Want the best of VICE News straight to your inbox? Sign up here.
“Her heart rate’s failing.”
Doctors at the University of Arkansas for Medical Sciences, a public medical school in Little Rock, donned N95 masks and gowns as a critical care team prepared a crash cart in the hallway.
The hospital’s ICU was over capacity with more COVID-19 patients than they’d had in any prior wave of the virus. Six doctors quickly filled the room where this patient was being treated, and two nurses waited on standby in case she was going to code.
“The patient’s oxygen saturation is dropping,” Carmen Eaken, a nurse who works with some of the most critical patients at UAMS Medical Center, told VICE News. “All these COVID patients are so sensitive to any change in the disruption of the ventilator that just a few seconds of activity can cause them to drop dangerously low.”
A team of six doctors worked furiously to reestablish the patient’s airways. When they succeeded, a nurse, watching through the glass pane of the ICU bay, let out a celebratory cheer.
Dr. Nikhil Meena, an interventional pulmonologist, stood by the head of the patient and oversaw the team as another doctor squeezed a self-inflating bag to manually pump oxygen into the patient’s lungs.
But this patient still wasn’t out of the woods.
“They are still bagging the patient,” Eaken explained about the technique, used when a ventilator doesn’t provide enough oxygen. Now that the patient was stabilized, doctors returned to attempting a bronchoscopy, a procedure that requires passing a thin tube down the patient’s throat to clear the lungs of what Eaken referred to as “gunk.”
“That's the only way that they're going to be able to ventilate properly,” she added.
With COVID-19 patients, doctors sometimes have to repeat this process over and over again, Eaken said. “You have to imagine that everything done in a COVID room is more difficult because you have to have someone outside to get the supplies, you're in the gowns, the N95 mask with a regular mask over it, goggles … You're hot, it's uncomfortable.”
While this patient survived, a growing number are not.
When VICE News visited UAMS Medical Center, the hospital had 66 COVID-19 patients, more than their last peak of 63 COVID-19 patients, in January 2021. The ICU was over capacity and over 90 percent of the patients hospitalized with COVID-19 were unvaccinated.
Arkansas has one of the lowest vaccination rates in the country with only 44.1 percent of the population 12 and up fully immunized, according to the Arkansas Department of Health. As a more contagious Delta variant becomes the predominant variant in Arkansas, the state is entering a new phase in the war against COVID-19.
“The second pandemic is a pandemic of the unvaccinated,” Dr. Meena told VICE News. “People were more rescuable in the first pandemic.”
Key differences with the Delta variant, Meena noted, are that 20 percent of patients hospitalized at UAMS Medical Center from COVID-19 are pregnant women and younger people have a higher mortality rate.
“So it's a whole lot more effective than the first virus was,” he added.
The median age of virus patients is also younger now, at 40, according to Dr. Cam Patterson, the Chancellor of UAMS, who called this wave a “completely different virus.”
“We've had many pregnant patients who have been admitted to the hospital with complications of COVID-19 sadly,” he said. “We've lost some babies from pregnant moms, so this has really shifted down. It's no longer a bad case of the flu.”
Despite the greater risks associated with contracting the Delta variant, many Arkansans still refuse to get vaccinated.
“I did not realize that the threat of death is inadequate to make people want to go have vaccines,” Dr. Meena said. The pulmonologist has attempted to convince patients and their families to get vaccinated, but he’s only succeeded about a fifth of the time. “There's a fair number of people who don't believe they have COVID and that we're lying to them,” he said.
When Dr. Meena attempts to educate his patients, he finds that the process itself can cause his patients to get unstable. “If they get too agitated, then they get more short of breath, then they require more support and then they get intubated, which then leads to a longer hospital stay,” he said.
VICE News wasn’t allowed into any of the patients’ rooms, but we did interview Celice Chandler, one of Dr. Meena’s COVID-19 patients, over a walkie-talkie, separated by a glass window. Chandler said that at first she thought she was only experiencing allergies but within seven days her symptoms escalated to pneumonia.
“When you cannot breathe, you can't get air, it is very scary,” she said through labored breaths.
Sitting upright on the hospital gurney with high-flow oxygen rushing through a nasal tube, Chandler explained that she and her husband both thought COVID-19 was just a hoax. While Chandler’s husband is still skeptical about her diagnosis, Chandler now says she understands.
“I'm living something I didn't believe. I'm living it. And people need to know that it is real. It is real, people are dying. They are dying,” pleaded Chandler, gripping the walkie-talkie in her hand.
While Dr. Meena had thought he broke through to Chandler, she’s still one of his many patients who refused to get vaccinated, despite being incredibly sick.
“She was going to advocate for vaccines when she left the hospital,” Dr. Meena said. “Over the last two days, she's gone back to her initial vaccine hesitancy.”
“I've read all the bad stuff on it and not read any of the good, ’cause I didn't believe it. So I have to change my thinking and study,” Chandler told VICE News. When asked if she’ll get the vaccine, Chandler responded, “Not at this time.”
When pressed about how the pandemic will end if more people don't get vaccinated, Chandler said, “I can't answer that.”
Lindsey Smith, who came into the hospital to give birth, didn’t get the vaccine either.
Smith tested positive for the virus, and though she's asymptomatic, she had to be separated from her newborn son, Mac. So instead of holding her newborn, she watches him in the NICU from a baby monitor app on her phone.
“He's supposed to be with me, you know. He's been with me the whole time, and now I can't even hold him,” Smith said. “So that's definitely hard. I haven't gotten to meet my son yet.”
As tears built up around Smith’s eyes, her husband leaned over to comfort her. But did being in the hospital, unable to be with her son made her regret not getting the vaccine?
“No, no,” she said. “Because even with getting the vaccine, you can still spread it. You can still get it. There simply aren't enough studies for it.”
Smith went on to cite debunked conspiracy theories to support her reasoning.
“You hear things, you know, like it's changing genetics. It's changing DNA and things like that. I don’t know how true that is but I also don’t know how true the things that they are saying—the good things about it that they say,” she said.
Doctors in the hospital aren’t only combating COVID-19. They're also fighting a surge of disinformation. Dr. Meena attributes his anti-vaccine patients’ views to the media they consume.
“I didn't think I would live through a time when vaccines would be so ridiculed,” he said.
Healthcare workers are exhausted and frustrated, with no end in sight. Some nurses at this hospital have even walked off in the middle of their shifts. Dr. Patterson told VICE News that he worries about what his staff witnesses on the front lines.
“You see people, young people, healthy people who are dying and they have babies, the babies are dying. You know, at some point that's not just burnout; it becomes acute mental trauma,” he said.
“It's really hard to come to work all the time and just see such sick young patients,” Alyssa Kirkpatrick, a critical care nurse, told VICE News. Many of her patients are in their 20s and 30s “who are on every single resource that we can throw at them to keep them alive.”
Kirkpatrick works with patients on ECMO, or extracorporeal membrane oxygenation, a machine that bypasses the lungs of critical patients when they’re too weak for a ventilator to work. To get through the day, Kirkpatrick said, she focuses on her own well-being.
“I always joke and say, you know, I can't take care of my patients until I take care of myself,” she said. “You know, at this point, I'm kind of like, it is what it is.”