1 00:00:01,600 --> 00:00:03,240 Speaker 1: What were you doing in there? I'm making sure they 2 00:00:03,279 --> 00:00:05,840 Speaker 1: clean don Long's event. I don't want one more person 3 00:00:05,920 --> 00:00:08,280 Speaker 1: getting a super bug might be too late for that. 4 00:00:08,480 --> 00:00:12,400 Speaker 1: In March, an episode of a Fox Network television show 5 00:00:12,440 --> 00:00:16,280 Speaker 1: called The Resident appears about a lethal fungus spreading through 6 00:00:16,280 --> 00:00:20,360 Speaker 1: a fictional hospital. The fungus has an ability to attack 7 00:00:20,400 --> 00:00:25,120 Speaker 1: people with underlying conditions, such as diabetes. The hospital staff 8 00:00:25,200 --> 00:00:26,680 Speaker 1: go to great pains to try to get rid of 9 00:00:26,760 --> 00:00:31,040 Speaker 1: the infection without causing panic or revealing their own mistakes. 10 00:00:31,960 --> 00:00:36,519 Speaker 1: Canada Horse is highly dangerous and immune coupleized patients. Half 11 00:00:36,560 --> 00:00:40,040 Speaker 1: the people will get it die. The coronavirus actually makes 12 00:00:40,040 --> 00:00:42,960 Speaker 1: a brief appearance in the episode We're Lucky is not 13 00:00:43,000 --> 00:00:45,400 Speaker 1: in irriable, and like the coronavirus, his dad is not 14 00:00:45,440 --> 00:00:48,640 Speaker 1: at risk, but the patients could be, but it doesn't 15 00:00:48,680 --> 00:00:51,640 Speaker 1: really figure into the plot anyway. One of the writers 16 00:00:51,640 --> 00:00:55,000 Speaker 1: behind this episode is named Daniella Lamas, and around the 17 00:00:55,040 --> 00:00:57,560 Speaker 1: time of the ears the episode starts to feel like 18 00:00:57,840 --> 00:01:00,800 Speaker 1: reality for her. That's be As. In addition to being 19 00:01:00,800 --> 00:01:03,880 Speaker 1: a TV show script writer, she's an ICU doctor at 20 00:01:03,880 --> 00:01:08,200 Speaker 1: Brighaman Women's Hospital in Boston. Initially, this sort of odd 21 00:01:08,240 --> 00:01:12,720 Speaker 1: feeling of truth being stranger than fiction, and and for 22 00:01:12,920 --> 00:01:15,360 Speaker 1: feeling slow to kind of realize that this was real. 23 00:01:15,440 --> 00:01:17,119 Speaker 1: You know, I have friends who work in New York, 24 00:01:17,160 --> 00:01:21,119 Speaker 1: like we saw what was happening there, but even so 25 00:01:21,640 --> 00:01:25,120 Speaker 1: it took a little bit of time to to to realize, 26 00:01:25,120 --> 00:01:29,480 Speaker 1: oh my gosh, this is this is happening. Reality was 27 00:01:29,520 --> 00:01:32,679 Speaker 1: following an alternative script in which a coronavirus was the 28 00:01:32,880 --> 00:01:36,840 Speaker 1: arch villain. Swaved in Ppe, Lamas was taking care of 29 00:01:36,880 --> 00:01:41,880 Speaker 1: patients with a previously unknown disease COVID. Nineteen hundreds across 30 00:01:41,920 --> 00:01:45,319 Speaker 1: Massachusetts became sick, with the disease piling into the hospital 31 00:01:45,400 --> 00:01:50,559 Speaker 1: in unforeseen numbers. Brigham Women's has a sixteen floor patient tower, 32 00:01:51,040 --> 00:01:53,840 Speaker 1: but across the street there's a newer cardiology building with 33 00:01:53,880 --> 00:01:57,040 Speaker 1: a number of rooms with negative airflow that can be 34 00:01:57,120 --> 00:02:00,880 Speaker 1: useful for keeping viruses under control. So the cardiology building 35 00:02:00,880 --> 00:02:03,880 Speaker 1: became a COVID facility. It was in one of those 36 00:02:04,000 --> 00:02:07,280 Speaker 1: rooms that Lamas took care of the patient. She'll never forget. 37 00:02:07,720 --> 00:02:10,240 Speaker 1: There's a room that will always be a guy in 38 00:02:10,280 --> 00:02:12,959 Speaker 1: his thirties with developmental delay who got COVID in his 39 00:02:13,080 --> 00:02:16,240 Speaker 1: group home and who was on a lung bypass machine 40 00:02:16,400 --> 00:02:19,079 Speaker 1: to keep him alive. But when it was clear that 41 00:02:19,080 --> 00:02:21,520 Speaker 1: that was not going anywhere, and we had to tell 42 00:02:21,600 --> 00:02:23,960 Speaker 1: his mother that that he was was going to die, 43 00:02:24,040 --> 00:02:27,520 Speaker 1: and she asked us not to take him off the 44 00:02:27,520 --> 00:02:29,560 Speaker 1: machine on Mother's Day, which was a Sunday, so we 45 00:02:29,560 --> 00:02:32,560 Speaker 1: waited until Monday morning. I was off that Monday morning. 46 00:02:32,560 --> 00:02:36,359 Speaker 1: It was no longer my time on service. Normally, interns 47 00:02:36,360 --> 00:02:39,000 Speaker 1: and training were generally kept at a distance from COVID 48 00:02:39,000 --> 00:02:42,040 Speaker 1: patients because of the risk of catching the disease. But 49 00:02:42,160 --> 00:02:45,160 Speaker 1: on the morning that Lamas's patient died, she wasn't in 50 00:02:45,160 --> 00:02:47,840 Speaker 1: the hospital. So an intern who had been involved in 51 00:02:47,840 --> 00:02:51,600 Speaker 1: his care put on protective gloves, a gown and mask 52 00:02:52,080 --> 00:02:54,040 Speaker 1: and went into the room with him, and she held 53 00:02:54,040 --> 00:02:57,720 Speaker 1: the phone to his ear, and you know, his family 54 00:02:57,800 --> 00:03:00,480 Speaker 1: said goodbye and told him apparently what heaven would be like. 55 00:03:00,600 --> 00:03:03,359 Speaker 