Doctor in COVID battle recalls the heartbreak and hope of early pandemic

The sound of construction around Cedars-Sinai Marina del Rey Hospital is hard to miss. Crews are essentially building a new hospital because the old one, just south of Los Angeles, isn’t big enough. For the staff, it is a sign of rebirth after an exhausting two years. The long-delayed construction is finally underway, after being postponed due to COVID-19, and it is a sign that the fight against the virus is better.

Only a few months ago, the parking lot outside of Cedars-Sinai Marina del Rey was essentially a battlefield hospital. There was a giant tent used for patient triage. Today, the big tent is gone and once again cars are filling parking spots.

The doctors and nurses at Cedars-Sinai, like their counterparts around the country, have seen the worst of the pandemic. They have witnessed countless patients unable to breathe and the heartbreaking goodbyes of family members to their loved ones who were dying from the coronavirus.

Now that the United States has hit 1 million dead, the staff at Cedars-Sinai is remembering the battle they have gone through.

“Certainly there were a lot of patients that were waiting to be seen,” said Dr. Oren Friedman, a pulmonologist and medical director of the Cedars-Sinai ICU. “Just the amount of patients that we had that needed hospital support and ICU support. There’s never been anything like that. It was just such a huge number. We never felt that way before.”

The staff remembers the early months when there was no test for the virus and treatments were extremely limited. Their colleagues were getting seriously ill. Patients were streaming in unable to catch their breath.

“It was overwhelming, I think, for anyone in the health care field. However, we relied on each other. We relied on as much of the literature that was coming out,” Friedman explained during a recent visit to the hospital. “We formed groups and committees of people who constantly reviewed the literature and the latest. I don’t think any of us have ever been in a situation where so many people that we were taking care of with a disease that was so novel and the information was coming out at lightning speed.”

Friedman, 44, has a unique perspective. Not only is he a pulmonologist who could see what was happening to patients’ lungs as they suffered with COVID-19, but he caught the virus early in the pandemic while on the job and struggled for weeks to recover. And once he was feeling better he went to New York City to help while the region was being overwhelmed by the virus.

“The last two years have been the most challenging time for anyone, certainly in my generation, in pulmonary and critical care medicine,” he said. “In some sense when we all look back at it, it’s like being in an alternate universe. I don’t think any of us ever saw so many patients coming in with such a volume of one particular disease. And certainly none of us ever saw the health care system so impacted and so overwhelmed.”

In the early months, so much was unknown. The virus was spreading so rapidly without a vaccine and without many precautions being taken by the American public. In mid-March of 2020, President Trump declared a national emergency. Medical experts’ predictions that 100,000 people could die were instantly discounted by skeptics. But the numbers of people dying kept growing. Doctors and nurses on the frontlines were at war, while politics played out in the national spotlight.

“In the last two years it’s been very overwhelming and frightening,” said ICU nurse Morgan Roverud. “At the beginning of the pandemic everything was unknown. So we didn’t know how to deal with COVID.”

“It was definitely scary,” Roverud remembered. “A lot of the times I felt like: ‘How can I do this?’ But I think with the teamwork aspect here at [Cedars-Sinai] Marina del Rey and the friendships that you form with the staff and other leadership it just makes everything easier.”

It was that teamwork that hospital staff says got them through it. The staff became one, working around the clock. Doctors and nurses were perpetually exhausted as they worked to save lives. Still, many patients would be overtaken by the virus.

“There was a cohesiveness, I suppose, because everyone was on the same mission together to take care of all of these patients. But it was also sad and, at times, it felt hopeless,” said Friedman.

Friedman said he knew the wave of death that he witnessed in New York was likely heading to California and elsewhere. He was right. The halls at Cedars-Sinai Marina del Rey became full during several waves of the pandemic. The sound of ventilators pumping air into patients’ lungs filled the hallways. COVID-19 was killing Americans.

“We had never seen that many patients who were that critically ill on ventilators,” Friedman said. “It was exhausting. The days were long. Everybody was working extra shifts, extra hours. People were doubling up on shifts. People had to be creative marshalling resources.”

As the pandemic claimed more victims, there were the doubters, including high-profile politicians and media figures, who claimed COVID-19 wasn’t real or wasn’t serious. For the health care providers in the ICU at Cedars-Sinai, there was nothing more aggravating than those who claimed the virus was not serious.

“There was a temptation from all of us to run out there and scream and shake people and tell people, ‘do you realize how bad this could be? Do you realize what it looks like inside of the hospital? You should be wearing masks, you should be getting vaccinated.’ It was enormously frustrating,” said Friedman.

Friedman said after the first surge, medical staff could feel that the general population wanted to move on from the virus but the virus was not done with Americans. “It made our jobs that much more difficult. It felt like you were fighting a war, but when you returned home from the battle people just simply didn’t believe that war was even occurring,” he said.

Today, after so much heartache and after so many Americans were lost to the virus, maybe the worst of COVID-19 is over and now we must learn to live with it.

“With the vaccines that still work well against variants, and the increase in antiviral medications that we now have,” Friedman said, “we should be able to control some of those numbers better than we have in the past.”

Now with the large tent gone and fewer COVID-19 patients, things are quieter at the hospital. But the team has scars from the past two years or so and the 1 million lives lost in the U.S.

“It’s a staggering number. It’s a number that most people have a hard time fathoming,” Friedman said. “Even what a million would look like. It’s also really disappointing as a medical provider to realize that many of those probably didn’t need to have happened.”