An ER Doctor Describes What It’s Like to Treat Covid-19

The coronavirus has landed, hard, in American emergency rooms. Hospitals in some areas are overwhelmed with critically ill Covid-19 patients, as the patient surge that epidemiologists warned us about is beginning.

Now it’s on doctors and nurses in emergency rooms across the US, who are also desperate for personal protective equipment like masks and gloves. “We think of the US as one of the most well-resourced places in the world when it comes to health care, but it just goes to show that when there’s sort of widespread panic, normal supplies can be depleted fairly quickly,” says Cedric Dark, an emergency room physician at the Baylor College of Medicine in Houston, which is preparing for a surge in patients.

“The other thing that we’ve been doing in hospitals—not only in Houston but across the country—is trying to figure out ways we can use one ventilator machine for more than one patient.” There are very few ventilators to go around, partly because our federal government has been so lackadaisical in preparing for this threat.

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This novel coronavirus is so deadly because of what it does to the lungs, which normally act like a sort of dry sponge to exchange oxygen with the air. But the lungs of coronavirus patients begin to fill with fluid, which ER doctors like Dark can see in X-rays as white clouds. The fluid interferes with the exchange of oxygen, and the patient struggles to breathe.

If it’s a milder case, doctors might give a patient oxygen that they can inhale through their nose. “If someone goes into what we call respiratory failure, where their lungs can’t pull in enough oxygen, that’s when we have to put them on a ventilator machine,” Dark says. Because the machines are in such short supply, Dark’s colleagues are trying to figure out how to hook two, four, maybe even eight people up to one ventilator.

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But if we want anyone working on this problem, it’s the battle-hardened doctors and nurses of America’s emergency rooms. “Of the medicine world, we are probably the Doomsday preppers,” Dark says. “But the thing we’re not prepared for is making the ethical decision of—once we reach our saturation point—who do I decide lives and who do I decide dies? That, we’re not ready for.” This is the kind of triage normally associated with mass casualty situations, like wars.

WIRED sat down with Dark to talk about how he and his colleagues are coping with the pandemic, what you should expect in the ER right now, and even how you can help. (Hint: Don’t hoard masks. Donate them. And do your part to “flatten the curve” by staying home, so fewer people get sick and need help at a hospital.)

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