Vermont has struggled to contain the delta surge for months now, and COVID-19 cases and hospitalizations have reached all-time highs. It comes at a time when hospital workers say they are exhausted from nearly two years of the pandemic, and frustrated by people who refuse to get vaccinated.
Every day this week, VPR is airing stories from frontline healthcare workers at Northeastern Vermont Regional Hospital in St. Johnsbury. In this story, independent producer Erica Heilman speaks with hospitalist Yelena Kogan.
Northeastern Vermont Regional Hospital in St. Johnsbury has 25 beds, and it covers southern Essex and Caledonia counties. And as far as I can tell, there's only one registration desk. Nobody gets lost at NVRH.
But it's been hit hard by the latest COVID surge, and an accumulation of critical patients who have deferred care since COVID. And in a hospital this small, resources can get stretched thin, really fast.
I spent a couple of days talking with nurses and doctors about what's going on inside this building and how they're holding up. Dr. Yelena Kogan is a hospitalist here. I asked her to describe her work with COVID patients during the current surge.
Here she is, talking about a patient she worked with recently.
Yelena Kogan: “I'm going to say that this patient was — previous to this — rather healthy, but presented to the hospital with COVID that had been going on for some time and was unvaccinated. And by the time that he became my patient, he was requiring maximum amount of oxygen that could be provided without being placed on a ventilator.
“My first meeting with this patient, I walk in there with shaking legs, knowing that I'm about to tell the patient that they're likely not going to make it. When I talk to them, my voice is trembling. And in that specific case, I cried. I mean, I wasn't crying a lot because there is also an understanding that if you're crying, you're going to get your N95 mask wet and then it's going to be ineffective. So you have to contain any kind of human emotion as much as you can.
“You're also having to speak pretty loudly because of the fans going in the room that are creating the negative pressure. So the reaction of the patient who is seeing this person and let's be honest, they're seeing a fragment of our face. All they see is our eyes behind face shield and goggles, and they're hearing a trembling voice that is trying to yell information at them while they're wearing a mask that is pushing air into them and making it hard for them to hear with the fans going.
“I think that this patient was scared to death. We did get them on the phone with the loved ones right away, because I said, ‘You need to talk to them. I'm not so sure you'll be here tomorrow to have these conversations.’ There was just overall sense of panic, I think, on the patient’s side, on respiratory therapist’s side, on the nursing side, on, if I'm honest, my side too, because this was going to be a young patient that was going to die on my watch. And the patient, I'll give him credit, put up quite a fight for the life, but did not make it.
"If the public is burnt out from hearing about COVID and wearing masks and just done talking about it, imagine how we feel when we have to continue to risk our lives because you got tired of it, Vermonter. "Dr. Yelena Kogan, hospitalist at Northeastern Vermont Regional Hospital
“You go home and you question why you were doing all this. Why is it that you're risking your life going into that patient's room when they are not taking the minimum precautions, like wearing a mask, like getting vaccinated, like staying away from people who are probably sick, like going to these events that are known to be super-spreader events. Why do they keep doing this?
“I understand that in Vermont, we had been spared a lot of tragedy. Up until now. So perhaps the deaths and COVID itself was not as visible to certain pockets of our community. It's possible to live your whole life in Vermont, I suppose, and not encounter that personally. But most people now know someone that's had it. And probably by now, most people have heard tales of people that did not make it. So I think that probably the reality of COVID is starting to sink in.
“Every patient here, it being a small community in a small hospital, is someone's best friend, someone's friend's father, someone's grandmother and one or two links of separation away. We know these people. So every death hits us personally.”
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Erica: “What do you say to the Vermonters who can't quite believe that this is a critical problem anymore?”
Yelena Kogan: “Well, let me tell you that last week we had run out of necessary equipment to take care of our patients. True story. I'm not even sure that this, at this time, has been remedied, because everything was on back order and we couldn't get things like BiPAP machines or masks for BiPAP machines. COVID or not, if you happen to require this respiratory equipment and you were an unlucky person that came to our hospital requiring this help, we probably wouldn’t be able to help you then.
“This happened here in St. Johnsbury, Vermont. We've never seen so many young, super sick patients in the hospital before. I'd never felt like we were going to run out of respiratory equipment, and there it was happening in front of us. Now we're about to have holidays, Thanksgiving and Christmas. People are going to be traveling across the country to spend time with their loved ones.
“Not everybody in this neck of the woods is vaccinated, far from everybody, and we really need to have higher numbers than that. Every time a sick person comes to the hospital, the potential of infecting other patients is there.
“And risking my life coming to work is not what I signed up for. If the public is burnt out from hearing about COVID and wearing masks and just done talking about it, imagine how we feel when we have to continue to risk our lives because you got tired of it, Vermonter. Get vaccinated. It's going to save your life, lives of your loved ones. Just do it.”
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