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The View From A Seattle Emergency Room As COVID-19 Cases Level Off


The doctors didn't have enough masks, so they held their breath when walking past patients with COVID-19. That's what Seattle emergency room doctor Sachita Shah told me when I spoke with her last month. Since then, the rate of new cases in Washington state appears to have leveled off, so we decided to check back in with Dr. Shah today. And I started by asking her what a leveling off felt like in her hospital.

SACHITA SHAH: What we've seen is that the sheer numbers of patients coming into the emergency department have actually remained the same, but they're sicker. The ones that are coming in are much sicker. They're needing to be admitted at a higher rate. They're needing to be admitted to the intensive care unit at a higher rate.

SHAPIRO: So if you're getting the same number of patients but they're much sicker, what does that mean for your experience and your limited medical supplies, what you're having to do on a daily basis at the hospital?

SHAH: We are approaching pretty much every patient wearing all of the protective gear. We have a general sense of how much care we're using, and the hospital has been pretty good about sorting it out and getting us resupplies when we need them. What we're falling short of is drugs to keep these patients sedated while they have the breathing tube in. So there's been severe shortages of a lot of those sedative drugs, and then the intubation drugs, as well as the swabs we use to check them for flu and check them for coronavirus. So...

SHAPIRO: How are you and your colleagues holding up? You've been on the front lines now for nearly two months seeing things that I'm sure you've never seen in your medical career before.

SHAH: A lot of us just feel really helpless, and that's been a sentiment that I have seen from a lot of my colleagues around the country as well as I feel myself. There's only so much we can do for COVID patients. We don't have a quick fix. And, you know, we've been experimenting with positioning the patient differently, like, flipping them over on their belly to help them breathe better. And we don't have a pill or a cure. We just have to help support them to have their bodies do what they need to do.

SHAPIRO: It's interesting to me that when I ask how you're doing after two months of this, you say you're frustrated that you can't do enough to help your patients, whereas I think other people would say I'm overwhelmed, I'm exhausted, I'm traumatized. Like, you're not even speaking about your own experience. You're still thinking from the patient's perspective.

SHAH: Yeah. I think in emergency medicine and through the training, we get really good at taking our own feelings and putting them in a box to tend to later. Like, we have to run from sick patient or dying patient to other sick patient and dying patient. And then at the end of the day, we can talk to our colleagues and take all those feelings out.

I mean, it's been pretty heartbreaking to watch this virus tear through families. Like, I had a set of brothers just in a curtained room next to each other glancing over at each other huffing and puffing and, you know, one of them much sicker than the other but both needing intensive care. And it's just heartbreaking to think of their family at home and what it must be like for them knowing how sick they are but also their family member that's right there.

SHAPIRO: I know you're taking a break for a couple of days to be home with your kids and your family. How does that feel right now?

SHAH: Glorious. I even forgot that coronavirus existed for a couple of hours.

SHAPIRO: (Laughter) Until we called.

SHAH: (Laughter) Until you made me talk about it. Yeah, no, it's been really nice to just be home with the kids. The kids help me forget about everything that's going on, but it comes out in their drawings and in their stories, too. So...

SHAPIRO: Like what?

SHAH: Well, last year, I asked them what they were most afraid of. And one of them said being eaten. And I was like, by, like, a bear? And they're like, yes, by a bear. And the other one said bears. And this year I asked what they were most afraid of, and they said getting coronavirus or you dying of coronavirus. So it's definitely on their minds.

SHAPIRO: Do they think of their mom as a hero? Do they understand the work you're doing on the front lines?

SHAH: They do. They understand. I think - they're still little, so they wish I could just stay home with them. But I hope when they're older they'll look back and recognize that it was important for me to leave them and go to work. And...


SHAH: ...Yeah.

SHAPIRO: State officials in Washington are talking about how to reopen the economy now. Do you think Seattle is ready for that?

SHAH: Oh, I would really hope they go easy on us. We're just getting a handle on being able to take care of the numbers and the types of patients that are coming in. And I know the economy is suffering everywhere, but I think we've had the success in Seattle that we did because a few large companies decided to have all of their employees work from home even before the state guidelines were there. I think that those decisions really did save lives. It's really helped to have less patients and have enough medicines and enough PPE to keep us safe.

SHAPIRO: Dr. Sachita Shah, thank you for the work you're doing and for talking to us about it.

SHAH: Thank you. Transcript provided by NPR, Copyright NPR.