“We are all in a better place,” Lee said. “For obvious reasons.”
In D.C. as of Friday, no coronavirus-related deaths had been reported since June 19 and just 10 intensive care unit beds were occupied by covid-19 patients, according to The Washington Post’s tracker.
Both Maryland and Virginia have seen similar declines in hospitalizations and deaths — with Maryland on Friday reporting that there were fewer than 100 people hospitalized, the lowest recorded level since the pandemic began.
All three jurisdictions now say that more than 50 percent of their populations are fully vaccinated, higher than the 47 percent national average.
The people who are still sick enough to be hospitalized are those who have not yet gotten vaccinated, according to physicians at hospitals in all three jurisdictions. Sometimes, though very rarely, these hospitals are seeing patients who are fully vaccinated test positive for coronavirus, the doctors said. But those vaccinated individuals are not sick enough that they need inpatient care.
Doctors said in interviews that dramatically lower patient censuses mean they are able to take time off — in some cases for the first time since March 2020 — and begin to process the chaos of those 16 months.
They said they are also looking toward the future, hopeful that the coronavirus pandemic will bring sustained attention to long-standing disparities in access to medical care and concerned that this will not be last global health crisis they confront.
“We are more aware of our own mortality,” Lee said, recalling the intense fear of the unknown that so many felt during the early days of the pandemic. “We know things are never going to be the same.”
At MedStar Washington Hospital Center, the largest private hospital in D.C., the number of covid-19 patients in the intensive care unit reached zero for the first time this week, said Alexandra Pratt, chair of the critical care department.
The moment felt “amazing,” she said. But at the same time, staff are now seeing a surge in patients needing care for illnesses not related to covid-19, some of whom delayed medical appointments because of the pandemic. “It’s almost like a catch-up effect,” she said.
And she and other staff are considering the possibility of another pandemic — which is something Pratt said she dreads, but she also notes that the hospital would be better prepared because of the lessons that were learned since last spring.
“We would say, ‘Okay we have done this before,’” Pratt said.
In neighboring Prince George’s County, Luminis Health Doctors Community Medical Center on Thursday reported no covid-19 patients in the hospital for the first time since the pandemic began, said Kanak Patel, the director of critical care for the health network. That’s markedly different than even two months ago, Patel said, when there were between 20 and 25 coronavirus-infected patients in the hospital daily.
And Patel said it feels like an entirely different career from last spring, when there were often almost 70 covid-19 patients being treated at Doctors.
“It’s surreal to think there was a time when we didn’t know whether this day was going to come, ever,” he said. “As quickly as this was brought upon us, it seems to be melting away, thanks to the vaccine.”
The Zip codes that Doctors served were some of the hardest hit by the pandemic in the state; Prince George’s, which is more than 80 percent Black and Latino, saw the highest per capita case and death rates in the region.
Patel said he hopes that as a result, there’s an increased awareness moving forward about the importance of addressing inequities in access to medical care.
At the UVA University Hospital in Charlottesville, intensive care unit director Taison Bell said the number of covid-19 patients in the ICU has held steady in recent weeks — about seven patients this week, down from a high of more than 20 during the winter peak.
Bell said vaccine uptake has been high in the community surrounding Charlottesville, but critically ill patients are still being transferred from pockets of the state where vaccination rates are lower.
He said he has seen more critically ill people in their 40s, 50s and 60s in recent months and fewer in their 70s or older — a shift he attributed to the success of the campaign to inoculate nursing home residents and prioritize seniors.
He is encouraging hospital staff, who are exhausted after more than a year of treating the sickest patients in the state, to spend more time in the garden outside the hospital and to focus on their own well-being.
“Health care workers,” Bell said, “are more used to shouldering our patients’ pain than to shouldering our own.”
At Suburban Hospital in Bethesda, epidemiologist Sonia Qasba, who co-led the hospital’s medical covid-19 response, has been on call 24-7 since last March, frequently working overtime and only recently taking her first vacation. She said it was striking to see how much everyone came together to confront the unknown in the pandemic’s early days.
“It was utter chaos,” she said. “But we had each other, and we had a lot of resiliency … I wouldn’t change it for anything.”
With no covid-19 patients in the hospital in recent days, she said, she and her colleagues are beginning to adjust to the “new normal.”
At Norfolk-based Sentara Healthcare system, pulmonary and critical care physician Mary Baker said she has been reflecting in recent days about what that phase will look like, and how she and her staff can process the trauma of the deaths they witnessed.
“I’ve been taking stock,” she said, “Trying to think about how we move on as a system. How do I help people heal?”
Baker, who helped lead the system’s covid-19 response, said all employees are being encouraged to seek counseling and that she plans to do the same. Many are evaluating their work-life balance, she said, in an attempt to readjust after months that felt “like an assault on the ICUs and on the hospitals.”
At United Medical Center in D.C. — the only full-service hospital in the city’s poorest wards east of the Anacostia River — there are still an “unfortunately” high number of covid-19 patients who have yet to be vaccinated, said Mina Yacoub, chairman of critical care medicine. It’s a problem the staff try to address via one-on-one conversations with every patient, he said.
Yacoub said the census in the ICU has declined since May — which he attributed not only to vaccine uptake, but also to decreased transmission during summer months and the availability of better treatments that prevent people from becoming severely ill.
There were two patients in the intensive care unit on Thursday, Yacoub said, dramatically lower than at the peak last April and May, when the 14-bed unit was almost always full or nearly full.
One-third of the hospital’s total admissions related to covid-19 were before May 30 of last year, he said, and one half of its pandemic-related deaths came before June 30 of last year.
As the number of admissions have decreased and survival rates increased, Yacoub said, staff morale has dramatically improved. Now when a covid-19 patient is admitted to the ICU, he said, they are seen as anyone else in need of critical care.
“It is just another admission . . . There’s much less apprehension,” he said. “It has become a new norm.”