1: And remember sure he telling her me that that night, 56 00:03:03,919 --> 00:03:06,359 Speaker 1: and I felt so short of guilty that she had 57 00:03:06,360 --> 00:03:10,200 Speaker 1: been in there and gotten that experience. Um it also 58 00:03:10,280 --> 00:03:11,760 Speaker 1: said it was good because she realized she had never 59 00:03:11,760 --> 00:03:14,400 Speaker 1: really seen the patient before. Because we kept the interns 60 00:03:14,440 --> 00:03:17,040 Speaker 1: from examining, from being in the rooms as possible, you know, 61 00:03:17,160 --> 00:03:20,000 Speaker 1: we sort of did the exams as attendings, and so 62 00:03:20,080 --> 00:03:21,839 Speaker 1: she's like, I've been caring for him for weeks since 63 00:03:21,880 --> 00:03:24,040 Speaker 1: was the first time I saw his face, and so 64 00:03:24,160 --> 00:03:26,040 Speaker 1: sort of those moments, I think, you know, are things 65 00:03:26,040 --> 00:03:29,520 Speaker 1: that will always be in our minds. Even doctors had 66 00:03:29,560 --> 00:03:31,840 Speaker 1: difficulty believing what they were seeing happen in front of 67 00:03:31,880 --> 00:03:35,680 Speaker 1: their eyes. COVID was changing everything. But there was a 68 00:03:35,720 --> 00:03:39,000 Speaker 1: big difference from Lamas's show, where doctors were trying to 69 00:03:39,080 --> 00:03:42,240 Speaker 1: hide the infection in the hospital. Now they were trying 70 00:03:42,280 --> 00:03:44,360 Speaker 1: desperately to make clear to the rest of the world 71 00:03:44,840 --> 00:03:48,080 Speaker 1: what was really happening within their walls and how COVID 72 00:03:48,160 --> 00:03:51,680 Speaker 1: was changing your rules collide Ishmael is a colleague of 73 00:03:51,720 --> 00:03:54,920 Speaker 1: Lamas is. We specializes in taking care of lung disorders. 74 00:03:55,480 --> 00:03:58,200 Speaker 1: This like a big conspiracy, I know. I think once 75 00:03:58,200 --> 00:04:00,200 Speaker 1: we start to hear these things on the out side 76 00:04:00,240 --> 00:04:01,960 Speaker 1: and see what's happening on the inside, I mean, I 77 00:04:02,000 --> 00:04:06,320 Speaker 1: think that really affected, you know, the way I see things. 78 00:04:06,440 --> 00:04:10,000 Speaker 1: And you know, I usually don't post much on on 79 00:04:10,000 --> 00:04:12,520 Speaker 1: social media, and I went, actually I had like a 80 00:04:12,560 --> 00:04:17,440 Speaker 1: post about people please listen and please follow recommendations for 81 00:04:17,600 --> 00:04:21,240 Speaker 1: prevention and PPE and mask and social distancing and all 82 00:04:21,279 --> 00:04:26,279 Speaker 1: of that. Now, Lamas and Ismail are both working in 83 00:04:26,320 --> 00:04:28,159 Speaker 1: a Brigham clinic where they take care of people with 84 00:04:28,240 --> 00:04:31,599 Speaker 1: long COVID, a mysterious syndrome they can affect people months 85 00:04:31,680 --> 00:04:34,880 Speaker 1: after they've been infected, even if their cases aren't serious. 86 00:04:35,960 --> 00:04:39,120 Speaker 1: Bit by bit, COVID is altering the space where they work. 87 00:04:40,080 --> 00:04:43,360 Speaker 1: Hospitals have long occupied a singular place in the community 88 00:04:43,600 --> 00:04:47,080 Speaker 1: and in the imagination. There are a place where discoveries 89 00:04:47,080 --> 00:04:49,599 Speaker 1: are made, where friends and relatives come to be with 90 00:04:49,640 --> 00:04:55,760 Speaker 1: a sick where medical miracles can happen. But that's changing. Increasingly, 91 00:04:55,960 --> 00:04:59,760 Speaker 1: hospitals are becoming fortresses that must carefully limit who enters 92 00:04:59,839 --> 00:05:02,880 Speaker 1: and who exits, no matter how many gowns and masks 93 00:05:02,920 --> 00:05:06,240 Speaker 1: they have. Now, workers are feeling overburdened with caring for 94 00:05:06,279 --> 00:05:10,160 Speaker 1: COVID patients who may stay for months needing highly intensive care. 95 00:05:11,480 --> 00:05:15,600 Speaker 1: Miracles are getting harder and harder to perform, and many 96 00:05:15,600 --> 00:05:20,240 Speaker 1: healthcare workers now feel less trusted than ever before. I'm 97 00:05:20,320 --> 00:05:23,440 Speaker 1: John Lawerman, and I'm a journalist with Bloomberg News from 98 00:05:23,440 --> 00:05:47,400 Speaker 1: the Prognosis podcast. This is Breakthrough Riemond Women's the hospital 99 00:05:47,440 --> 00:05:50,919 Speaker 1: where scriptwriter Danielle Allamas works as a doctor is one 100 00:05:50,960 --> 00:05:53,440 Speaker 1: of the most storied in the world. It can trace 101 00:05:53,480 --> 00:05:56,600 Speaker 1: its history back almost two years when it was one 102 00:05:56,640 --> 00:06:01,400 Speaker 1: of the first American maternity hospitals. Come doctors actually developed 103 00:06:01,440 --> 00:06:05,159 Speaker 1: the idea of the intensive care unit in the nineteen fifties. 104 00:06:05,760 --> 00:06:08,640 Speaker 1: You're in Boston um and at the Brigham. Yes, we 105 00:06:08,720 --> 00:06:12,640 Speaker 1: definitely have critically ill, unvaccinated patients, but not to the 106 00:06:12,680 --> 00:06:14,919 Speaker 1: extent that there are in other places in the country. 