News & Analysis

The JAMA Forum

“This Level of Death, It’s New”—Health Care Workers in Their Own Words
Olivia Veira, AB; Joshua M. Sharfstein, MD

T
he surge in hospitalizations for coro-
navirus disease 2019 (COVID-19)
around the country has led many
physicians and other health care workers to
speak out. We created this post directly from
the recent words of frontline health care
workers and medical administrators
in 19 states, with the sources linked to
the first word or two of each quote. Their
words reflect an unprecedented time for
the US health care community in the midst
of the pandemic.
“This level of death, it’s new. It’s differ-
ent” (Nashville, Tennessee). “I have seen so
many emergent intubations. We’re taking
care of very, very sick patients and our pa-
tient load just keeps going up” (Omaha,
Nebraska). “I’ve done more CPR and
seen more people die in the last 2 weeks
than I have in my entire career combined”
(El Paso, Texas). “I’m terrified. It’s engulfing my entire “It’s as if we live in two separate
“We are tired of our beds filling up. waking moments” (Frederick, Maryland). worlds. There’s the world inside the hospi-
We are tired of watching people die. We “I cry a lot” (Kingsport, Tennessee). “We tal where we see patients coming in gasp-
are also tired of hearing family members are depressed, disheartened and tired to ing for breath, their lungs full of infection,
say, ‘Isn’t there anything else you can do?’ the bone” (Johnson City, Tennessee). and then there’s the world we see outside
and for us to say ‘no’” (Colorado Springs, “I find myself telling everyone that others of the hospital with people not wearing
Colorado). “I’ve put an ungodly amount of are going through this, you are not weak” masks, eating out in restaurants, party-
people in body bags that I was not pre- (Towson, Maryland). ing…” (Nashville, Tennessee).
pared to do, that I was not prepared to “I’ve had to face down the fear of “It is so disheartening and demoraliz-
give up on a patient, but there was noth- being exposed without proper [personal ing to leave work and just not see it, to see
ing else we could do and we lost them” protective equipment], and have almost people gathering and talking about their
(Kingsport, Tennessee). daily conversations with coworkers who travel plans, to see people waiting in a line
“The beds that we had created for our go to work every day fearful that this is the outside a bar to get in when you’re driving
COVID units, we’ve had to take away non- day they’ll get sick and take COVID home home after a horrible day. It’s so upsetting”
COVID beds” (Mishawaka, Indiana). “When to their families” (Seattle, Washington). (Columbia, Missouri).
we talk about limiting surgeries, it’s not “To protect yourself, you just shut “I do this day in and day out and
like we’re talking about minor things” down. You get to the point when you real- people are out there doing the wrong
(Tacoma, Washington). “Strokes are still ize that you’ve become a machine … thing. People are out there in bars, restau-
going to happen, heart attacks are still There’s only so many bags you can zip rants, malls—it is crazy—it’s like we work,
going to happen, cancer is still going to (Altoona, Iowa). “It’s demoralizing and work, work, work, work and people don’t
happen … There’s no one to send help” exhausting” (Chicago, Illinois). listen and then they end up in my ICU”
(Beaver Dam, Wisconsin). “You can’t over- “Many of you cheered and rang (Houston, Texas).
whelm a hospital and expect that care is bells and put up signs calling us heroes, “You see on social media people
not going to be compromised as a result” and we’re so grateful for that” (Portland, kind of mocking or saying it’s not very seri-
(Yuma, Arizona). Oregon). “… by fall people are questioning ous or comparing it to the flu but, you
“I wish people understood how hard what we’re trying to say” (El Paso, Texas). know, they don’t see what we see every
this is on health care workers” (Beaver “Nobody’s clapping anymore” (St Louis, day. They’re not holding the hands of
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Dam, Wisconsin). “It can be emotionally Missouri). “I guess people are tired of dying people whose family can’t get to
exhausting to give so much to your being alone or in their homes and want to them” (Greensboro, North Carolina).
patients and they’re still dying at such a get out and be social again” (Kingsport, “It’s so disheartening to feel that leaders
high rate” (Columbus, Ohio). Tennessee). in our government don’t have our backs”

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 News & Analysis
(Salt Lake City, Utah). “It kind of feels like
we’re just, you know, yelling into the
abyss” (Topeka, Kansas).
“We here, at the hospital, are no longer
the frontlines. We’re the last line of de-
fense” (Columbus, Ohio).
332 JAMA January 26, 2021 Volume 325, Number 4 (Reprinted)
© 2021 American Medical Association. All rights reserved.
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“We need community support right
now” (Mt Vernon, Ohio). “Right now, we’re
asking you to be our heroes and to listen
to our call for help again” (Portland,
Oregon). “Keep your social distance; wear
your mask; wash your hands and avoid
going to places where there are a lot of
people” (Houston, Texas).
“We cannot do this without you”
(Hamilton, Montana). “This is the time to
double down, not to give up” (Providence,
Rhode Island). “If you could just stop one
case by wearing a mask or staying home
when you didn’t have to go out, it would
help us so much…If everybody did that for
one person, I think we could stop this”
(Kingsport, Tennessee). “They seem like
minuscule tasks, but to us they could
make the greatest difference” (Marysville,
Ohio). “If people can do that, health care
workers like me will be able to—hopefully
rest” (Houston, Texas).
Author Affiliations: Bloomberg School of Public
Health, Johns Hopkins University, Baltimore,
Maryland.
Corresponding Author: Joshua M. Sharfstein, MD,
Bloomberg School of Public Health, Johns Hopkins
University, 615 N Wolfe St, Room W1033D,
Baltimore, MD 21205 (joshua.sharfstein@jhu.edu).
Conflict of Interest Disclosures: None reported.
Note: Source references are available through
embedded hyperlinks in the article text online.
Previous Publication: This article was previously
published in JAMA Health Forum at
jamahealthforum.com.
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