A Houston Doctor On His Hospital's 'Deadliest Week' So Far

Jul 31, 2020

"In my hospital, last week was the deadliest week I've ever had in my life."

The words of a Houston doctor treating COVID-19 patients illustrate the brutal reality facing many in the U.S. medical system now.

Dr. Joseph Varon is the chief of critical care at Houston's United Memorial Medical Center. Harris County, where Houston sits, has the fifth-highest number of confirmed coronavirus cases of any U.S. county. More than 1,200 people in the county have died.

"I signed more death certificates last week than in my entire life almost all put together," Varon tells NPR's Steve Inskeep on Morning Edition.

For the last four months, Varon has been waking up at dawn every day and heading to the hospital, where he spends between six and 12 hours on rounds before seeing new admissions. When he gets home, he sleeps at most two hours a night. "I try to go to sleep, but people call me nonstop," he says.

Varon manages a large team of people who are both exhausted and afraid.

"I have over 300 doctors in the staff at our hospital and only three or four of us go into the COVID unit," Varon says. "And I am there most of the time. People are afraid of going into COVID units, and I cannot force them to go in. That's one thing that I cannot do because there is an intrinsic risk of working in a COVID unit."

Here are excerpts of his interview:

Is your unit ever on the verge of being overwhelmed?

Every day. I mean, it's been crazy. The last few weeks have been way overwhelmed. What I mean by that is that I may have the beds, but I don't have the staff. You know, my nurses are exhausted. They're tired. These are individuals that normally, let's say, work three times per week, and they have been stretching themselves to work six, seven times a week. I mean, they're both physically and emotionally drained, because if you look at the last three weeks where we have our highest mortality rates, it's scary and it drains you emotionally.

If the governor were to call you up and say he'd really like to reopen schools, but he wants to know if your hospital can handle it locally, the extra cases, what would you tell him?

Absolutely not. There is no way that our hospitals could handle it. Not only my hospital, no hospital could handle it, because it can be a really large surge. Just to give you an idea, one individual can infect up to 52 persons per hour. ... You can get yourself into a serious situation.

We were reporting on a large number of health experts who are essentially arguing that the national strategy against COVID up to now has been a failure and that it's time for a do-over. Let's go back to where we were in March, shut everything down and start all over again. Is it that bad?

I mean, you cannot shut down a city, a state, a country without an educational component. You know, when we closed the city in April, the city is closed and then everybody gets cabin fever. And the day that we open the city, everybody goes out, people go to the beach, people go to bars. They don't care. I mean, they fill it up.

If you were going to close the city, you would have to have an educational component that would have to be enforced. Enforced means: If I'm telling you to wear a mask, you are going to wear a mask. Because when you wear a mask, you are not doing it to protect yourself. You are doing it to protect the other person. To be honest with you, as Americans, we can do much better than what we're doing at the present time.

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STEVE INSKEEP, HOST:

Texas is reporting its highest single-day coronavirus death toll - 322 people. A lot of the suffering is concentrated in Houston. Surrounding Harris County is one of the worst affected counties in the nation. The people who manage the consequences include Dr. Joseph Varon, chief of critical care at Houston's United Memorial Medical Center.

JOSEPH VARON: Well, you know, for the last 133 days, I've been working on my COVID unit. So I wake up, you know, at the crack of dawn, go to the hospital, start rounds. And that can take me anywhere between, you know, six and 12 hours. Then I go to see new admissions. And then, eventually, I get to come home. I try to go to sleep. But people call me nonstop. I've been sleeping no more than two hours per night.

INSKEEP: Oh, my goodness. As chief of critical care, are you managing other doctors and nurses as well as seeing patients directly yourself?

VARON: Well, I mean, I manage the entire system. I'm the chief of staff as well. So I manage a lot of people. However, in the COVID unit, you know, doctors don't want to go to the COVID unit. Interestingly, you know, I have, you know, over 300 doctors in the staff at our hospital and only three or four of us going to the COVID unit. And I am there most of the time. People are afraid of going into COVID units. And I cannot force them to go in. That's one thing that I cannot do because there is an intrinsic risk of working in a COVID unit.

INSKEEP: Well, that brings to mind what many people have said, that the shortage here is not necessarily of hospital beds, it's of people to man them, to staff them. Is your unit ever on the verge of being overwhelmed?

VARON: Every day (laughter). I mean, it's been crazy. The last few weeks have been way overwhelmed. What I mean by that is that I may have the beds. But I don't have the staff, you know? My nurses are exhausted. They're tired. These are individuals that normally, let's say, work three times per week. And they have been stretching themselves to work six, seven times a week. I mean, they're both physically and emotionally drained because if you look at the last three weeks, where we have our highest mortality rates, I mean, it's scary. And it drains you emotionally.

INSKEEP: Doctor, I'm troubled to hear you say that in the last three weeks, you've had your highest mortality rates because, nationwide, we've been told that mortality rates have been going down, that more people may be getting infected or sick but they don't die as often. Is that not the case in your hospital?

VARON: Well, I will tell you that, you know, I don't know what happens in the rest of the country. I can tell you what happens in my hospital. And in my hospital, last week was the deadliest week I have ever had in my life. I signed more death certificates last week than in my entire life almost all put together.

Now, having said that, I still have the best record for success of treatment of patients with COVID in the country. I have a success rate in excess of 95%. So we're doing pretty good. You need to see some of the other hospitals that I have been talking to. I mean, I have some of my friends in south Texas. I mean, they basically have refrigerator trucks outside the hospitals so they can put the bodies of people in there because they - their morgues are not capable of handling more patients.

INSKEEP: If the governor were to call you up and say he'd really like to reopen schools but he wants to know if your hospital can handle it locally, the extra cases, what would you tell him?

VARON: Absolutely not. There is no way that our hospitals could handle it. Not only my hospital, no hospital could handle it because it can be a really large surge. Just to give you an idea - one individual can infect up to 52 persons per hour. Imagine a kid. How many people can a kid infect? You can get yourself into a serious situation.

INSKEEP: Just earlier this week, Doctor, on NPR, we were reporting on a large number of health experts who are essentially arguing that the entire strategy, national strategy, against COVID up to now has been a failure and that it's time for a do-over. Let's go back to where we were in March. Shut everything down. Start all over again. Is it that bad?

VARON: I mean, you cannot shut down a city, a state, a country without an educational component. You know, when we close the city in April, the city is closed. And then everybody gets cabin fever. And the day that we opened the city, everybody goes out. People go to the beach. People go to bars. They don't care. I mean, they fill it up.

If you were going to close the city, you would have to have an educational component that would have to be enforced. Enforced means if I'm telling you to wear a mask, you are going to wear a mask because when you wear a mask, you are not doing it to protect yourself. You are doing it to protect the other person. To be honest with you, as Americans, we can do much better than what we're doing at the present time.

INSKEEP: Dr. Joseph Varon in Houston. Thank you so much.

VARON: My pleasure. Transcript provided by NPR, Copyright NPR.