107 00:06:15,000 --> 00:06:17,560 Speaker 1: In our vaccine rights are good here in Massachusetts, and 108 00:06:17,600 --> 00:06:19,640 Speaker 1: there's some outlying hospitals who have been a lot more 109 00:06:19,720 --> 00:06:22,200 Speaker 1: hit than we are. My father is a doctor in Miami, 110 00:06:22,279 --> 00:06:24,520 Speaker 1: and so the hospital he works at is just full 111 00:06:24,640 --> 00:06:28,600 Speaker 1: of one vaccinated, super sick on vaccinated COVID and and 112 00:06:28,640 --> 00:06:31,000 Speaker 1: I think, you know, there's a different tone to it. 113 00:06:31,400 --> 00:06:34,080 Speaker 1: The pandemic is making health workers feel like they're on 114 00:06:34,080 --> 00:06:37,800 Speaker 1: an island. On the outside, the hospital looks pretty much 115 00:06:37,800 --> 00:06:41,320 Speaker 1: the same as it always did, banners, the glass and steel, 116 00:06:41,839 --> 00:06:45,440 Speaker 1: the emergency room, parking lot. On the inside, it's become 117 00:06:45,480 --> 00:06:49,240 Speaker 1: a very different place, one of constant stress and worry 118 00:06:49,360 --> 00:06:53,080 Speaker 1: and feeling like there's no way out. Late this summer, 119 00:06:53,160 --> 00:06:56,600 Speaker 1: Idaho was overrun with COVID cases. At one point there 120 00:06:56,640 --> 00:07:01,280 Speaker 1: were more than six people hospitalized. That about more than 121 00:07:01,320 --> 00:07:05,000 Speaker 1: in December, when COVID was running rampant across the US 122 00:07:05,040 --> 00:07:10,160 Speaker 1: and vaccines weren't yet available. Staffing shortages were limiting hospital's 123 00:07:10,200 --> 00:07:15,360 Speaker 1: ability to provide good standards of care. Even today, only 124 00:07:16,440 --> 00:07:21,480 Speaker 1: Idaho residents are fully vaccinated. Washington's Governor j Insley appealed 125 00:07:21,520 --> 00:07:25,320 Speaker 1: to Idaho residence to wear masks because the Idaho crisis 126 00:07:25,720 --> 00:07:29,920 Speaker 1: was spreading west into his state. Jim Susa is a 127 00:07:29,920 --> 00:07:33,160 Speaker 1: pulmonologist at St. Luke's Hospital and catch him Idaho. He 128 00:07:33,200 --> 00:07:36,440 Speaker 1: says it's difficult to find enough beds and to keep 129 00:07:36,480 --> 00:07:42,480 Speaker 1: them staffed, where we're just experiencing an unprecedented wave of 130 00:07:42,520 --> 00:07:48,200 Speaker 1: acute illness, and that acute illness is all COVID and 131 00:07:48,400 --> 00:07:55,840 Speaker 1: it is almost exclusively in unvaccinated individuals. They checked the 132 00:07:55,960 --> 00:08:02,640 Speaker 1: statistic right before our interview today, and of our intensive 133 00:08:02,640 --> 00:08:07,360 Speaker 1: care unit patients who are in the hospital with COVID, 134 00:08:09,200 --> 00:08:14,920 Speaker 1: of them are unvaccinated. There's a small handful that are vaccinated, 135 00:08:15,000 --> 00:08:21,560 Speaker 1: including organ transplant patient, cancer patient and and so on. 136 00:08:21,560 --> 00:08:25,160 Speaker 1: On the zoom call, Jim looks tired. He talks about 137 00:08:25,200 --> 00:08:28,640 Speaker 1: constantly dawning and daffing personal protective equipment as he and 138 00:08:28,680 --> 00:08:30,400 Speaker 1: his team go from one SAG room to the next. 139 00:08:31,160 --> 00:08:34,280 Speaker 1: Jim also says the actual interior of the hospital has 140 00:08:34,320 --> 00:08:37,440 Speaker 1: had to change to accommodate more COVID patients. Just like 141 00:08:37,480 --> 00:08:43,199 Speaker 1: Briggerman Women's. This wave has has caused us to change 142 00:08:43,240 --> 00:08:47,800 Speaker 1: where we're providing care. So we've opened up surge units. 143 00:08:48,520 --> 00:08:51,520 Speaker 1: We had one surge unit which was a cardiac observation 144 00:08:51,679 --> 00:08:54,520 Speaker 1: unit that we turned into a nine bed intensive care unit. 145 00:08:55,360 --> 00:08:59,679 Speaker 1: We filled it today, but still more COVID patients come 146 00:08:59,679 --> 00:09:03,440 Speaker 1: into doo Are and today is this day is probably 147 00:09:03,440 --> 00:09:06,040 Speaker 1: going to be the day that we spill over into 148 00:09:06,120 --> 00:09:11,840 Speaker 1: our next surge unit, which is a telemetry unit. And 149 00:09:12,320 --> 00:09:17,000 Speaker 1: you know, for those who know something about this, intensive 150 00:09:17,000 --> 00:09:20,800 Speaker 1: care unit rooms are specifically designed to meet the needs 151 00:09:20,800 --> 00:09:24,240 Speaker 1: of those patients. Very large rooms to accommodate all of 152 00:09:24,280 --> 00:09:28,840 Speaker 1: the machinery, equipment, monitoring, etcetera that's needed, all of the 153 00:09:28,920 --> 00:09:30,679 Speaker 1: people that might need to be in the room to 154 00:09:30,760 --> 00:09:34,160 Speaker 1: care for a patient. A telemetry room is not designed 155 00:09:34,200 --> 00:09:36,440 Speaker 1: for that, but we're gonna We're gonna do our best. 156 00:09:37,200 --> 00:09:40,240 Speaker 1: Adding to all this, though, is the open hostility that 157 00:09:40,280 --> 00:09:44,160 Speaker 1: he and other workers encounter some patients tell them that 158 00:09:44,200 --> 00:09:47,280 Speaker 1: COVID is a hoax, and they demand that the word 159 00:09:47,320 --> 00:09:50,320 Speaker 1: be kept out of their relatives death certificates. Many of 160 00:09:50,360 --> 00:09:53,000 Speaker 1: these people have been getting their information about COVID from 161 