Colorado’s Coronavirus Pandemic Transformed Once Busy ERs Into Hurry Up And Wait Rooms

courtesy of Dr. Ramnik Dhaliwa
Nurses at St Joseph (From right to left: Kristi Legaarden, Katie Greer, Angie Romero, Jenn Fisk, Sarah Bailey, Wyn Chen)

After a snowstorm in Denver left inches of heavy, wet snow on the ground, Dr. Ramnik Dhaliwal started his emergency room shift at St. Joseph Hospital. Just after 8 a.m., the ER was quiet. Almost eerily so.

“Not gonna lie, a little bit bored today,” he said.

On a snowy day, the ER is usually quiet, but COVID-19 preparations have magnified the effect.

This story is part of a project that follows a day in the life of Colorado on Thursday, April 16, 2020

Through the statewide stay-at-home order and measures enacted to keep people out of hospitals who don’t need to be there, hospitals have seen fewer patients overall in preparation for coronavirus patient surges. 

The drop in patients, combined with the cost to prepare for COVID-19 patients and the effects from the general economic downturn means hospitals are losing money. 

courtesy of Ramnik Dhaliwal
Dr. Ramnik Dhaliwal at St. Joseph Hospital Emergency Room.

“A number of hospitals have had to lay off staff for a couple of reasons,” said Katherine Mulready, senior vice president and chief strategy officer of the Colorado Hospital Association. “Certainly we have a lot of patients coming in with COVID and other conditions just like normal, but it's not necessarily the same types of skill sets. So, for example, you might not need your surgical oncologist as much as you did two months ago because they're not doing a lot of those non-emergent surgeries.”

St. Joseph has not laid off staff, according to a statement from Dina Bush, the hospital’s vice president and chief nursing officer. But it has had to adjust scheduling and staffing by asking those who are not working at full capacity to take paid-time-off.

Dhaliwal said it’s just another part of adjusting to the pandemic, sort of like wearing personal protective equipment. Each day he wears a mask, protective glasses, a scrub hat and shoe coverings. He understands the need, but he’s bothered that it takes away from the personal nature of his interactions with patients. 

“Hopefully this doesn’t stay like this forever,” he said. “Just waiting for that vaccine.”

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Around midday, someone dropped off headbands with clips for face masks, which will take the pressure off the backs of nurses' ears. He hopes to see the support not only for health care workers but for one another, continue after the pandemic ends. 

“It’s been kind of amazing, to me, to see how much people do care about each other in times of need,” he said, “and come out of the woodworks to do it.” 

While he’s been proud to see the community rally together and take care of one another, he worries about people who avoid the ER when they shouldn’t

“I had a person who had an MI the other day or heart attack,” he said, “and he waited three days and that causes worsening heart injury.” 

He said it’s part messaging — people know to stay away from the ER — but it’s also fear of contracting the virus at the hospital. 

“While initially people weren't sure as far as what was going on, and in essence, we were still creating plans of how we were going to manage this, I think now, the EDs across the state are fully capable of providing safe care for folks,” Dhaliwal said.

As chair of COVID-19 response for the American College of Emergency Physicians, he’s heard stories from other doctors of patients who had strokes and someone with a ruptured appendix waiting to go to the ER, which causes complications and worse outcomes. 

It remained slow most of the day, but Dhaliwal said they still got their share of the “regulars,” folks who are intoxicated and end up in the ER, and who sometimes provide a little levity.

A colleague of his had an intoxicated patient who was found outside. She went in to examine the patient who grabbed her arm and said, “Doctor, you know I’m naked under here.” 

By 4 p.m., Dhaliwal was ready to head home. He looked forward to seeing his 3-year-old son and his 4-month-old daughter. One of the silver linings of the pandemic is the time they spend together as a family. No daycare means his kids are home when he gets there. 

“Something I’ve been cherishing every day,” he said.

This story is part of a statewide reporting project with more than 20 newsrooms led by the Colorado News Collaborative to document a day in the life of Colorado on Thursday, April 16.