When COVID-19 patients flooded St. Louis hospitals, respiratory therapists who came on another busy shift with a dwindling supply of ventilators would often watch their chores and cry and go to the locker room to collect themselves.

“They said, ‘Man, 12 hours from that slog to these patients on the verge of death who might be walking at any moment.’ And just knowing they had to take care of them with that kind of stress in mind, ” recalled Joe Kowalczyk, a respiratory therapist who sometimes works in a supervisory role.

Now, the number of people hospitalized with COVID-19 in the U.S. has fallen by 80,000 in six weeks, and 17% of the country’s adult population have received at least one dose of vaccine, which gives some relief to frontline workers like Kowalczyk. There were only about 20 coronavirus patients on his last shift at Mercy Hospital in St. Louis, up to 100 at the height of the winter flood.

“It’s so strange to look back on,” he said. “Everyone definitely hit the end of their joke towards the end just because we’d been doing it for so long at the end of the year.”

The U.S. has seen a dramatic turnaround since December and January, when hospitals were full of patients after holiday gatherings and pandemic fatigue led to an increase in cases and deaths. Health officials acknowledge the improvement, but note that hospital stays are still around the same level as previous highs in April and July and just before the crisis worsened in November. Deaths are still persistently high, albeit much lower than the high in early January when they sometimes exceeded 4,000 a day.

Missouri hospital stays hovered around 3,000 a day from late November to January, but have fallen by about 60% since then. According to the state, 1,202 people had been hospitalized by Monday.

In Wisconsin, hospital stays have fallen dramatically in the past three and a half months, from 2,277 patients on Nov. 17 to 355 on Wednesday, according to the Wisconsin Hospital Association. And the patients who are hospitalized are not that sick. The number of patients in the intensive care unit has decreased by 81% since November 16.

On February 15, state health officials removed all employees from a field hospital set up at the state fairgrounds in suburban Milwaukee in October. They have stopped dismantling the facility amid concerns the state could see a surge in cases caused by variants of the virus that causes COVID-19.

“It’s a balancing act. You don’t want to close it too early until you really believe we’re on the other side of this pandemic, but we don’t want to tie up (the fairgrounds) for too long if we really are going to set up the facility don’t need, “said Deputy Secretary of the Ministry of Health, Julie Willems Van Dijk.

Behind the overall positive trends in hospital stays are worrying indications that the worst may not be over, said Ali Mokdad, professor of health metrics at the University of Washington in Seattle.

“Over the past week we’ve seen the decline slow,” Mokdad said. In many states, hospital stays are decreasing or actually increasing.

The biggest driver behind the overall decline in hospital stays in the US is people’s behavior in December and January, Mokdad said. For the first time in the US, the shape of the wave is symmetrical, with the decline as steep as the rise.

“That has never happened in the last two waves,” said Mokdad. “For us in business, it’s like, ‘Wow, we’re doing something really good right now.'”

In Minnesota, intensive care hospital stays fell from around 1,400 in late November to just 233 on Tuesday. According to government data, the number of ICU patients has fallen by about 85% since early December to just 59 patients on Tuesday.

Illinois hospital stays stood at around 6,000 patients for several days at the end of November but fell to 1,488 by Monday, a decrease of about 75%. The number of patients in the intensive care unit has also fallen from 1,224 on November 25 to just 361 on Monday, according to the state Ministry of Health.

In California, hospital stays have fallen by an impressive 70% since January, from 22,821 patients on January 5 to 6,764 on Tuesday. The number of patients in the intensive care unit fell from 4,971 on Jan. 10 to 1,842 on Tuesday, according to the state.

In Kansas, where many rural hospitals lack ventilators, at one point the situation was so dire that patients were flown hundreds of miles for treatment.

According to the state health department, the number of hospital stays in the state fell by nearly 84% from 1,282 on December 2 to 208 on Sunday. More than 300 people were in intensive care in December; that’s only 50 left, the status data show.

“It was just quiet out here with COVID,” said medical assistant Ben Kimball, who primarily works at Graham County Hospital in Hill City, a town of about 1,500 in rural northwest Kansas.

At the height of the climb, it once flew a patient to a Denver hospital about 402 kilometers away. All nearby hospitals that were able to offer more advanced care were full and turned away patients.

“We’re pretty lucky I think,” he said. “I can definitely feel things are getting better. We’re not constantly fighting for space in bed. We’ve observed some COVID patients overnight, but we haven’t sent anyone out in a while.”

Kris Mathews, the administrator of Decatur Health, a small hospital in rural northwest Kansas, also telephoned for hours and arranged transfers for patients at the height of the surge. Its staff got sick themselves, and those who had done well looked after coronavirus patients.

“I could feel the tiredness and exhaustion of the staff,” he wrote. “Nobody complained to me about it, but I could see and feel them burn out.”

It has now been weeks since the hospital was caring for an inpatient coronavirus. He thought back and said, “I couldn’t be more proud.”

US COVID-19 hospital stays at lowest level since November

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