As patients stream into Mississippi hospitals one after another, doctors and nurses have become all too accustomed to the rampant denial and misinformation about COVID-19 in the nation's least vaccinated state.
People in denial about the severity of their own illness or the virus itself, with visitors frequently trying to enter hospitals without masks. The painful look of recognition on patients' faces when they realize they made a mistake not getting vaccinated. The constant misinformation about the coronavirus that they discuss with medical staff.
"There's no point in being judgmental in that situation. There's no point in telling them, 'You should have gotten the vaccine or you wouldn't be here,'" said Dr. Risa Moriarity, executive vice chair of the University of Mississippi Medical Center's emergency department. "We don't do that. We try not to preach and lecture them. Some of them are so sick they can barely even speak to us."
Mississippi's low vaccinated rate, with about 38% of the state's 3 million people fully inoculated against COVID-19, is driving a surge in cases and hospitalizations that is overwhelming medical workers. The workers are angry and exhausted over both the workload and refusal by residents to embrace the vaccine.
Physicians at the University of Mississippi Medical Center, the only level one trauma center in all of Mississippi, are caring for the sickest patients in the state.
The emergency room and intensive care unit are beyond capacity, almost all with COVID patients. Moriarity said it's like a "logjam" with beds in hallways, patients being treated in triage rooms. Paramedics are delayed in responding to new calls because they have to wait with patients who need care.
In one hospital in Mississippi, four pregnant women died last week, said state health officer Dr. Thomas Dobbs. Three of the cases required emergency C-sections and babies were born severely premature.
"This is the reality that we're looking at and, again, none of these individuals were vaccinated," Dobbs said.
Moriarity said it's hard to put into words the fatigue she and her colleagues feel. Going into work each day has become taxing and heartbreaking, she said.
"Most of us still have enough emotional reserve to be compassionate, but you leave work at the end of the day just exhausted by the effort it takes to drug that compassion up for people who are not taking care of themselves and the people around them," she said.
During a recent news conference, UMMC's head, Dr. LouAnn Woodward, fought back tears as she described the toll on healthcare workers.
"We as a state, as a collective, have failed to respond in a unified way to a common threat," Woodward said.
As the virus surges, hospital officials are begging residents to get vaccinated. UMMC announced in July that it will mandate its 10,000 employees and 3,000 students be vaccinated, or wear a N95 mask on campus. By the end of August, leaders revised that policy, vaccination is the only option.
Moriarity said this surge has taken a toll on morale more than previous peaks of the virus. Her team thought in May and June that despite Mississippi's low vaccination rate, there was an end in sight. The hospital's ICUs were empty and they had few COVID patients. Then cases surged with the delta variant of the virus, swamping the hospital.
Numbers of total coronavirus hospitalizations in Mississippi have dipped slightly, with just under 1,450 people hospitalized for coronavirus on Sept. 1, compared with around 1,670 on Aug. 19. But they are still higher than numbers during previous surges of the virus.
In the medical center's children's hospital, emergency room nurse Anne Sinclair said she is tired of the constant misinformation she hears, namely that children can't get very ill from COVID.
"I've seen children die in my unit of COVID, complications of COVID, and that's just not something you can ever forget," she said.
"It's very sobering," continued Sinclair, who is the parent of a 2-year-old and a 5-year-old and worries for their safety. "I just wish people could look past the politics and think about their families and their children."
To deal with overflow COVID patients, Christian relief charity Samaritan's Purse set up an emergency field hospital in the parking garage of UMMC's children's hospital.
The hospital is treating an average of 15 patients a day, with the capacity for seven ICU patients.
Nurse Kelly Sites, who has also treated COVID patients in hotspots like California and Italy, said it's heartwrenching to know that some of the severe cases could have been prevented with the vaccine. Many patients are so sick they can't talk. Nurses walk around with scripture verses on duct tape on their scrubs and will recite them to their patients.
Samaritan's Purse is an international disaster relief organization with missions spanning multiple continents. Sites has responded to 20 missions, in Haiti, the Philippines, Liberia, the Democratic Republic of Congo and other places.
"To respond to the United States is quite surreal for us," she said. "It's a challenge because usually, home is stable. And so when we deploy, we're just going to the disaster. This is the first time where home is a disaster."
Leah Willingham is a corps member for the Associated Press/Report for America Statehouse News Initiative. Report for America is a nonprofit national service program that places journalists in local newsrooms to report on undercovered issues.