WATERLOO, Iowa (KWWL)- They say superheroes don't always wear capes. These days they mostly wear PPE. You can find them on the front lines of the fight against COVID-19 at Waterloo Hospitals.
"I am mentally and physically exhausted," MercyOne Intensive Care Unit nurse Lindsey Panicucci said.
There have been 131 patients hospitalized in Iowa within the last 24 hours, and as of Sunday, the total number of hospitalizations is 1,175, which is down from the previous day's numbers. Of those hospitalized, 235 are in the ICU.
"This is real," Panicucci said. "People are dying here. I've seen more people die in the last seven days than I've talked to my own family members."
Down the road at UnityPoint Allen Hospital, House Supervisor and Floor Nurse Daniel Boese said it has also taken a toll.
"We're just tired," he said. "It's hard to come into work some days, knowing that you're short-staffed, and knowing that you're going to see people die."
When the COVID-19 pandemic first started in March, the biggest concern from front line workers was whether they would have enough PPE and the possibility of bringing the virus home from work with them. At one point, Panicucci sent her daughter out of her house for more than 70 days.
It is still a lingering fear but not as much as it was back in the Spring.
"What's so different this time around with this surge as it's so widespread in the community you never get away from it, " MercyOne Clinical Nurse Specialist Lindsey Nelson said.
It isn't their biggest worry, though. The top concern is not over a shortage of beds or equipment, but rather of staff.
Despite immense precautions, some hospital staff on the front lines treating COVID-19 patients are also being infected or having to quarantine from being exposed. It leads to more strain on the rest of the staff.
"We pick up extra shifts and cover those holes until we can get through that time period until they come back," Panicucci said. "I have a co-worker who has worked for the last 14 days."
Part of why hospitals like MercyOne have limited elective surgeries is to free up bed space and staff to help with COVID patients.
At UnityPoint, they see similar staffing issues. Boese said every day he tries to figure out where the biggest need is. Most days he said they are very close to being at capacity.
"We might have some open beds, but with the staff that we have available, sometimes we're close to our safe capacity for the number of staff that we have," Boese said. "Every day is a game of shuffling patients where they need to go so we can take care of everybody safely."
By and large, the staff at both hospitals have stepped up to pick up extra shifts, but the work is draining and takes a toll.
Nelson said one of the hardest moments was videotaping a patient's death for the family because they couldn't be there.
"Those are human beings that have families just like the rest of us, and they have to die without their family being there with them," she said.
The past few weeks have been tough emotionally for so many on the front lines. Boese said it is the times when there isn't anything he can do to help a patient that weigh heavily on him.
"You can set up a zoom call you can you can talk to people on the phone to try and comfort them, but there is only so much you can do," he said. "You go into nursing, or you go into being a physician to help people. And it's draining when you can't. And there's nothing you can do about it. Emotionally it's been very tough."
"Before this pandemic for me personally, I would get attached to patients, or I would get emotional when somebody's not doing well, but it's different now than it used to be. We are seeing such massive numbers of very sick people and people who aren't able to see their families. They can't even talk on the phone because they've got a mask over that you know like a breathing machine over their face.Daniel Boese, Unity Point Allen Hospital Floor Nurse and House Supervisor
To cope with it, Panicucci said she sometimes has to momentarily step away.
"If I need to take a 15-minute break to walk down to the chapel and just sit there in that stillness to regroup my mind and come back and be full force on the floor caring for these patients, I know my coworkers will step up," she said. "We cover for each other and we make it happen."
The front line workers said this latest surge is far more strenuous than the one in the spring.
"Things were steady, and then all of a sudden, boom," Panicucci said. "we are seeing community members coming in and they can't breathe anymore so they come into the hospital. It just seems to be nonstop."
While we know a lot more about the virus and how to treat it, Boese said the patients now are much sicker.
"We're a lot better at treating at this time but people are very very sick," he said. "Before, you could look at where these people were coming from and say, okay, they got it most likely from this area of their life they got from this workplace or from this thing. Now it's everywhere. There's no rhyme or reason to who's coming in."
There has always been a need for hospitals even before the coronavirus pandemic. Nelson said the latest surge is coming at the busiest time of year for hospitals in a non-Covid year.
"Fall into winter is our normal respiratory season, people get the flu, people slip and fall on ice, and everyone's trying to get their surgeries before the end of the year," Nelson said. "The added numbers and having the COVID patients has made it really hard to handle.
"How long will this go on and how long can we continue like this?"
Despite warnings from the nation's top health experts, Millions of Americans are taking to the skies and the highways for Thanksgiving.
On Meet the Press Sunday, Dr. Anthony Fauci said the holiday travel could make the current surge in Covid-19 cases even worse.
At MercyOne, nurses worry it could stretch already thin resources to the brink.
"People have been really helpful and willing to do whatever is needed to help their team. We have come in and work extra shifts to get through this," Nelson said. "But how much longer can you keep doing that? We really are depending on people being responsible for Thanksgiving so that we don't have the surge like we did this last month because we can't sustain that."
"We can handle a lot and we will stretch to accommodate the community. But if the community can do things to prevent more than we can handle, I think it's, it's our collective responsibility to do that.Lindsey Panicucci, BSN, RN MercyOne Intensive Care Unit
Front line health care workers are calling on the community to do its part. They are asking us to do the same things we have been talking about since the pandemic began. Wash your hands, wear and mask, and stay socially distant.
"We are hoping that people do those things because, at some point in the future, we may not have the capability to take care of the people who need care," Boese said. "We were capable of taking care of people now. But if the spike continues to go up, at some point, we are not going to be able to accommodate everybody that needs care. And that's never a place that we want to be."
Medical staff at both hospitals said they are doing everything they can to make sure that does not happen, but they need the community to help.
"In the beginning, it was fear, we were also scared about protecting our families and staying safe at work, and we quickly learn how to get over that," Nelson said. "Now it's anger. I'm angry that we're in this situation, and I'm sad. And I'm resolved to continue to fight and to continue to be safe and to continue to protect our community."
Watch the video above to see Panicucci, Nelson and Boese describe their experience on the front line fighting COVID-19 in their own words.
You can click through the slideshow of pictures to see the three in action.