Carola Holzner, senior physician in charge of the central emergency room at the University Hospital, is wearing a face mask. | Marcel Kusch/Picture Alliance via Getty Images

His day starts at 6:30 am, and Dr. Craig Spencer knows the symptoms by heart because everyone he sees has them.

The key to weathering the coronavirus pandemic will be to utilize social distancing and other techniques to “flatten the curve” and keep the health care system from becoming too overwhelmed at any one moment.

Except, in some places — including in the US — those systems already are.

Hospitals have only a limited number of ICU beds with which to treat patients with Covid-19, the disease caused by the novel coronavirus, and hospital systems were generally unprepared for the pandemic. Policymakers have started to try to increase capacity to handle the oncoming surge of cases, but a total collapse of the system is still very possible.

And it’s not just equipment that’s in short supply — health care workers themselves are spread thin and overwhelmed.

In Italy, doctors have had to choose between patients for who gets put on a ventilator. Elsewhere, medical personnel are begging for personal protective equipment like masks, face-shields, and gloves to treat the onslaught of infectious patients.

While we know what we need to do to support doctors, nurses, and other health care workers to adequately deal with the pandemic, the everyday reality of caring for so many patients at once is sometimes difficult to report.

But in a viral tweet thread Tuesday, one emergency room doctor shed light on what is happening inside America’s hospitals and why it’s so important to follow the rules of social distancing in the first place.

Craig Spencer is the director of global health in emergency medicine at Columbia University’s Irving Medical Center and New York Presbyterian Hospital. He mentions that he worked during an Ebola outbreak in West Africa several years ago (he was then isolated and treated for disease in the US) and yet coronavirus scares him. He’s been working around the clock treating patients in New York City, which is one of the hardest-hit cities in the US so far. And he described a typical day as an ER doctor in the age of coronavirus in a recent viral tweet thread.

It starts, he says, when you walk in at 8 am and the previous shift hands off their cases to you, including one patient they’re “really worried about,” who is “very short of breath, on the maximum amount of oxygen we can give, but still breathing fast”:

You immediately assess this patient. It’s clear what this is, and what needs to happen. You have a long and honest discussion with the patient and family over the phone. It’s best to put her on life support now, before things get much worse. You’re getting set up for that, but…

You’re notified of another really sick patient coming in. You rush over. They’re also extremely sick, vomiting. They need to be put on life support as well. You bring them back. Two patients, in rooms right next to each other, both getting a breathing tube. It’s not even 10am yet.

He talks about how doctors and staff have become intimately familiar with the symptoms of Covid-19 — cough, shortness of breath, fever — and he wonders about what happened to the heart attack cases he used to see before the pandemic. You should read his thread in full:


Do you work in health care? Vox wants to hear about your coronavirus experience. Fill out this Google form to share your story.

SHARE