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Is California Headed for a NYC-Type COVID Crisis? Interview With UCSF’s Dr. Bob Wachter

Hospitals across California are filling up with COVID-19 patients, and some counties report their intensive care units are already maxed out.

KQED’s Brian Watt spoke earlier in the week about this dire situation with Dr. Bob Wachter, chair of the Department of Medicine at UCSF. The following has been edited for length and clarity.

Is California heading for what we saw in New York in the spring?

Bob Wachter: If we don’t turn the curve around, the answer is probably yes. We’re better prepared than we were. We have medicines. We know how to treat this disease. But, if we get overwhelmed with patients in our ICUs we don’t have enough doctors, don’t have enough nurses, we know that the outcomes are going to get worse, and mortality will spike. And in some communities in California, we’re getting perilously close to that. So we have to do everything we can to turn that around.

What have hospitals done to prepare for this critical moment? 

Many of them have increased their capacity. At UCSF, for example, we were able to open Mount Zion Hospital in San Francisco. And St. Francis opened up some capacity.

We’re better at treating it; there are now a few medicines that we now know work. And we’re better at just the day-to-day care of COVID patients. We understand some of the complications that we didn’t in the beginning.

But a lot of that goes out the window if we simply don’t have enough doctors and nurses and ventilators to take care of the patients. So,  you’re better off getting sick today than you would have been in March. But you still don’t want to get this disease, and you certainly don’t want to get this disease and need to go to a hospital that is absolutely overwhelmed.

As more people get sick, they could infect more health care providers. Is this something that really worries you, that we’re just going to run out of people to help care for people? 

Yes. That’s our most precious commodity, our people. And it’s not just the doctors and nurses who might get infected by people in the hospital. You know, we’re living in the community, too, and we are essential workers. We’ve got to be out and about and go to the hospital and and go to the stores and do everything else. And so as the communities are surging, health care workers are getting sick the same as everybody else.

If we don’t have enough doctors and nurses, that’s probably our critical shortage. There may be shortages of protective equipment, as there were in the beginning, but that’s not as critical as just making sure we have enough doctors and nurses and respiratory therapists and others to take care of you.

What does burnout look like for physicians and nurses?

People are tired and frazzled and frustrated and it makes it just harder for them to do their job. They’re professionals and they come in and they will do the work. But, you know, people are depressed and they’ve been at this for 10 months now in the Bay Area. We have had the most benign experience of any large city in the country so far, so the burnout is tempered by the fact that we have not gotten hammered. But it still is exhausting, and particularly when you know that a lot of the cases could have been prevented if people followed the guidelines.

Are you worried about vaccine hesitancy among people?

Yes, we really are. We need about 70 percent of people to get vaccinated in order to bring this pandemic to something that resembles an end. In the short term, we’re not that worried because there’s not going to be enough vaccine for everybody. But as we go on, I’m hoping that people recognize this vaccine is remarkably effective and appears to be very, very safe. And if they take it, we can get back to something resembling normal by the late summer, maybe fall.

Copyright 2020 KQED