MARY LOUISE KELLY, HOST:
Well, hospitals in much of the country are filling up with COVID-19 patients, but it's not space that's the main concern. It is staffing, and bringing in backups from out of town is not the solution it was early in the pandemic, when the surge was concentrated in a handful of cities. Blake Farmer of member station WPLN reports from Nashville.
BLAKE FARMER, BYLINE: Finding reinforcements really wasn't a problem with the first wave of COVID-19 back in the spring. Hospitals in most of the country were actually seeing fewer patients than normal. So nurses like Laura Williams were excited to catch a flight and join the effort.
LAURA WILLIAMS: It was really a hot zone where we were always in full PPE and every patient who was admitted was COVID-positive.
FARMER: Williams helped launch a field hospital in New York City.
WILLIAMS: So I was working mainly six or seven days a week, but I felt very invigorated.
FARMER: After two taxing months, Williams returned to her nursing job at the University of Tennessee Medical Center in Knoxville. Things had been relatively quiet on the COVID front until now, with record hospitalizations in Tennessee nearly every day. And reinforcements are getting much harder to find. Tennessee built its own field hospitals, but Dr. Lisa Piercey of the Tennessee Department of Health says the state would have trouble finding the doctors and nurses to run them.
LISA PIERCEY: Hospital capacity is almost exclusively about staffing. Physical space, physical beds - not the issue.
FARMER: COVID creates a compounding effect. Dr. Alex Jahangir, who chairs Nashville's coronavirus task force, says record numbers of staff are out themselves with COVID-19 or because they have to quarantine.
ALEX JAHANGIR: But here's the kicker. They're not getting infected in the hospitals. In fact, hospitals, for the most part, are fairly safe. They're getting infected in the community.
FARMER: Some states already allow COVID-positive nurses to keep working as long as they feel OK. Patients are seeing it firsthand. Dr. Jessica Rosen is an emergency physician at St. Thomas Health in Nashville, where diverting patients has been rare over the last decade. Now, she says, it's a common occurrence.
JESSICA ROSEN: We have been frequently on diversion, meaning that we don't take transfers from other hospitals. We try to send ambulances to other hospitals because we have no beds available.
FARMER: Even the region's largest hospitals are filling up.
MATTHEW SEMLER: The vast majority of our patients now in the intensive care unit are not coming into our emergency department.
FARMER: Dr. Matthew Semler is a pulmonary specialist at Vanderbilt University Medical Center.
SEMLER: They're being sent hours to be at our hospital because all the hospitals between here and where they present to the emergency department are on diversion.
FARMER: Semler says his hospital would typically bring in nurses from out of town to help, but there is nowhere to pull them from right now. National systems are still moving personnel around, though increasingly it means leaving somewhere else a little short-staffed. In Texas, Dr. James Johnson with the physician services firm Envision has deployed reinforcements to Lubbock and El Paso this month. He says the country hasn't hit it yet, but there's a limit.
JAMES JOHNSON: I honestly don't know where that limit is.
FARMER: And the limitation at this point won't be ventilators or protective gear. It's people. So Johnson says he's more focused than ever on trying to boost morale and stave off burnout. He's generally optimistic.
JOHNSON: What we experienced in New York and have in every episode since is that humanity rises to the occasion.
FARMER: But it shouldn't just be sacrifices for health care workers. Johnson says everyone bears a responsibility to keep themselves and others from getting sick in the first place.
For NPR News, I'm Blake Farmer in Nashville. Transcript provided by NPR, Copyright NPR.