00:09:53,120 --> 00:09:57,400 Speaker 1: different sources, Jim says. So they come with a different 162 00:09:57,480 --> 00:10:01,600 Speaker 1: mental model about this disease ease, and they come with 163 00:10:01,760 --> 00:10:06,760 Speaker 1: a different belief system about this disease. And as they 164 00:10:06,880 --> 00:10:12,560 Speaker 1: do that, they're coming with a bit more hostility, which, 165 00:10:13,520 --> 00:10:16,320 Speaker 1: which I got to say, is a really unique thing 166 00:10:16,480 --> 00:10:21,720 Speaker 1: in healthcare. We are very used to taking care of 167 00:10:22,040 --> 00:10:25,760 Speaker 1: all comers. I mean we right, we take care of 168 00:10:26,400 --> 00:10:28,400 Speaker 1: We take care of lots of folks who have chronic 169 00:10:28,440 --> 00:10:31,920 Speaker 1: problems that they've decided not to manage. Doctors don't resent 170 00:10:32,040 --> 00:10:35,760 Speaker 1: patients for their beliefs about COVID, Jim says. We take 171 00:10:35,760 --> 00:10:40,440 Speaker 1: care of, you know, prisoners, We take care of good people, 172 00:10:40,559 --> 00:10:43,520 Speaker 1: bad people. We just take care of people. That's our job. 173 00:10:45,000 --> 00:10:49,360 Speaker 1: And what what helps you have that sort of um 174 00:10:50,559 --> 00:10:57,240 Speaker 1: cool indifference to the um the individual characteristics of the 175 00:10:57,280 --> 00:11:01,160 Speaker 1: patient you're caring for is the fact that almost all 176 00:11:01,160 --> 00:11:03,960 Speaker 1: of the time, what you get back from the patient 177 00:11:04,240 --> 00:11:08,280 Speaker 1: is an overwhelming sense of appreciation for the efforts being 178 00:11:08,280 --> 00:11:11,280 Speaker 1: applied to try to return them to health. So to 179 00:11:11,320 --> 00:11:14,520 Speaker 1: be met with hostility is unusual. And I don't want 180 00:11:14,600 --> 00:11:18,760 Speaker 1: you to think that that is pervasive, but even when 181 00:11:18,800 --> 00:11:23,160 Speaker 1: in small doses it it does take a toll. And 182 00:11:23,200 --> 00:11:25,640 Speaker 1: then there are the meetings of the school board. We 183 00:11:25,720 --> 00:11:29,000 Speaker 1: were invited by the school board and the request was 184 00:11:29,080 --> 00:11:34,719 Speaker 1: to speak about the wisdom of a mask requirement as 185 00:11:34,760 --> 00:11:39,079 Speaker 1: they started school, um whether we should or shouldn't do that, 186 00:11:39,200 --> 00:11:41,880 Speaker 1: and we shared our pros and cons and we were 187 00:11:41,920 --> 00:11:44,080 Speaker 1: not going to share an opinion unless they asked for it, 188 00:11:44,160 --> 00:11:47,960 Speaker 1: and they did ask for it, and you know the 189 00:11:47,960 --> 00:11:53,959 Speaker 1: the it's just jeers, booze. Those jeers and booze came 190 00:11:54,000 --> 00:11:56,800 Speaker 1: after Jim and as Kylie recommended the use of masks 191 00:11:56,800 --> 00:12:00,400 Speaker 1: in schools. Jim wasn't able to actually see the audience, 192 00:12:00,440 --> 00:12:02,280 Speaker 1: but his wife is at the meeting in person and 193 00:12:02,320 --> 00:12:05,680 Speaker 1: told him afterwards what she'd seen. The moderator did an 194 00:12:05,720 --> 00:12:08,959 Speaker 1: excellent job, by the way it was she was trying 195 00:12:08,960 --> 00:12:13,120 Speaker 1: to mitigate that and what the way she did that. 196 00:12:14,360 --> 00:12:16,360 Speaker 1: And my wife's a school teacher, so she had she 197 00:12:16,440 --> 00:12:19,000 Speaker 1: admired this technique. She said it was a very school 198 00:12:19,040 --> 00:12:22,520 Speaker 1: teacher type thing to do. She said, Look, I know 199 00:12:22,600 --> 00:12:24,480 Speaker 1: people are going to have different opinions about what our 200 00:12:24,520 --> 00:12:29,360 Speaker 1: experts are saying. You know, if if you don't like it, 201 00:12:29,480 --> 00:12:32,360 Speaker 1: you can kind of do this. Jim is waving his hands. 202 00:12:32,600 --> 00:12:35,160 Speaker 1: If you like it, you can do this. Now he's 203 00:12:35,200 --> 00:12:37,920 Speaker 1: giving a thumbs up. So apparently while we were talking, 204 00:12:37,960 --> 00:12:41,440 Speaker 1: there was all kinds of crazy gesticulation happening in the audience. 205 00:12:41,440 --> 00:12:46,160 Speaker 1: You know, that sense of disconnectedness between hospitals and the 206 00:12:46,160 --> 00:12:49,720 Speaker 1: communities they care for has perhaps never been so strong 207 00:12:50,040 --> 00:12:53,640 Speaker 1: or uncomfortable. It's making the job of working in hospital 208 00:12:54,000 --> 00:12:57,400 Speaker 1: harder all the time, and this means healthcare workers are 209 00:12:57,400 --> 00:13:01,679 Speaker 1: starting to burn out and leave. That threatens to create 210 00:13:01,760 --> 00:13:17,199 Speaker 1: an entirely new crisis in hospital understaffing. Wendy Dean is 211 00:13:17,240 --> 00:13:19,880 Speaker 1: the co founder of a group called Moral Injury of Healthcare. 