The nurses of California are afraid.
It's Christmas Eve, and they aren't home with their families. They are working, always working, completely gowned up — and worn down.
They're frightened by what people are doing, or not doing, during a coronavirus pandemic that has already killed more than 320,000 nationwide and shows no signs of slowing down.
They're even more terrified of what's next.
"Every day, I look into the eyes of someone who is struggling to breathe," said nurse Jenny Carrillo, her voice breaking.
A charge nurse at Providence Holy Cross Medical Center in Los Angeles' San Fernando Valley, Carrillo is haunted by the daily counts of COVID-19 patients. Dark shadows circle her eyes.
By Tuesday evening, the hospital had 147 coronavirus patients — a record for Holy Cross but a tiny fraction of the nearly 2 million cases recorded in California since the pandemic began.
Close to 18,000 people were hospitalized in the state Tuesday, and models project the number could top 100,000 in a month — unimaginable for medical systems that are already running out of room. More than 23,000 people with COVID-19 have died in California, and the number is expected to climb.
Dr. Jim Keany, associate director of Mission Hospital's emergency department in Southern California's Orange County, wonders how much more they can handle.
"Are we going to have the resources to take care of our community?" he said.
The first COVID-19 case in California was confirmed January 25. It took 292 days to get to 1 million infections on November 11.
Just 44 days later, the number was closing in on 2 million.
On Tuesday, Holy Cross had 147 coronavirus patients across its 377 beds, more than double the record seen at the hospital in the first wave of the pandemic earlier this year.
"If you had told us in April that we'd have 147 patients?" said Elizabeth Chow, Holy Cross' executive director of critical care and a nurse leader. "Never in my wildest dreams."
And the nightmare is expected to get worse.
Despite health officials' pleas that people stay home, millions of Americans are traveling ahead of Christmas and New Year's, much like they did last month for Thanksgiving.
Hospitals in California and elsewhere already have been pushed to the brink. They have hired extra staff, canceled elective surgeries and set up outdoor tents to treat patients, all to boost capacity before the cases contracted over Christmas and New Year's show up in the next few weeks.
Holy Cross and Mission Hospital have sprinkled holiday decorations throughout the hallways: poinsettias perched on counters, scraggly miniature trees in patients' rooms, caricatures of the Grinch doodled at nurses' stations.
But the bright colors don't distract from the constant cacophony: ventilators belching like foghorns, monitors beeping, machines whirring — all trying to keep even one more person from adding to the death toll.
Still, there are hopeful moments.
On Monday, Mission Hospital celebrated a milestone: 100 patients who had been in the isolation intensive care unit — reserved for the sickest of the sick — have survived and gone home.
In Holy Cross, "Here Comes the Sun" by the Beatles plays throughout the hospital when a COVID-19 patient is discharged.
The new pandemic tradition has happier roots — hospitals often sound a lullaby each time a baby is born.
It's a few seconds of respite, but it's not enough. For every patient who goes home, more are admitted.
Holy Cross charge nurse Melanie LaMadrid tends to her patients in 12-hour shifts, holding their hands in her purple gloves.
"It's all we can do," she said. "Watching them suffer is hard."
These nurses are not only exhausted, they are angry with those who flout pleas to stay home, stay safe.
"It's not some selfish person who doesn't want to wear a mask," Carrillo said. "I wish they could just walk down our unit for a day and look at the faces of some of these patients."
You can be our messengers, nurse Genyza Dawson tells her patients when — or if — they get discharged. Dawson, who has a scar forming on her nose from the tight masks, begs them to spread the word.
"Now you know how it is," she tells them. "You were one of the lucky ones."
