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MARY LOUISE KELLY, HOST: Rhode Island has one of the highest per capita COVID-19 rates in the country, and its hospitals are struggling to respond. One doctor described a night in the

emergency room to health reporter Lynn Arditi of The Public's Radio in Rhode Island. LYNN ARDITI, BYLINE: The first patient of the night that Dr. Joseph Lauro saw had all the telltale

signs of COVID-19. JOSEPH LAURO: Very short of breath, terrible chest X-ray, low oxygenation, breathing very quickly. ARDITI: As an emergency medicine physician, Lauro normally would be able

to admit this patient directly into the hospital. But on that night, all of the beds in the hospital were full. So a staffer wheeled the patient's cot into one of the emergency

department's isolation rooms and closed the door. Lauro says the pandemic is hard for some people outside of health care to grasp. LAURO: They see what's on the news. But until you

feel what's happening in the emergency department, you don't understand how bad this really is. ARDITI: It's so bad that Rhode Island has opened two field hospitals with more

than 900 beds in all. As in other parts of the country, staff shortages have hampered efforts to care for COVID patients. That means more of them waiting in emergency rooms. On the night of

Lauro's shift, the intensive care unit was full. So was the step-down ICU, which is used for less critically ill patients. LAURO: I wanted to send somebody to the field hospital, but

there wasn't enough staff even at the field hospital to send the patient there. So he was waiting in the emergency department to get a bed inside the hospital. ARDITI: Lauro is used to

caring for very sick patients under trying conditions. He started his career as a paramedic in New York. He was 24 when he worked at the site of the World Trade Center after the 9/11

terrorist attacks. Back then, the rescue effort lasted days. This one now is lasting months. LAURO: You close your eyes, and you hear coughing. We hear retching. You hear people talking.

ARDITI: He can hear, but his N95 mask and face shield create a barrier. LAURO: I can tell so many things just by using my senses. I could smell strep throat. I could smell a GI bleed. You

know, you could smell gangrene, smell urinary tract infection. ARDITI: I asked him to imagine what COVID would smell like. LAURO: Death. It just smells like terror. ARDITI: At one point

during his shift, he was treating a COVID patient, and he felt the seal of his N95 mask had been broken. LAURO: I could feel in my mask that the air is escaping through the top corner of my

nose where it always does, no matter what mask I wear. ARDITI: After finishing with the patient, he put on a new mask. But these are the risks he lives with on every shift. By the time

Lauro's shift ended that night, he had admitted about 14 patients. And that first patient, the one who was wheeled into an isolation room... LAURO: When I left my shift at 11

o'clock, he was still in the emergency department. ARDITI: The next day, Lauro received his first shot of the COVID-19 vaccine. He recorded his thoughts as he got into his RAM pickup to

head home. (SOUNDBITE OF ARCHIVED RECORDING) LAURO: Now that's a relief. ARDITI: These shifts are tough. But less than a year after the coronavirus came to this country, he may soon be

immune. Medicine, he says, is just remarkable. Lauro is among some 3,000 hospital staff in Rhode Island who are now being vaccinated against COVID-19. For NPR News, I'm Lynn Arditi in

Providence. (SOUNDBITE OF MUSIC) Transcript provided by NPR, Copyright NPR.