Frontline Health Care Workers Reflect On Early Days Of Covid 5 Years After Who Declared Pandemic

Dr. Kimberly Shriner remembers the first COVID-19 patient who came into Huntington Hospital in Pasadena, California, in March 2020.

He was a 35-year-old man who arrived at the hospital short of breath.

"He went straight to our intensive care unit. We were very suspicious that he had COVID," Shriner, an infectious disease specialist and the hospital's medical director of infectious disease and infection prevention, told ABC News.

Testing was minimal at the time, but eventually the results came back and confirmed that he had COVID. The patient was eventually sedated and intubated, and he died 24 hours later. Shriner said the next few patients admitted to the hospital for COVID-19 followed similar trajectories, becoming more and more short of breath before eventually dying of their illness.

"As physicians, we understand death," Shriner said. "We understand that we can't save every patient, but when you're having 100% mortality with your first experience with this thing, it was pretty overwhelming and daunting. That first week [was] particularly surreal."

Tuesday, March 11, marked five years since the World Health Organization (WHO) declared the global outbreak of COVID-19 to be a pandemic. The U.S. is in a much better situation now, with fewer hospitalizations and deaths -- and vaccines to prevent severe illness from COVID, frontline health care workers say.

However, they add that, as Americans become more removed from the early days of COVID, it may be hard to remember what it was like -- especially for those who were treating patients.

"Everybody was worried, doctors, nurses," Dr. Matthew Sims, director of infectious disease research for Corewell Health, a non-profit health care system located in Michigan, told ABC News. "It was absolutely crazy, and I think that people have forgotten. I think people have forgotten the horror of what COVID was like in the beginning and, I mean, it was a horror situation."

Quickly changing world

Shriner said one of the indicators of how quickly the world was changing was the evolution of her hospital's meetings about the virus and how to prepare as information was starting to come out of China.

"Meetings were held in a very tiny, little meeting room. Nobody was wearing masks or anything," she said. "And then as things began to evolve, and we saw it was happening, that the rooms got started getting bigger, and then we started meeting with masks on, and then, eventually, went virtual."

Shriver recalled that the situation was "very terrifying" on a personal and professional level.

"If we'd known how difficult it was going to be, I think we would have been even more disturbed," she said.

Sims said it became clear how quickly patients could get infected in March 2020. Not long after the WHO declared a global pandemic, he came on shift that week to be the infectious disease doctor rotating in the hospital.

"We had two confirmed cases admitted at that point. By the end of the week I spent on, we had over 100 confirmed cases admitted," he told ABC News. "It was absolutely devastating to the hospital, to the health care system as a whole ... It was a crazy time."

The state of hospitals

Both Sims and Shriner said the lack of early testing at the time was a source of frustration. Since routine testing wasn't available, results often took days -- or even weeks -- to return.

Additionally, hospital labs often had to confirm results with state departments of health.

Sim said as the hospitals became full, it sometimes became a race against the clock to try and treat patients.

A patient is taken from an ambulance to the emergency room of a hospital in the Navajo Nation town of Tuba City during the 57-hour curfew, imposed to try to stop the spread of the Covid-19 virus through the Navajo Nation, in Arizona, May 24, 2020.

Mark Ralston/AFP via Getty Images

"I remember one of the most devastating cases I saw was a young man, relatively young, young kids at home," he said. "A little overweight, I think he was a diabetic, but he just got super sick, and we were trying to get remdesivir, which was compassionate use at the time," referencing an antiviral drug later approved to treat COVID-19.

Sims said the hospital had to call up the company manufacturing the drug, tell them about the patient and then get approval from the U.S. Food and Drug Administration (FDA) to use doses on the patient.

"And we got approval, and then they have to ship it to us," Sims said. "It was all being shipped as fast as possible, but before it could even get here, that patient got too sick to even use it, and the patient died. A week before, he was home with his kids, his wife, et cetera, in normal state of health, and then, all of a sudden, got this terrible virus and died."

As it became clear how contagious the virus was, hospital staff were required to always wear masks. Shriner said she still has a scar or imprint on her nose from having to wear a mask for 18 hours a day.

One of things she remembers most was the lack of sound, other than machines, whenever she visited ICUs.

"As the months progressed, we ended up having six different intensive care units because the patients were so sick," she said. "We had many, many patients that were on ventilators. You'd walk into these areas, and it was just silence. All you heard were the ventilators going and seeing people in full protective gear all the time."

To handle the influx of patients, both hospitalized and in emergency departments, Shriner said her hospital stopped all non-emergency surgeries to be able to have extra physicians available.

COVID-19 vaccines arrive

On Dec. 11, 2020, the FDA granted Pfizer-BioNTech the first emergency use authorization for a COVID-19 vaccine for those aged 16 and older. Three days later, nurse Sandra Lindsay became the first person to receive a COVID-19 vaccine in the U.S. as distribution began.

Both Shriner and Sims felt a sense of relief that a tool was finally available to help stem the spread of disease.

Shriner said she was the first person in her hospital to receive the COVID-19 vaccine, even though she didn't want to be.

COVID-19 vaccine is stored at -80 degrees celsius in the pharmacy at Roseland Community Hospital, Dec. 18, 2020, in Chicago.

"I didn't want to be the first person. I was perfectly fine with letting other people go ahead of me," she said. "And [the CEO] said to me, 'You have to be.' She said, 'If you don't get vaccinated, nobody else is going to do it.'"

Shriner said the distribution of the vaccine "was a sign of the way out. It was very hopeful."

Lessons learned

Both Sims and Shriner say COVID-19 taught health care workers many lessons, including how to share information quickly, how to diligently monitor diseases and how to scale up health care capacity.

Sims said another valuable discovery was better communicating to the public that information during a public health crisis can change rapidly.

One example is that early studies would come out suggesting certain drugs might help treat patients. Eventually additional information would be published proving the opposite.

"We were learning, and we were learning in such a rapid [way], it was hard to communicate," he said. "I think if we had any failure, it was that in that rapid push to communicate."

Sims noted how that created some uncertainty.

"We didn't get the message across enough that some of what we're learning may be wrong, and we will tell you that as we learn," Sims said. "We're going to tell you what we know now that may not be the same thing we know tomorrow."

Shriner added that stay-at home orders and lockdowns were hard on people and, if another pandemic happens, she is hopeful there would be different decisions on what should be locked down.

"Maybe we don't have such stringent lockdown rules and isolation rules," she said. "You know, the outdoor restaurant became a great thing. You know, think of all the home delivery services really took off. And so, a lot of good things came out of it, but they were hard won."