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caption: Nurses on the Covid ICU at UW Medicine tend to a patient on April 24, 2020, in Seattle. The patient, a woman from eastern Washington, regaled them with her story of the infamously painful nasal swab for the Covid-19 test.
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Nurses on the Covid ICU at UW Medicine tend to a patient on April 24, 2020, in Seattle. The patient, a woman from eastern Washington, regaled them with her story of the infamously painful nasal swab for the Covid-19 test.
Credit: KUOW Photo/Isolde Raftery

Health care workers are tired, frustrated with Covid complacency as cases surge

With coronavirus cases skyrocketing across Washington state, Governor Jay Inslee has issued new business restrictions for the next four weeks, mostly halting non-essential indoor services.

Officials worry that a third, rapidly surging coronavirus wave stands to overburden hospitals and keep people from accessing routine medical care.

Cassie Sauer is the President and CEO of the Washington State Hospital Association. She's helping hospitals get prepared for a potential surge of patients.

This interview has been edited for clarity.

The biggest challenge is qualified staff — people who can work in the intensive care units and critical care units taking care of the sickest patients. Our staff are exhausted. I think that's a really important thing for listeners to hear.

We've had so many statements of support for frontline health care workers. The most important thing you can do to support your frontline health care workers is to not get sick, so you don't need their care.

By staying home, canceling your Thanksgiving plans — that is a strongest statement of support, strongest action of support you can do for your frontline health care workers.

[Hospitals now] are better prepared, because we can see it coming. We were the first state that got hit by Covid, so we were really surprised by it. Trying to react in the midst of a crisis was challenging. A lot of planning has gone into place. With that said, staff are also tired — I think that's really important.

I think that makes the staff so frustrated: To feel like they're having to put themselves at risk to take care of patients because people wanted to have a social gathering that they could have skipped.

The frustration level that staff feel when they have to care for a whole family who got sick because they had a football party, or we have an outbreak that's related to a gender reveal party ... which made me think, were the grandparents there? Are the grandparents sick now?

I think that makes the staff so frustrated: To feel like they're having to put themselves at risk to take care of patients because people wanted to have a social gathering that they could have skipped.

The first thing [I'm hearing from front line health care workers] is this sense of, why is the public not listening to these very science-based messages about no indoor, unmasked social gatherings with people who are not in your immediate household? So that sense of real frustration about that, and very much wishing people would do that.

The second is, I feel like we've gotten a little complacent about Covid because people are getting better, the treatments have gotten better. But there's still a lot of people who die from it, and they essentially are suffocating. So you've got staff who are watching people die alone, because most of their family members can't be there, because of the contagion issue, and watching them suffocate to death. It's terrible — it's truly terrible.

Having people die from a disease that the staff feel could have been prevented, having to watch them die, and hold their hand while they die, while they're alone, is really challenging.

I want people to not think “Oh, if I get Covid it's no big deal — I'll just get over it.” Mostly people do, but a lot of people don't. Having people die from a disease that the staff feel could have been prevented, having to watch them die, and hold their hand while they die, while they're alone, is really challenging.

Is there a standard treatment for people who enter the hospital with Covid?

Yes, the treatment has gotten quite a lot better. Some of the drugs that are available, remdesivir for example, has been very effective in treating people who are just entering the hospital to keep them from getting really sick.

Use of oxygen has improved quite a lot, and better understanding about how to use a ventilator, including putting people in the prone position, which essentially means putting them on their stomach when they're on a ventilator. There are a lot of advances in treatment.

But again, I worry about that question too, because there are more people surviving who are hospitalized, for sure. And also, there are still a lot of people dying. And those who survive, many of them have ongoing, serious health conditions.

I worry that people hear, “Oh, treatment's gotten better. If I get it, I'll just get treated, I'll be fine.” You might not be fine. I don't want people to be blasé about "If I get this, it'll be okay."

They're still tired, they may continue to have shortness of breath, a lot of weakness, headaches — just things none of us want. I worry that people hear, “Oh, treatment's gotten better. If I get it, I'll just get treated, I'll be fine.” You might not be fine. I don't want people to be blasé about "If I get this, it'll be okay."

There are definitely things that we are continuing to work on with the state. A big one is helping to move patients out of the hospital who no longer need hospital care. These are often patients who are part of the Department of Social and Health Services system, or Medicaid enrollees who essentially get stuck in the hospital with no place to go. A very strong investment in that would be really worthwhile.

We would like there to be more domestic production of personal protective equipment. We are too reliant on international production. The main producers of personal protective equipment are India and China. As they need the equipment for their own care, they're keeping more of it, which makes sense. I think we need to have the ability to be much more [self] reliant.

Finally, I would like there to be a national mask mandate. I know it's unclear whether the president has the ability to do that, but I would very much like for the current administration to be asking, especially the Republican governors that have not instituted a state mandate, to do so.

We are receiving patients from Idaho, Montana, Wyoming, for example. It's frustrating to care for patients from states where they're not doing the right thing, but our health care workers have to be put at risk.

The possibility that two weeks after Thanksgiving we could have an explosion of cases is truly terrifying.

There's a lot that's keeping me up at night right now. I think what's keeping me up at night the most is wondering, what it will take to get people to follow the rules, to follow the science? Thanksgiving is really keeping me up at night. I am not thankful for Thanksgiving right now.

We are hearing too much of a sense of “Thanksgiving is a break day.” People saying, “I've been following the rules, for eight months, but I'm not giving up my Thanksgiving.” The possibility that two weeks after Thanksgiving we could have an explosion of cases is truly terrifying.

Listen to the interview by clicking the play button above.