There’s an average of 20,000 new cases a day in Texas

The Alabama hospital’s ICU has been overflowing for six weeks, with 16 virus patients on ventilators in a hospital that a year ago had only 10 of the breathing machines. “You can see the stress in people’s faces and in their body language. It’s just a lot for people to carry around,” Smith said.

“Just the fatigue of our staff can affect quality of care. I’ve been encouraged we’ve been able to keep the quality of care high,” Smith said. “You feel like you are in a very precarious situation where errors could occur, but thankfully we’ve managed to stay on top of things.”

Hospitals say they are upholding high standards for patient care, but experts say surges compromise many normal medical practices. Overwhelmed hospitals might be forced to mobilize makeshift ICUs and staff them with personnel without any experience in critical care. They might run out of sedatives, antibiotics, IVs or other supplies they rely on to keep patients calm and comfortable while on ventilators.

“It’s really daunting and mentally taxing. You’re doing what you believe to be best practice,” said Kiersten Henry, a nurse at MedStar Montgomery Medical Center in Olney, Maryland, and a board director for the American Association of Critical-Care Nurses.

In Oklahoma City, OU Medicine Chief Medical Officer Dr. Cameron Mantor said while the vaccines hold promise, hope still seems dim as ICU cases keep mounting. The number of COVID-19 hospitalizations at OU Medicine has declined from more than 100 daily in recent weeks to 98 on Wednesday, Mantor said.

“What is stressing everybody out,” Mantor said, “is looking at week after week after week, the spigot is not being turned off, not knowing there is a break, not seeing the proverbial light at the end of the tunnel.”