212 00:13:20,360 --> 00:13:23,920 Speaker 1: The group focuses on healthcare workers, who they say are 213 00:13:23,960 --> 00:13:26,360 Speaker 1: forced to work under conditions that violate their sense of 214 00:13:26,480 --> 00:13:29,520 Speaker 1: right and wrong. She says COVID has pushed that to 215 00:13:29,600 --> 00:13:33,640 Speaker 1: a boiling point, and hospitals are the focus. It is 216 00:13:33,679 --> 00:13:37,120 Speaker 1: a much less comfortable space. That's what I'm hearing from 217 00:13:37,160 --> 00:13:42,920 Speaker 1: across the country. I'm hearing more more clinicians now who 218 00:13:43,000 --> 00:13:46,360 Speaker 1: say I cried all the way to work. I didn't 219 00:13:46,360 --> 00:13:48,080 Speaker 1: want to get up this morning. I love my job, 220 00:13:48,600 --> 00:13:51,040 Speaker 1: I usually love my job. I don't want to go 221 00:13:51,080 --> 00:13:56,319 Speaker 1: to work. It's too hard. It's too much watching thirty 222 00:13:56,360 --> 00:14:03,240 Speaker 1: year old on thenolators that you know of chance for 223 00:14:03,280 --> 00:14:10,240 Speaker 1: a chance of not getting off. That is excruciating, and 224 00:14:10,280 --> 00:14:12,360 Speaker 1: we don't just leave it when we walk out of 225 00:14:12,400 --> 00:14:17,160 Speaker 1: the hospital. One of the key points of frustration is vaccination. 226 00:14:18,320 --> 00:14:22,040 Speaker 1: Many people about those coming to the hospital with COVID 227 00:14:22,440 --> 00:14:26,400 Speaker 1: have refused to get shots. Doctors and nurses still feel 228 00:14:26,400 --> 00:14:31,360 Speaker 1: compassion for them, but the frustration is extreme. There are 229 00:14:31,400 --> 00:14:34,400 Speaker 1: all kinds of reasons why patients can't get the vaccine 230 00:14:34,480 --> 00:14:37,280 Speaker 1: or don't have access to it, but at the same time, 231 00:14:37,920 --> 00:14:40,160 Speaker 1: it's frustrating to us that we can't make it more 232 00:14:40,160 --> 00:14:44,640 Speaker 1: available and that we can't no matter how how much 233 00:14:44,720 --> 00:14:48,320 Speaker 1: we encourage people to get it or ask them to 234 00:14:48,360 --> 00:14:52,480 Speaker 1: come with us, come to us with questions that it's 235 00:14:52,800 --> 00:14:58,800 Speaker 1: that turning that corner so that there's there's less vaccine 236 00:14:58,840 --> 00:15:05,280 Speaker 1: hesitancy has been really hard, and I think that is 237 00:15:05,560 --> 00:15:09,840 Speaker 1: that's becoming more frustrating for healthcare workers. Doctors are often 238 00:15:09,840 --> 00:15:13,760 Speaker 1: at pains to help people understand that COVID isn't a fantasy, 239 00:15:13,920 --> 00:15:17,440 Speaker 1: that it can be life altering or even lethal, and 240 00:15:17,440 --> 00:15:21,240 Speaker 1: that it's threatening their lives every day. Katie Muro Johnson 241 00:15:21,600 --> 00:15:25,280 Speaker 1: is an infectious disease doctor in Denver, where hospitals have 242 00:15:25,360 --> 00:15:28,360 Speaker 1: also been hit hard. She says she recently bumped into 243 00:15:28,360 --> 00:15:30,600 Speaker 1: a neighbor on the street whose friend was sick with 244 00:15:30,680 --> 00:15:35,120 Speaker 1: COVID and on a ventilator. The neighbor asked Johnson how 245 00:15:35,240 --> 00:15:38,160 Speaker 1: she thought her friend might do and I looked at her. 246 00:15:38,160 --> 00:15:41,840 Speaker 1: I said he's probably gonna die. I said, there's there's 247 00:15:42,000 --> 00:15:46,040 Speaker 1: very low chance he's going to survive. Johnson says her 248 00:15:46,120 --> 00:15:49,560 Speaker 1: neighbor's face went white. I felt bad walking away from 249 00:15:49,560 --> 00:15:51,880 Speaker 1: that that I was so honest, But I said, she 250 00:15:51,960 --> 00:15:56,520 Speaker 1: asked what was what what I thought? Because I think 251 00:15:56,560 --> 00:15:59,440 Speaker 1: people are asking what do you think about this? And 252 00:15:59,480 --> 00:16:03,120 Speaker 1: if I say something such as that they're gonna die, 253 00:16:04,000 --> 00:16:07,240 Speaker 1: you know, um, it scares people and they don't know 254 00:16:07,720 --> 00:16:11,640 Speaker 1: how to grasp that that's a possibility, and that's hard. 255 00:16:12,200 --> 00:16:15,320 Speaker 1: The neighbor's friend was only in his forties and with 256 00:16:15,360 --> 00:16:19,360 Speaker 1: no underlying medical problems. But there's often little that can 257 00:16:19,400 --> 00:16:21,680 Speaker 1: be done by the time someone is on a ventil latter, 258 00:16:22,720 --> 00:16:26,400 Speaker 1: and I don't want to be that person. It feels 259 00:16:26,440 --> 00:16:31,400 Speaker 1: hard to uh, um, for them to look at me 260 00:16:31,440 --> 00:16:37,200 Speaker 1: in the same way, you know, with saying things like that. UM. 261 00:16:37,240 --> 00:16:42,120 Speaker 1: But when you're around it every day, UM, I don't, 262 00:16:42,240 --> 00:16:44,920 Speaker 1: you know, I don't feel it is that gravity that 263 00:16:44,960 --> 00:16:52,120 Speaker 1: they do. It's a strange feeling for doctors not being 264 00:16:52,120 --> 00:16:54,680 Speaker 1: able to be heard. They're used to being the voice 265 00:16:54,720 --> 00:16:58,360 Speaker 1: of authority, the last word on medical issues and experts 266 00:16:58,360 --> 00:17:00,800 Speaker 1: on life and death. But this is how it is 267 00:17:00,840 --> 00:17:04,440 Speaker 1: in the time of COVID. One reality inside the hospital 268 00:17:04,880 --> 00:17:09,639 Speaker 1: and one outside and not enough communication in between. And 269 00:17:09,680 --> 00:17:14,600 Speaker 1: I think you know, going forward, UM, there is a 270 00:17:14,640 --> 00:17:20,720 Speaker 1: disconnect still with UM. There's a substantial amount of people 271 00:17:20,760 --> 00:17:27,200 Speaker 1: getting admitted with these long sixty day hospital admissions, unvaccinated, 272 00:17:27,520 --> 00:17:34,040 Speaker 1: and we are using our highest resources possible to keep 273 00:17:34,040 --> 00:17:42,040 Speaker 1: them alive. And and it's hard, UM, it's hard, UM. 274 00:17:42,280 --> 00:17:47,560 Speaker 1: Venolatory support you know, ivy medicines daily and some of 275 00:17:47,600 --> 00:17:50,840 Speaker 1: them taking a flight for life plane from other you know, 276 00:17:50,880 --> 00:17:56,000 Speaker 1: other states even to come here, which is you know, um, 277 00:17:56,040 --> 00:18:01,639 Speaker 1: which is desperate, which is uh yeah, that's kind of 278 00:18:01,640 --> 00:18:04,840 Speaker 1: what we're what we're dealing with now. Just a few 279 00:18:04,880 --> 00:18:07,679 Speaker 1: months ago, it looked like the pandemic would fade, at 280 00:18:07,760 --> 00:18:11,760 Speaker 1: least in the US as vaccines rolled out. So far, 281 00:18:12,040 --> 00:18:15,400 Speaker 1: that hasn't happened. In the states where vaccine uptake is low, 282 00:18:16,600 --> 00:18:21,680 Speaker 1: unvaccinated people, particularly those with chronic illnesses, are still getting sick. 283 00:18:22,600 --> 00:18:25,159 Speaker 1: Kate says there's still a lack of good treatments to 284 00:18:25,240 --> 00:18:29,160 Speaker 1: take care of people who get really sick. I think, 285 00:18:29,240 --> 00:18:33,520 Speaker 1: from the health care provider standpoint, UM, we want this 286 00:18:33,600 --> 00:18:37,360 Speaker 1: to be over UM just as much as everyone else does. UM. 287 00:18:37,520 --> 00:18:42,400 Speaker 1: And UM. I do think that if we can increase 288 00:18:42,520 --> 00:18:47,760 Speaker 1: vaccination worldwide, which is the goal, is the only way 289 00:18:47,760 --> 00:18:51,120 Speaker 1: we're going to bring us to an end, UM and 290 00:18:51,240 --> 00:18:55,439 Speaker 1: protect all of our most vulnerable people UM in the 291 00:18:55,560 --> 00:18:58,960 Speaker 1: US M from continually to be you know, coming to 292 00:18:59,040 --> 00:19:02,760 Speaker 1: the hospital, be sick and and ultimately die. UM and 293 00:19:02,800 --> 00:19:07,040 Speaker 1: so UM I think from our standpoint, we were giving 294 00:19:07,280 --> 00:19:11,880 Speaker 1: treatments that we have high quality evidence for but are 295 00:19:11,960 --> 00:19:16,480 Speaker 1: not willing to risk using other things that UM have 296 00:19:16,720 --> 00:19:20,040 Speaker 1: low quality evidence or or are negative have negative studies 297 00:19:20,040 --> 00:19:25,600 Speaker 1: behind them. And UM, I think that UM, if there 298 00:19:25,680 --> 00:19:28,760 Speaker 1: was something that we thought would cure someone, we would 299 00:19:28,760 --> 00:19:32,600 Speaker 1: be giving it. Drugs with poor quality evidence behind them 300 00:19:32,600 --> 00:19:37,960 Speaker 1: include ivermectin and hydroxy chloroquine. Hydroxy Chloroquine is a drug 301 00:19:38,000 --> 00:19:41,399 Speaker 1: from malaria that was touted by former President Donald Trump 302 00:19:41,800 --> 00:19:44,880 Speaker 1: as a cure for COVID early in the pandemic, when 303 00:19:44,880 --> 00:19:49,440 Speaker 1: there were even fewer options than there are now. Studies 304 00:19:49,440 --> 00:19:52,240 Speaker 1: have shown it doesn't work, but there's still a large 305 00:19:52,240 --> 00:19:54,760 Speaker 1: segment of the population that puts its trust in the drug. 306 00:19:56,160 --> 00:19:59,879 Speaker 1: Ivermectin is another drug for parasites that hasn't shown effectiveness. 307 00:20:00,760 --> 00:20:03,719 Speaker 1: Many patients in their families come into hospitals demanding it. 308 00:20:04,800 --> 00:20:08,240 Speaker 1: Katie says the controversies over COVID treatment are eroding trust 309 00:20:08,280 --> 00:20:13,600 Speaker 1: in hospitals and health professionals. I still think that we 310 00:20:13,720 --> 00:20:18,120 Speaker 1: are used as a way to take care of acute 311 00:20:18,160 --> 00:20:22,040 Speaker 1: illness and hopefully turn it around. But I do think people, 312 00:20:22,760 --> 00:20:28,879 Speaker 1: certainly a certain certain um subtype or our subpopulation of 313 00:20:29,080 --> 00:20:32,760 Speaker 1: folks are not coming to the hospital because they're worried 314 00:20:32,920 --> 00:20:37,879 Speaker 1: that somehow the hospital is going to make them worse. Now, 315 00:20:38,200 --> 00:20:42,080 Speaker 1: doctors sometimes have hard time treating patients because of mistrust 316 00:20:43,119 --> 00:20:46,120 Speaker 1: no matter where they're cared for. Patients who do get sick, 317 00:20:46,280 --> 00:21:01,320 Speaker 1: are very worried and often mistrustful. What we have is 318 00:21:01,359 --> 00:21:05,200 Speaker 1: an invisible war, uh and where the war is being 319 00:21:05,240 --> 00:21:08,480 Speaker 1: conducted is on the insides of the hospitals and in 320 00:21:08,520 --> 00:21:13,240 Speaker 1: our clinics. Those places are on fire right now with 321 00:21:13,359 --> 00:21:18,240 Speaker 1: sick patients. The rest of the community doesn't see that. 322 00:21:18,240 --> 00:21:21,560 Speaker 1: That's Ted Epperley, a doctor and CEO of residency program 323 00:21:21,640 --> 00:21:25,800 Speaker 1: based in Boise. When we talked, Idaho had the second 324 00:21:25,840 --> 00:21:29,480 Speaker 1: lowest vaccination rate of any state, and residents were just 325 00:21:29,520 --> 00:21:32,919 Speaker 1: starting to return to events like state fairs and football games, 326 00:21:33,440 --> 00:21:37,600 Speaker 1: most of them unmasked. I was a family medicine physician 327 00:21:37,600 --> 00:21:40,240 Speaker 1: of the physician in the Army for twenty one years. 