The weight of the pandemic first caught up with New York City ER physician Jane Kim in April. After spending weeks caring for seriously ill patients, she learned of four deaths among her “work family.” Three died of the virus, another from suicide. Her grief “halted” her, she says: “You can’t think. You can’t move. You can’t breathe.”
Since then, Kim, 39, has leaned on friends, family and therapy to cope. She’s also heartened that doctors now better understand how to treat COVID-19 compared with those early, uncertain days. But as cases rise nationwide, she worries that doctors are about to face a “tsunami” of patients. “I fear that we’re not ready—emotionally, physically, mentally—to go through that again,” Kim says. “I’m not.”
As the COVID-19 pandemic has surged, receded and surged again, it has taken a tremendous toll on people like Kim. In the U.S. alone, more than 218,400 health care workers have contracted the virus and at least 800 have died, according to the U.S. Centers for Disease Control and Prevention; an estimated 12% of U.S. health care workers have been infected compared with approximately 3.4% of the general population. And many more are suffering in other ways—more than 40% of doctors in the U.K. are reporting worsening mental-health issues, according to an October survey from the British Medical Association. As another wave builds, it’s safe to say that many health care workers are very far from O.K.
The problem of doctor burnout stretches far beyond U.S. shores. Silvia Giorgis, a 49-year-old anesthesiologist at the Maria Vittoria hospital in Turin, Italy, says doctors there rode the “adrenaline of a new challenge” during the first wave, but are now frustrated that too little was done to prevent a rebound. She’s especially disheartened by the spread of false claims that doctors are exaggerating the danger to justify unpopular and economically damaging lockdowns. “We used to receive tons of food, enough pizza to feed entire neighborhoods and all kinds of encouragement every day,” says Giorgis. “We went from being heroes … to being killers.”
That so many doctors are exhausted could result in patients receiving inadequate care, potentially negating the benefits of our newfound treatment knowledge. Dr. Patrick Pavwoski, a 37-year-old neurologist at Mercy Health hospital in Muskegon, Mich., knows he needs a break, but several of his colleagues have tested positive or have suspected COVID-19. “If I get sick, I don’t know what they’re going to do,” Pavwoski says. He recently had to walk away from a patient to take a moment to collect himself. “I was so exhausted, I was literally falling asleep in the room and wasn’t listening to anything the patient was saying,” he says.
Like other health care workers, Pavwoski is frustrated that more people aren’t making sacrifices to help contain the virus. He’s upset by photos of friends gathering without masks and when he hears that people are planning their usual Thanksgiving dinners, all while some of his neighbors are being admitted with COVID-19. “You see these people in the hospital you know weren’t wearing masks,” he says.
For Kim, the New York City doctor, it’s been especially hard to deal with people who doubt the pandemic’s severity despite all evidence, from the skyrocketing caseloads in state after state to the upticks in hospitalizations that betray a calamity unfolding before our eyes. After someone sent her an article questioning whether her city’s surge was real, she almost threw her phone against the wall. “How could these people?” she says. “How could you dare say that?”
–With reporting by FRANCESCA BERARDI/TURIN
This appears in the November 30, 2020 issue of TIME.