‘Shared Challenge’ And ‘Shared Courage’: Bracing For The Coronavirus Surge

April 6, 2020
Dr. Timothy Rummel, pulmonary critical care physician in Colorado SpringsCredit Courtesy Dr. Timothy Rummel
Dr. Timothy Rummel, pulmonary critical care physician in Colorado Springs

Colorado is among the places on the national radar for an emerging surge in possible COVID-19 cases. As of this past weekend, Colorado had seen nearly 5000 known cases, and 140 deaths as a result of the spread of the new coronavirus. 

In El Paso County alone, there have been 25 related deaths.

KRCC's Andrea Chalfin recently spoke with Dr. Tim Rummel, a pulmonary critical care doctor at UCHealth, on what it's like as the number of cases continues to grow.

Excerpts from the conversation, edited for clarity:

[Dr. Tim Rummel]: We have a steadily and accelerating enlargement of the population in the ICU that are occupying ventilators with COVID-19. A couple of weeks ago it was in the single digits. Over the last week to 10 days, our ICU population of COVID patients has doubled every three to four days so that now we're about half of our ICU beds to two thirds of our ICU beds are occupied with COVID patients.

[Andrea Chalfin] Colorado's numbers, they keep going up. I'm just wondering what the expectation is. 

[TR] Well, our biggest difficulty is the duration. If you look at our historical average length of stay in the ICU, we certainly have folks that have long stays in the ICU. But our average length of stay for an admission is somewhere between three and five days. Whereas with COVID patients, we know from other centers and from our initial experience here, they are on the ventilator two or three weeks, if they do well. It's a really arduous, slow process. It's like swimming against mud. And because of that, this group of ICU patients just grows and grows and grows. 

"People are really caring for the welfare of each other. And they come to work, acknowledging that there is a rational amount of fear that you have to operate with."

[AC] And is that across all demographics? 

[TR] Yeah. So once you're sick enough to need a ventilator, then you've kind of defined yourself as that group. And it's a unique illness. We're sort of learning on the fly, sharing with other groups across the nation, and everybody is kind of describing very similar characteristics. 

[AC] What is that like when you go in everyday on a normal basis and you've got these protocols and procedures to follow, but now everything, it seems like, it's a little bit different. 

[TR] I would say that's been one of the greater challenges, is that if you've been in practice for 10 to 15 years, most of the time, you know what to expect. Whereas we are, I guess I would say, we're taking it on as a real challenge. And at the same time, it really makes your work a little bit more heavy lifting because it's hard enough just to have the increased volume. 

[AC] What's the mood like around the facilities? 

[TR] You know, I would say overall, what you notice is that people are really caring for the welfare of each other. And they come to work, acknowledging that there is a rational amount of fear that you have to operate with. 

Once you acknowledge that, you acknowledge it to each other, you have to basically set it aside and say, now we're doing the task at hand while we're staying careful with each other. So in some ways it's a big shared challenge. And there's a certain amount of shared courage that that people have to have. 

I wouldn't say it's this kind of dark mood or dreadful mood. It's actually more of soldiers doing their job. And then at the same time, feeling a calling. I think people realize this is mission in ministry, and sacrifice, and that in the end, it may be our finest hour. 

"In some ways it's a big shared challenge. And there's a certain amount of shared courage that that people have to have."

[AC] What are you expecting and what are you preparing for? 

[TR] I think when you're preparing for the surge, which is what we're preparing for right now, the problem is we don't know how big the surge is going to be. There's best case scenarios and worst case scenarios, we just know it's going to happen. And in some ways, it is like preparing for a blizzard. You know the blizzard is coming, but it's Colorado. It could be eight inches. It could be 24 inches. If it's eight inches, I can still drive to work. If it's 24 inches, I can't get out of my driveway. 

When Anthony Fauci... he said we don't determine the timetable, the virus determines the timetable. I really think there's a worst case scenario, best case scenario.

But in the end, whether that's six months from now or 12 months from now, there's only going to really be one story. And it's revealing, you know, as it goes.