There is a word being used to describe how it feels to be a health care worker in mid-Missouri.

"They keep saying the word ‘eerie’ to describe low ICU census and no visitors in the halls," an ICU nurse at University Hospital posted on her Facebook page April 1. "It’s like the calm before the storm."

Officials confirmed the first case of COVID-19 in Boone County on March 17. According to the state Department of Health and Senior Services, there were 75 cases in Boone County on Saturday and 2,291 statewide.

"We haven’t seen the exponential growth we have seen in New York and China," Scott Clardy said. Clardy is the Assistant Director of the Columbia/Boone County Department of Public Health and Human Services.

Clardy and other health department officials are using a University of Washington model to predict when Missouri will see a peak in cases. The model uses the date schools were closed and statewide stay-at-home orders issued, among a myriad of other factors.

As of now, Missouri is slated to see a peak in cases between May 20 and 28, but if any of those factors change, so could the projected peak.

So far, as of Saturday morning, MU Hospital had four inpatient COVID-19 cases and another seven awaiting results. Statewide, there were 475 inpatients and 520 under investigation.

"This is a marathon, it's not a sprint," Clardy said. "People just need to be ready. It is going to be a new normal for a while here."

For Mary Beck, University Hospital’s chief nursing officer, the existence of a new normal is obvious from the moment she arrives at work.

"There are only two entrances I can come in," Beck said. "I get screened every morning. I have to have my name badge on. I go to a screener and they ask if I’ve been coughing."

After being screened Beck spends her day contacting suppliers to source more personal protective equipment, or PPE. The illness spreads quickly via respiratory droplets when a sick person coughs or sneezes, which is why Columbia residents have been encouraged to keep at least six feet of distance between one another since mid-March.

But a health care worker can’t practice social distancing, which makes PPE essential in protecting them from the illness. Beck said her facility has an adequate supply right now. The objective, she said, is to use it wisely, so if there is a surge in cases, she’ll be able to protect both her staff and her patients.

"Using PPE appropriately is the work that we do all the time," she said. "Just right now we have to make sure we’re doing it right. It’s a different disease that we have seen before. It’s new. And we don’t have a vaccine for it."

The Missouri Hospital Association is the traffic cop for directing PPE supplies to hospitals outside the two largest metro areas.

The organization forwards requests to the Department of Health and Senior Services, which allocates the state supply.

"Five to 10 percent of hospitals on any given day are saying they have a critical shortage of PPE," spokesman Dave Dillon said. "In that definition, a critical shortage means two days of supply or less."

All of which makes preparing for COVID-19 unlike anything hospitals have had to prepare for before. MU Health Care canceled elective procedures March 19 and began limiting visitors. Just like Beck, the few visitors that are allowed into the facility must be screened for symptoms indicating COVID-19 prior to entering the building.

"There’s concern that ‘What if I’m exposed by somebody who walks in?’" Beck said. "It’s very special circumstances that we allow visitors in any of our facilities."

During an online briefing March 24, Beck said University Hospital had been able to free up more than 100 beds in its facility. As of April 4, the hospital was treating four known COVID-19 cases with seven pending test results. With 100 ICU beds available, the hospital is well under capacity.

"We’re flattening the curve, but that means it will go longer," Beck said.

With few visitors and no non-emergent procedures, hospital halls are emptier than usual, which brings up that word again.

"It’s kind of eerie, right?" Missouri Nurses Association Director Heidi Lucas said.

Lucas isn’t a health care worker, but part of her job is to listen to nurses across the state.

"A lot of them are terrified to bring (COVID-19) home with them," she said. "They are self-quarantining at home or not going home, just staying with someone else who might work in health care so they don’t infect family members unintentionally, especially if they have family members who are elderly or immunocompromised."

With Missouri’s projected peak still a month away, this is, as Clardy said, health care’s new normal. The benefit, though, is it’s given hospitals more time to prepare.

"We’ve had the gift of time that New York did not have," Beck said. "We’ve had the gift … to learn from them. We’re able to make adjustments in our planning."

For Clardy, the time for hospitals to wait, maybe worry and adjust their procedures is a sign the system is working. If current projections persist, Missouri isn’t slated to see a shortage of ICU beds, though there may be a shortage of ventilators. But that’s only if residents continue to keep social distancing.

"We’re pleading to everyone’s sense of community here," Clardy said. "I think if we didn’t social distance what you would see is possibly an earlier peak, but a much, much higher peak. The problem with that is it’s going to overrun the health care system. There won’t be enough beds if that’s what we do."

Neither Clardy or Beck want to be alarmists. They want the community and their workers to be ready.

"You don’t want to have false hope, so you want to be prepared for the worst," Beck said.

So, she, like all health care workers, continues to go to work, get her temperature taken and prepare, hoping that social distancing will keep the worst far away from mid-Missouri.

If you’re a health care worker in Mid-Missouri wanting to share your concerns and experiences, we want to hear from you. Please email to share your story.

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