The recent surge of COVID-19 infections hit the Peninsula harder than when the pandemic first reached the region last March, leaving many nurses sitting bedside as infected patients die without their families nearby.

“This has been, in my 25-year-career, the most devastating way to see someone leave this Earth,” said Rachel Daly, a respiratory therapist and clinical services manager with San Mateo Medical Center.

COVID-19 brought the work of a respiratory therapist into focus, said Daly. And understanding how to treat the highly infectious respiratory disease has evolved as some regions battled it harder than others.

San Mateo County wasn’t hit with the massive surge expected in the early days of the pandemic but major areas like New York were, providing the Peninsula with “the luxury of time,” said Daly.

San Mateo Medical Center was as prepared as a facility could be when faced with an unknown disease, she added. But that extra time allowed the hospital to make small changes like adding different filters to ventilation tubes and big moves like standing up an outdoor screening area.

Despite being prepared, Daly said she’s never experienced such professional hardship. She, like many nurses and health care staff, has had to fill the empty space left by families barred from being near their loved ones out of an abundance of caution, even during their final moments.

“What I'm used to is someone holding the hands of their loved ones and that can't happen,” said Daly. “That’s the hardest thing to see, their families can't be with them.”

While some families can look on from a distance, separated by glass, others are left with video calls with hospital staff holding the devices. But patients never die alone at the medical center, noted Daly, highlighting the honor she feels having been a part of a patient’s care whether they survive or not.

Shanon Egan, an ICU nurse at Seton Medical Center, has been heartbroken while caring for her patients. As a nurse of 21 years, most of that time spent in the ICU, she said those in her position have learned to “bury" the pain of losing a patient “deep down" to redirect their attention to a grieving family.

“Sometimes patients are unaware of what’s going on but families have no closure. To see families not be able to come in and give their loved ones a hug or kiss goodbye, it’s difficult to watch,” said Egan, thankful for the connection technology lends to families.

Her department was hit hard over the holidays while understaffed. Before the pandemic, the facility had filed for bankruptcy and was set to close in March but the state decided to set up beds at the hospital to prepare for the virus to take hold.

Around that time, support was brought in through the state’s mutual aid program but the initial devastating surge never came and those contracts have since expired, Egan said. Now the pandemic has only worsened while 50 positions remain open and travel nurses are in high demand across the state.

At times, duties can be so demanding that it becomes difficult to comfort each patient — scared, alone and potentially dying. And unlike the early days of the pandemic, patients seem to be recovering less frequently, said Egan.

“In the beginning, we had success with people coming off ventilators but nowadays it seems like once they get insulated they don’t get better,” said Egan. “You try your best to comfort them and try to reassure them but you can’t lie to your patient either. You don’t want to lie to them because they know.”

Both Daly and Egan knew the holiday season would lead to gatherings. After months of social isolation, people were eager for some sense of normalcy and the holidays are traditionally a joyful time for many.

But those gatherings would eventually result in case and death rates 10 times higher than reported in September and October, said the county Health Officer Dr. Scott Morrow in a statement released last Tuesday. Since the start of the pandemic, 340 San Mateo County residents have died from COVID-related complications, more than half occurring within the past two months.

Despite the emotional toll of losing patients, Egan and Daly said the moments when a patient recovers are highlights for the longtime health care professionals. Their co-workers also function as a team, supporting each other with duties and making each other laugh when needed.

With officials believing the state has nearly cleared the peak of the surge, both medical professionals implored the public to abide by health guidelines — wearing a face mask, social distancing, sanitizing and avoiding large gatherings.

“If you are not in the medical field you don’t see or understand the devastation this has caused,” said Daly. “If they saw what we saw, there would be no questions. They would wear a mask. There would be no question that large gatherings wouldn’t happen.”

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