328 00:21:40,280 --> 00:21:42,560 Speaker 1: I've been in a war and the first Golf War, 329 00:21:42,640 --> 00:21:44,960 Speaker 1: and did a lot of work in the Gulf War 330 00:21:45,520 --> 00:21:51,320 Speaker 1: at a mash hospital with emergencies, UM and UM. The 331 00:21:51,359 --> 00:21:54,480 Speaker 1: analogy I like to use for this is that if 332 00:21:54,560 --> 00:21:57,040 Speaker 1: tanks were rumbling down the streets here and there are 333 00:21:57,080 --> 00:22:00,919 Speaker 1: bombs going off, planes flying over in helicopters, smoke fire, 334 00:22:01,160 --> 00:22:05,000 Speaker 1: everybody would get it, and everybody would be appropriately concerned 335 00:22:05,040 --> 00:22:09,159 Speaker 1: and pulling together as a team. That's not happening. That 336 00:22:09,280 --> 00:22:14,000 Speaker 1: says the invisibility and isolation of hospitals. Plate is particularly 337 00:22:14,080 --> 00:22:18,239 Speaker 1: deep and some very rural, very conservative communities, people are 338 00:22:18,320 --> 00:22:21,560 Speaker 1: kind of uh, you know, stacking up like logwood, like 339 00:22:21,640 --> 00:22:26,920 Speaker 1: cordwood in the UH in their waiting areas. They've had 340 00:22:27,119 --> 00:22:33,280 Speaker 1: fairly significant amounts of bad cases that are right in 341 00:22:33,359 --> 00:22:36,520 Speaker 1: front of them that they can't do much for. And 342 00:22:36,800 --> 00:22:40,679 Speaker 1: what that leads to is a sense of both isolation, 343 00:22:41,800 --> 00:22:45,800 Speaker 1: fear and loneliness. Um, they feel like they're out on 344 00:22:45,800 --> 00:22:50,360 Speaker 1: an island trying to manage all of this and with 345 00:22:50,520 --> 00:22:54,200 Speaker 1: all the resources the United States has to offer around them, 346 00:22:54,520 --> 00:22:58,680 Speaker 1: but not being able to get anything accomplished. So it's 347 00:22:58,720 --> 00:23:03,760 Speaker 1: that that's sense of disillusionment that the whole system is 348 00:23:03,840 --> 00:23:07,920 Speaker 1: kind of shutting down and breaking that. I think it's 349 00:23:08,000 --> 00:23:12,040 Speaker 1: part of the dynamic and the tragedy of this that 350 00:23:12,119 --> 00:23:15,399 Speaker 1: we're going through in Idaho right now. Ted says he 351 00:23:15,480 --> 00:23:17,680 Speaker 1: thinks this could be the case for a long time. 352 00:23:18,119 --> 00:23:20,160 Speaker 1: I think this could go on for quite a while. 353 00:23:20,440 --> 00:23:23,960 Speaker 1: And what I mean for quite a while maybe or 354 00:23:24,000 --> 00:23:28,359 Speaker 1: forty years um. And I know that sounds almost like 355 00:23:28,440 --> 00:23:31,760 Speaker 1: you gotta be kidding. That just sounds unbearable. But Ted 356 00:23:31,800 --> 00:23:34,960 Speaker 1: studies pandemics and says some have lasted from forty to 357 00:23:35,400 --> 00:23:40,560 Speaker 1: a hundred years. Now, science and technology wasn't like it 358 00:23:40,680 --> 00:23:44,760 Speaker 1: was back in those times. But we currently have another 359 00:23:44,800 --> 00:23:50,440 Speaker 1: pandemic simultaneously ongoing that's been ongoing for forty years already simultaneously. 360 00:23:50,440 --> 00:23:54,320 Speaker 1: That's the HIV epidemic pandemic. We've not resolved that, and 361 00:23:54,359 --> 00:23:57,760 Speaker 1: the reason we haven't is that we haven't developed a 362 00:23:57,840 --> 00:24:02,240 Speaker 1: vaccine for it. Um. What could happen in this scenario 363 00:24:02,560 --> 00:24:04,760 Speaker 1: because we only have about three to four percent of 364 00:24:04,800 --> 00:24:08,720 Speaker 1: the world that's been vaccinated, A key problem is the 365 00:24:08,800 --> 00:24:11,480 Speaker 1: lack of access to vaccination in many parts of the 366 00:24:11,520 --> 00:24:15,159 Speaker 1: world in resistance to it in the US it's a 367 00:24:15,320 --> 00:24:22,280 Speaker 1: very low percent. Is that this continues to reverberate in 368 00:24:22,400 --> 00:24:26,520 Speaker 1: populations of people with low vaccination rates, and new variants 369 00:24:27,200 --> 00:24:32,120 Speaker 1: UM get spun off of that reverberation, so that different 370 00:24:32,200 --> 00:24:36,359 Speaker 1: variants continue to slam populations. We have one, as you 371 00:24:36,440 --> 00:24:39,280 Speaker 1: well known now called the new variant that's coming out 372 00:24:39,320 --> 00:24:44,080 Speaker 1: of South America that has immune of Asian properties, which 373 00:24:44,119 --> 00:24:48,359 Speaker 1: means that the vaccines and the plasma of the serum 374 00:24:48,400 --> 00:24:52,960 Speaker 1: plasma that we have right now may be ineffective against 375 00:24:53,040 --> 00:24:56,240 Speaker 1: this variant, meaning that we go through another whole cycle 376 00:24:57,040 --> 00:25:00,879 Speaker 1: of infection and illness only to spawn another AUNT that 377 00:25:01,119 --> 00:25:05,119 Speaker 1: kicks off from the process. So um, the optimist in me, 378 00:25:05,240 --> 00:25:08,359 Speaker 1: and I tend to be an optimist, would like to 379 00:25:08,400 --> 00:25:11,639 Speaker 1: see this resolve and the team months to twenty four months. 