By Shannon Stapleton

MISSION VIEJO, Calif. (Reuters) – Alexandria Scott rests her head in her hand at the emergency room reception and hopes the worst is over after the COVID-19 Omicron variant swept into her Orange County, California, hospital.

“It’s been crazy,” said the 26-year-old technician as patients lie on seats a few feet away at Providence Mission Hospital Mission Viejo, waiting for beds. “We have had literally 24-hour wait times, 18-hour wait times, and it’s just people after people coming in.”

Orange County, in southern California, has one of the highest COVID-19 hospitalization rates in the state, where cases peaked about two weeks ago.

As in hospitals across the country, Omicron hit Providence Mission’s emergency room hardest with record numbers of patients. Fewer intensive-care beds are needed for this less-deadly variant, but it is still inflicting major lung damage on the unvaccinated, doctors say.

The 504-bed acute care hospital triaged patients into modern surge wards and intensive care units that have been able to expand and contract to COVID-19 waves like few others in the country.

Staff, depleted by sickness and resignations, have taken a beating. Many say they have caught COVID-19 twice, have had little time to process hundreds of coronavirus deaths, and face tense moments with patients and families in a county known for its political conservatism, according to about a dozen doctors and nurses who spoke to Reuters.

“We responded, but it was overwhelming, it nearly broke all of us,” said emergency room doctor Jim Keany. Many of his colleagues, Keany said, are exhausted, see no end to the pandemic and have quit.

Emergency room patient numbers have plateaued at an “unsustainably high level,” said Keany, leaving people waiting on gurneys in corridors.

“I think a lot of us just feel numb,” said Amy Langdale, an emergency room trauma nurse. “There’s just an underlying depression, there’s definitely a very high burnout.”

Around eight of 10 patients on ventilators in intensive care are unvaccinated, according to Dr. Robert Goldberg, a critical care specialist at Providence Mission.

Nationally, deaths, which tend to lag infection rates, have been rising and have averaged over 2,500 a day, double the level seen before the Omicron surge, but below the peak of 3,300 a day during the Delta surge in January 2021, according to a Reuters tally. Cases and hospitalizations continue to fall rapidly.

Some patients in the Providence Mission intensive care unit spend the last weeks of their lives on ventilators that pump oxygen in and out of coronavirus-damaged lungs.

A middle-aged man in the unit struggling to breathe decided to go on a ventilator. His children leaned over him, his son with an arm on his bare back, his daughter with a hand on his head, their heads pressed to his side, praying for him to get better.

“Doctor, what do you think about my decision?” the man asked as he lay face down to help him breathe.

“I think that if you want to fight as hard as you can, you made the right decision,” said Dr. Tauseef Qureshi as he unplugged the patient’s mobile phone to make room for the ventilator.

The patient’s family asked that none of their names be used.

Outside, a picture in a staff area showed nurses who volunteered to work in the unit back in early 2020 when many medics were scared to set foot there. Danielle Shaw is among them.

“I call it Russian roulette. You could have no risk factors and still get super sick,” Shaw said of the coronavirus she has seen kill young, old and healthy people.

One constant is the high survival rate of vaccinated patients, added Goldberg, a pulmonary critical care doctor.

He finds it difficult working with “politicized” families who accuse his team of doing little for patients when he says everything is being done to keep them alive.

“We are seeing our colleagues go down, becoming sick, and then to have families that are confrontational is very frustrating and difficult – and emotionally trying,” Goldberg said.

Although Orange County was long a Republican bastion, Democrats now hold five of the seven U.S. congressional districts there.

For now, Keany, the emergency room doctor, is thankful that only 25% of emergency room patients have COVID-19, compared with well over half a few weeks ago.

Sitting on the ER frontline, Scott said she is tired but knows patients are even more exhausted.

“I choose to be here, I love my job,” said the “tech,” who has known nothing but COVID-19 since she began work at Providence Mission two years ago.

(Reporting by Shannon Stapleton in Mission Viejo, California; Writing by Andrew Hay; Editing by Donna Bryson and Leslie Adler)

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