moment, Forbes has 58 COVID-19 patients, with a handful more in the emergency room waiting for beds.
It wasn’t always like this. A year ago, there was hope. There was a new vaccine promising a return to eating at restaurants, drinks with friends and summer vacations without masks.
Hope went away as the year wore on, said AHN Forbes Hospital Director of Nursing Jill Direnzo, who is 34 years old. COVID-19 cases spiked again and then again in the year since, as patients coming through the hospital doors turned younger and sicker — and as death came faster for many of them.
“Everybody was so excited,” Ms. Direnzo recalled. “We have a vaccine; it’s going to get better. Maybe we’re coming to an end; and we’re not. It’s still going. There’s no end here.”
Two years of a grinding COVID-19 pandemic has exhausted nurses and doctors and pushed hospitals to the limit. Nationwide staffing shortages have grown acute, even as doctors became smarter about treating the virus. Overburdened rural hospitals, like the 10-bed Bradford Regional Medical Center in McKean County, were forced to close admissions in the fall and divert COVID-19 patients to other facilities while seeking state Health Department approval to add beds.
The only constants for caregivers are workweeks that bleed into each other and the stream of people — hacking, short of breath, scared — outside hospital doors.
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Emma McLain, of Verona, waits in the emergency department waiting room for treatment of persistent COVID-19 symptoms after having the disease in mid-November. (Alexandra Wimley/Post-Gazette)
“It’s terrible,” Verona resident Emma McLain, 56, said as she struggled to catch her breath in AHN Forbes’ emergency waiting room. “I just want to get better.”
Ms. McLain, a care manager at a health insurer, was diagnosed with COVID-19 in late November. She’d gotten her second vaccine shot but hadn’t yet received a booster.
She canceled her Thanksgiving plans, stayed home and tried to get better. But by mid-December, she needed help.
“It was just getting worse. None of the over-the-counters were helping,” she said. “This is the last resort.”
Also at the hospital doors is COVID-19’s highly contagious omicron variant, still mostly just a bad dream in Pittsburgh in the weeks before a snowless Christmas. But omicron cases, which have been doubling in number every two to three days elsewhere in the world, threaten to stagger U.S. hospitals. Even if the strain causes less serious disease than earlier variants as early reports suggest, because so many more people will get sick, doctors worry that hospitals will again be flooded.
“It will overwhelm us,” AHN Forbes Hospital President Dr. Mark A. Rubino said. “We don’t see the light at the end of the tunnel.”