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How health workers are getting through the day in the face of surging COVID cases


Hospitals and health care workers have been stretched to their limits by the omicron surge - staff falling sick, some patients waiting 20 hours to receive care and ongoing testing shortages. In this pandemic, the health care system seems to be carrying a burden it's never seen before. So we are joined by Dr. Daniel Buckland, who's going to give us a picture of what life is like for many health care workers today. He's an emergency physician at Duke University Hospital, and we reached him in Durham, N.C. Welcome, Dr. Buckland, and thank you for making time.

DANIEL BUCKLAND: Thank you for talking to me.

PFEIFFER: I think, by the way, that this is telling of what your work life is like these days because you had to reschedule our interview once because you needed to cover for a colleague. How regularly has that been happening at your hospital?

BUCKLAND: It's beyond just the colleagues being sick. Like you said, I needed to move this interview. And then in the time when we've talked and put this stuff together, my kids' school was cancelled. And so I had to leave in the middle of the day and go get them and bring them home. So hopefully, you will not hear them - because of - the teachers at their school needed time to go get PCR tests to be able to continue to teach and stuff like that. So among the - all the hospital staff, among the staffing things and all the things we mentioned, just, like, the thing that's affecting everybody else is also affecting us as health care workers. And it's just - I can't expect that the day is going to ever operate like I need it to do in order to do the stuff that we expect to be able to do.

PFEIFFER: Right - ripple effects throughout our lives in so many ways. How would you describe in general the impact of COVID on your hospital right now?

BUCKLAND: We are in this perfect storm right now. COVID cases are rising. And so even though the omicron effects may be less than before, there's just so many people who are getting it now that a small percentage of a giant number is just still a massive amount of people. And then people who've been delaying care for this entire pandemic - the effects of all those people needing that care that they can no longer delay are just also hitting the waves against the hospital. And the staff now also testing positive and unable to work means that the resources I thought I had available in the hospital as an emergency room doctor - I'm only able to function in the emergency department if people can be admitted to the hospital and there's beds available to admit them to. Otherwise, they stay in the emergency department. And so I'm doing a lot of my care out in the waiting room. And I spend a lot of my time apologizing for everyone's experience and frustration. And it's just miserable for everybody.

PFEIFFER: Right. We're really seeing that even if people aren't badly sick, if they're sick and they can't come to work, the consequences of that throughout the economy and the society and the hospital system is enormous.

BUCKLAND: Right. And sometimes, I will see them, like you said, 20 hours or 15 hours later. And so if you're like, well, I can't go back to work unless I'm sure I'm OK, I can't give you that answer now sometimes for - until the next day and - which now you've been stayed up all night in the waiting room. You're probably not going to work the next day. Or who is taking care of your kids that night? And stuff like that. It's just - everything's building on each other. And if you get the sense in my voice that I'm just frustrated and, like, defeated from that, that's true. It's just - it's so - I - it's hard to do this - just this general sense of, like, why isn't this working better? And I don't have an answer for them.

PFEIFFER: I almost feel like I hear futility in your voice. And I was going to ask you how you would describe your and your colleagues' states of mind at this point in the pandemic. And it sounds like it's not great.

BUCKLAND: It's not. I mean, it's not. So I talked to you guys near the beginning of the pandemic about similar things. And at that point, the sense was, OK, we - it's an education problem. We're all going to come together, and we're all going to get through that. And so even though the - like, the clinical questions right now are better - we know how to treat COVID. We know what to do. We no longer have that sense of, it will get better, right? We think it's going to continue to evolve and change, but that, like, light at the end of the tunnel - like, we see that light. It's going to get better if we're - all work together in it. I would say that is the big difference - is I no longer have the confidence that that's going to happen.

PFEIFFER: You mentioned people who have delayed care because of the pandemic and are now coming in. And as you said, we talked to you two years ago about elective surgeries being postponed. At that time, there were predictions that, eventually, we would see people with advanced stages of non-COVID diseases coming in for help - cancer as an example. Are you seeing that play out as predicted?

BUCKLAND: Yes. And I've certainly been seeing that for the last year. Like, in the emergency department, I will routinely diagnose a new cancer because I'm the first physician they have seen in a while. And so that stomach ache that just hasn't gone away, I will find out that - because I was looking for something else, that it's from a tumor growing in their abdomen.

PFEIFFER: What's your advice to anyone afraid to go to a hospital now who might really need hospital care?

BUCKLAND: I will say, if you feel that you are not safe to stay at home or that you can't wait to see an urgent care or primary care, the emergency room is still the place to go. Just expect that you're going to be waiting longer than you think to get seen. Like, at my emergency department, we see everyone within 20 minutes of arriving to establish how ill they are at the moment. But we may not get back to you for many hours to finish up your care or to do a final diagnosis.

PFEIFFER: Even if they're afraid that, by going to the hospital, they increase their chance of catching COVID?

BUCKLAND: Yes. I mean, if - everyone's going to make their own risk-benefit discussion, but if you're - if you do not think that care could be happening anywhere else, then the emergency room remains that 24/7 place to get seen. And I'm - I haven't seen a dentist in over two years for the exact same reason. Like, I don't want to expose someone or be in there, so I understand where everyone's coming from and what it's going through. But if you need care, please come see us, and we will do what we can to get you that care.

PFEIFFER: Dr. Daniel Buckland is an emergency physician at Duke University Hospital. Thank you again for making time. And we hope that there will be an end to this for you and for all the rest of us soon.

BUCKLAND: Yep, thank you. I really didn't intend to come across as depressing, I think, as it came about, but I think that's kind of where we're all at right now.

PFEIFFER: I spoke to Dr. Buckland on Friday afternoon. That evening, a man shot another man in the Duke University Hospital's emergency department. The already stretched trauma staff turned to trying to save the victim, who did not survive.

(SOUNDBITE OF BLACKSTRATBLUES' "NORTH STAR") Transcript provided by NPR, Copyright NPR.

Sacha Pfeiffer is a correspondent for NPR's Investigations team and an occasional guest host for some of NPR's national shows.
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