COVID-19 has touched nearly every aspect of life since the first cases appeared in the U.S. in Jan. 2020, but perhaps no developments have been quite as drastic as the ones seen in the U.S. healthcare system. As hospitals scramble to accommodate new quarantine measures and treat a growing number of patients, healthcare workers are confronted with unprecedented challenges. The COVID-19 death toll in the U.S. on April 5 was over 8,300 and has since risen to over 93,000 as of May 20. 

To get a look into how the pandemic has affected first-responders, I talked to Andee Vaughan, a nurse at Harborview Medical Center in Seattle, Washington, who works in trauma surgery. Any serious trauma (major burns, car accidents, gunshot wounds) that occurs in a five-state radius ends up at Harborview’s trauma floor. Vaughan explained that during the pandemic, Harborview has cancelled all elective surgeries and transitioned entire floors into COVID wings. “You have a lot of floors that have a lot of empty rooms, which you wouldn’t expect, but for a trauma hospital where our bread and butter is surgery, you’re gonna have a lot of empty space,” she said. “I feel like I’ve been pretty isolated from it because I got sick right around the time we first started seeing this in Seattle… I ended up getting tested but at that time it was tests that took about eight days turnaround time, so I missed 8 business days… and wasn’t working for the big breakout in Seattle. But a bunch of my friends were.” The experiences of Vaughan’s peers who work in healthcare vary, but all are struggling to keep up with the physical and mental toll that the pandemic has placed on healthcare workers. “I’ve got friends who work as doctors in palliative care and they are unbelievably emotionally exhausted and overwhelmed. And physically overwhelmed too, because we just don’t have enough resources,” she explained.

Lack of resources such as PPE, medical equipment, and ventilators has put enormous stress on medical facilities. Shortcuts have been taken at the cost of the safety, much to the frustration of healthcare workers such as Vaughan. “My friends, especially in places like Providence Everett and Northwest Hospital, they have to wear surgical masks which we know have been proven not to protect us,” she said. “I’m sure you’ve read that the CDC has revised their guidelines and liberated them so we can wear things like cloth masks and bandanas. That was a policy that was written into the CDC’s newest guidelines because of the shortage. It doesn’t protect us; the particulates of this virus can get through cloth. We know that. It just sucks because we don’t have the PPE to protect ourselves as healthcare workers and we are starting to get sick.” The CDC endorsed “limited reuse” of masks, as well as cloth and homemade masks as a “last resort” when treating COVID patients. Research done on the effectiveness of surgical and cloth masks was limited up until the outbreak of COVID-19, and remains inconclusive. One study found that neither surgical nor cloth masks contained SARS-CoV-2, a type of coronavirus, while another study concluded that filtration of particles was poor in cloth masks compared to surgical masks, finding that penetration by particles was nearly 97 percent for cloth masks and 44 percent for medical masks. Vaughan says, “As first responders… the number one thing that we are taught is always if the scene is safe… And right now, all first-line workers don’t get to say that. We don’t get to say the scene is safe because it’s not. We know that when patients are sick and they’re coughing or even breathing, they are potentially spreading this virus… And we don’t have access to body substance isolation gear like we used to.” 

Additionally, the outbreak of COVID-19 has ushered in policy changes on both the federal and local level. State stay-at-home orders, as well as federal programs such as stimulus checks under the CARES act, all were decisions made in a relatively short time to combat the economic and medical consequences of the virus. “I think Governor Inslee made a really difficult call and did it really quickly, and I think he is the number one reason we are not seeing more death cases in this state,” said Vaughan. “I think he really did the right thing by shoring up and saying ‘this is what we need to do’ early on.” However, Vaughan also feels that many healthcare workers have been unsupported by administrations during this time. “I’m lucky to work for an organization that… is actually doing a really good job of protecting me compared to a lot of my peers in other organizations, where they’ve literally been told that they will be fired for wearing masks… because it ‘sends the wrong message’ to the public.” She elaborates that “[the concern] is that it doesn’t show solidarity, and that it’s ‘causing alarm’…. Most of this is coming from administrators, not medical professionals… they’re just worried about the panic-induced fear that people protecting themselves could cause, which is super unfortunate.”

Despite stay-at-home orders and other legislative measures, lack of support and preparation in the US has left many healthcare workers in difficult situations. One of the greatest concerns is lack of life-saving resources in hospitals, such as ventilators. “I think a lot of healthcare workers have gotten super creative with how to attach multiple people to vents in case of an absolute shortage,” Vaughan explained. “I think one thing people don’t realize is that medical professionals are having to make difficult calls about who gets to access a vent and who doesn’t… It’s super hard because there’s so many factors you have to put into consideration, and at the end of the day that’s putting a hard decision on somebody who shouldn’t have had to make that decision because we should have been better prepared.”

The effects of COVID-19 have touched every individual in the United States, but for healthcare workers the consequences have been perhaps the most devastating. However, community efforts to stay home and support essential workers from afar do not go without notice. Additionally, new policies continue to be developed on every administrative level in order to confront these new challenges. “I think that there’s a lot of growth potential and I think that we need to hear from your age group on how to move forward as a country. I think that there’s going to be a lot of cool policy ideas that are gonna come from your generation because of this, and I am super curious to see what comes of it because of the experiences that your age group has had from this whole situation,” Vaughan concluded. For those who want to do more to support US healthcare workers, there are some ways to help. However, the best thing that individuals can do right now is stay home, stay up-to-date, and continue to follow guidelines set by their local government.

IMPORTANT NOTE: COVID-19 is a rapidly evolving situation. This interview was conducted on 4/4/20 and developments in healthcare and legislative efforts have occurred since then. Staying up-to-date on current information is crucial for a complete understanding of the COVID-19 pandemic and its effects on our country and the world.