By Drew Armstrong
The Covid-19 patient in the Kentucky hospital’s intensive-care unit bed had a high-flow oxygen mask on. He was gasping, despite barely moving, and his mouth made small, rapid bites at nothing, trying to get more air. It looked like he was suffocating, like a dying fish washed up on the beach.

Kentucky has faced a wave of virus cases that’s consumed staff and hospital beds. The surge of patients essentially suffocated the state’s network of health-care facilities.

Kentucky’s health-care system, and its uneven vaccination rates, resemble a lot of the rest of the U.S. It has small critical-access hospitals that serve rural areas, some with just a few beds. Mid-size regional facilities then take in more severe patients from the surrounding counties, and finally, huge, advanced facilities like University of Kentucky Health Care take the worst of the worst — the most complex and challenging patients who can’t be served anywhere else.  A nurse sets up a video call with the family of an isolated Covid patient at Saint Claire Regional Medical Center in Morehead, Kentucky.

There’s been lots written about how Covid has hit individual hospitals and doctors. Our reporting, which you can read here, focused on how a wave of cases affects health care across a state, even in places where vaccination rates are high. When the wave is big enough, as it was in Kentucky, it overwhelms the ability of hospitals to take care of not just Covid patients, but those coming in with heart attacks, strokes, cancer and other conditions. Because of patient privacy laws, most people will never see what severe, hospitalized Covid cases look like. In Kentucky and elsewhere, though, health-care workers have been seeing it since the start of the pandemic. Many of them, like the health systems where they work, have been pushed to the brink.

What happened in Kentucky is now happening around the U.S. Michigan hospitals are rapidly filling up. In Minnesota, doctors took out a newspaper ad pleading with people to get vaccinated. And the country is just at the start of a winter wave coinciding with the arrival of the omicron variant, a scenario likely to persist through the holidays and the colder months.

The U.S. has been stress-testing its health-care networks, and the people who run them, for almost two years. They are already frayed. And they are being stretched again.

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