Doctor Bela Patel vividly remembers her worst day of the pandemic. Her hospital in Houston lost three patients in the space of a few hours.
- More than 8,000 Texans have died from COVID-19
- Some doctors say they have not had have enough beds for patients
- The Governor has ordered that most Texans must wear a mask in public
It deflated the entire team working in the intensive care unit at Memorial Hermann Texas Medical Centre.
Not only were they unable to save the patients, but there was no end in sight to the stream of critically ill patients flowing in.
The hospital was housing dozens of patients, all on some sort of ventilation. Some people battling COVID-19 were hooked up to multiple devices to help them breathe.
All of them were seriously ill — many critically.
In just one month, the number of patients her emergency department was treating jumped fivefold.
In more than two decades working in an emergency department, Dr Patel had never seen anything like it.
“This is 10 times worse than our worst year,” she said.
“Usually you have a small number of patients in an ICU that are that ill. Right now, you walk in, every patient is of that level of intensity.”
Dr Patel is used to only seeing patients over the age of 60 on her ward.
“Not 18, 19, 20-year-olds. Not pregnant women, not post-partum women. That’s where the emotional toll is so difficult,” she said.
Like many doctors on the front line of America’s coronavirus crisis, she tapes a photo of herself to the personal protective gear which obscures her face.
That way, her patients will hopefully feel a little less isolated.
Coronavirus in Texas went from slow burn to explosion
America’s coronavirus outbreak first erupted in Washington state before New York became the country’s epicentre in April.
The situation was more of a slow burn in the country’s south, with states like Texas, Florida and Arizona recording relatively lower rates of infection.
That all changed in May.
Texas’s curve quickly shot up and Dr Patel remembers her team being shocked to have 30 patients at one time.
Then they had 90. They thought there was no way they could handle 100.
A few weeks ago, during the peak of infections in Texas, they hit 160 patients.
“The second peak clearly happened after Memorial Day,” Dr Patel said.
“We started seeing a steep incline and it was just relentless.”
Several US states said mass gatherings to celebrate the May 31 federal holiday caused a spike in COVID-19 infections.
“It really stretched every resource we had, both the manpower and the equipment, Dr Patel said.
“The intensity has been phenomenal.
“It’s something I would say as critical care physicians we’ve never seen.
The hospital hired extra nurses, shut down non-essential departments and redeployed health workers from other wards to cope with the surge.
They broke their records for the highest number of people on ventilators and dialysis machines at any one time.
The huge rise in cases in Texas is being seen as a direct consequence of lifting coronavirus restrictions too early.
The state started opening up again in May, though the Governor has since issued a statewide mask mandate and shut down bars again.
Some Texan bars have simply started serving food so they can be classified as restaurants and remain open, according to local media.
‘None of us went to school to play God’
Three hours from Houston, in San Antonio, the state’s second-largest city, Salim Rezaie is also on the front line of the battle against COVID-19.
The 43-year-old has been an emergency doctor for 15 years but has never before had to make decisions like those he has made in recent weeks.
One day he had 10 patients aged between 20 and 30 who needed to be transferred into his care.
Only three beds at the hospital were available.
“So how do you decide out of 10 people which three are more important?” he said.
“I can’t even put words to how stressful that is.
His hospital opened up five additional COVID-19 intensive care units across its San Antonio campuses within three weeks.
A few weeks ago, there was a waiting list to get a bed at his emergency department.
“When the resources start getting tapped and you’re getting at capacity, you have to start making tough decisions and the psychological impact is no joke,” he said.
Not only did patient volume go up, but so did the severity of cases. And the age of the patients dramatically fell.
“You’re driving home from a shift, you’re completely exhausted, and you see a bar and it’s packed with all these 20 and 30-year-olds not physical distancing, not wearing masks,” Dr Rezaie said.
He said people younger than 30 represented the biggest surge of patients coming to hospital.
“Some of them are actually pretty sick … a lot of them are requiring oxygen,” he said.
Texas sees early signs of improvement, but doctors fear another spike
Texas has started the see the first signs that cases are starting to decrease.
By most accounts, putting a pause on fully reopening the state and issuing the mask mandate has helped slow the spread in the state.
But while cases have come off the peak of 15,000 new infections in a day, Texas is still averaging about 8,000 a day.
And more than 8,000 people have died from close to half a million COVID-19 infections.
Doctors and nurses are hoping they have seen the worst of it, but with schools reopening this month and autumn rapidly approaching, concerns of a second spike are ever present.
Dr Patel’s mind is constantly racing with questions about what happens next.
“You always worry as the volumes get higher, at what point do we start breaking?” she said.
“Luckily we haven’t got there, but the thing that worries me is if we hadn’t seen the slight decrease over the past 10 days, what would it look like?
“Would our teams be stretched to the limits? Would they be mentally and physically exhausted?”.
Dr Patel worries about the coming weeks.