380 00:25:11,840 --> 00:25:16,800 Speaker 1: The potential realist in me, h really says that this 381 00:25:16,840 --> 00:25:21,280 Speaker 1: could be forty year experience that we all just learned 382 00:25:21,320 --> 00:25:31,679 Speaker 1: to manage. Jim Susa, the Idaho pulman ologist, has been 383 00:25:31,720 --> 00:25:34,200 Speaker 1: trying to get local politicians to come to St. Luke's 384 00:25:34,720 --> 00:25:37,920 Speaker 1: and see what's really happening. He says many have had 385 00:25:37,920 --> 00:25:40,240 Speaker 1: their eyes opened and gone back out to the community 386 00:25:40,600 --> 00:25:45,119 Speaker 1: to talk about the desperate situation and hospitals. But another thing, 387 00:25:45,160 --> 00:25:48,800 Speaker 1: he wants them to talk about his vaccination and its benefits, 388 00:25:50,000 --> 00:25:52,600 Speaker 1: because that's the only way he and his colleagues see 389 00:25:52,600 --> 00:25:56,560 Speaker 1: out of this situation. I'd like them to talk about 390 00:25:56,600 --> 00:26:01,479 Speaker 1: the fact that this is real. I mean, there's all 391 00:26:01,480 --> 00:26:03,840 Speaker 1: this stuff on social media that our hospitals are filled 392 00:26:03,840 --> 00:26:06,919 Speaker 1: with patients who have gotten the vaccine and gotten COVID 393 00:26:07,000 --> 00:26:10,760 Speaker 1: from that, and that's why I'm like, people are pulling 394 00:26:10,800 --> 00:26:14,879 Speaker 1: that this stuff out. I'm talking thin air here, so 395 00:26:15,720 --> 00:26:21,439 Speaker 1: talk about it's real, talk about your own vaccine. That 396 00:26:21,600 --> 00:26:25,320 Speaker 1: separation between what people say outside the hospital and what 397 00:26:25,440 --> 00:26:31,359 Speaker 1: actually happens inside, between beliefs and scientific facts, remains a 398 00:26:31,440 --> 00:26:35,560 Speaker 1: huge challenge to hospitals and the workers. At the end 399 00:26:35,560 --> 00:26:40,280 Speaker 1: of Daniello Llamas's Resident episode, the vital information about the 400 00:26:40,280 --> 00:26:44,240 Speaker 1: deadly fungus gets out, people start to take precautions, and 401 00:26:44,320 --> 00:26:47,639 Speaker 1: things go back to normal more or less. That's what 402 00:26:47,760 --> 00:26:50,480 Speaker 1: Lamas would like to see happen with COVID, but it 403 00:26:50,520 --> 00:26:53,760 Speaker 1: may take a long time. It ended and tied with 404 00:26:53,800 --> 00:26:58,760 Speaker 1: a boat though, So that's the difference between fiction and reality. Said, 405 00:26:59,040 --> 00:27:01,680 Speaker 1: when you're tired of a plotline, you can say, let's 406 00:27:01,680 --> 00:27:03,439 Speaker 1: put that one to bed, let's just move on. And 407 00:27:03,520 --> 00:27:08,720 Speaker 1: here we are unable to do that. Caring for deathly ill, 408 00:27:08,800 --> 00:27:12,680 Speaker 1: contagious patients with a poorly understood disease is always a 409 00:27:12,720 --> 00:27:16,879 Speaker 1: difficult job. An absence of trust makes it even harder. 410 00:27:18,119 --> 00:27:21,240 Speaker 1: COVID is not only doing damage to patients, it could 411 00:27:21,280 --> 00:27:24,280 Speaker 1: poison the atmosphere of many hospitals for years to come. 412 00:27:46,200 --> 00:27:48,439 Speaker 1: Next week, on Breakthrough, we're going to look at how 413 00:27:48,560 --> 00:27:51,960 Speaker 1: COVID revolutionized medicine with the development of the m r 414 00:27:52,040 --> 00:27:57,280 Speaker 1: and A vaccines. We'll meet Catline Carrico, Hungarian biochemist. Two 415 00:27:57,400 --> 00:28:00,880 Speaker 1: decades of early work, sometimes making two dollar an hour, 416 00:28:01,440 --> 00:28:03,879 Speaker 1: paved the way for vaccines that could go from idea 417 00:28:04,680 --> 00:28:09,520 Speaker 1: to immunization in just a year. This was incredible. Yeah, 418 00:28:09,640 --> 00:28:17,240 Speaker 1: this boss just wait taking and in this moment we understood, Hey, 419 00:28:17,280 --> 00:28:21,320 Speaker 1: there's a vaccine for mankind and corna is a problem 420 00:28:21,359 --> 00:28:34,719 Speaker 1: that can be soft. That's next time on Breakthrough. This 421 00:28:34,800 --> 00:28:38,000 Speaker 1: episode of Prognosis. Breakthrough was written and reported by me 422 00:28:38,120 --> 00:28:43,520 Speaker 1: John Lowerman over four is our senior producer. Carl Kevin 423 00:28:43,600 --> 00:28:47,840 Speaker 1: Robinson Jr. Is our associate producer. Our theme music was 424 00:28:47,880 --> 00:28:53,240 Speaker 1: composed and performed by Hannas Brown. Rick Shine is our editor. 425 00:28:53,840 --> 00:28:57,840 Speaker 1: Francesca Levie is the head of Bloomberg Podcasts. Be sure 426 00:28:57,880 --> 00:29:00,520 Speaker 1: to subscribe if you haven't already, and if you liked 427 00:29:00,560 --> 00:29:04,360 Speaker 1: this episode, please leave us a review. It helps others 428 00:29:04,400 --> 00:29:06,920 Speaker 1: find out about the show. Thanks for listening.