On December 11, the Food and Drug Administration (FDA) approved the first COVID-19 vaccine, created by Pfizer-BioNTech, for emergency use. One week later, the Moderna vaccine was authorized as well.

For many, this light at the end of the tunnel could not come soon enough. Health care workers, including Dr. Brecken Armstrong, an Emergency Room (ER) doctor in what is known as the busiest ER in California, said managing the pandemic, particularly in recent months, has felt similar to a war zone.

“Under normal circumstances we have wait times of [about] four to five hours,” Armstrong said. “But we have had wait times during this pandemic of up to 20 hours. We have people dying in corners and every bed of our entire ER has been turned into an [Intensive Care Unit (ICU)].”

The influx of COVID-19 patients in the ICU has deferred many specialized doctors from their own practice, instead requiring them to assist in the ICU. Many of these specialized doctors have not done this work since they were interns.

“They are doing it in a team wise approach,” Armstrong said. “An internal medicine doctor is in charge of the team, and they’ve turned all of these highly-paid neurosurgeons, ophthalmologists and incredible specialists into basically their little minions.”

In New Orleans, Louisiana, Dr. Robin Davis, a board certified neurologist and epileptologist, was drafted into the ICU at the beginning of COVID-19’s initial surge in the United States. Davis spent about two and a half months working there.

“I will never get what I saw in that ICU out of my mind,” Davis said. “I watched a guy in his twenties choke to death on his own blood; [I] watched him know he was dying and that we couldn’t save him.”

Closer to home, Arlingtonian Therese Kent is a nurse practitioner in the ICU at the National Institute of Health (NIH) in Bethesda, Maryland. Typically, the hospital only allows research patients who are willing to be tested on for treatments and research protocols.

“The state of Maryland is really becoming full of ICU beds because of COVID surging now,” Kent said. “So, basically, NIH has developed an agreement with the state of Maryland to offload ICU patients whenever we can. So, for the first time, we are taking patients who are not on a reasonable protocol.”

Since March, people around the world have become used to their own personal protection equipment (PPE). Masks, gloves, sanitizer and more have become staples in many homes. However, healthcare workers who are regularly in contact with patients confirmed to have COVID-19 have greater protective measures in place.

“We use pappers, which is this big white thing that has a little fan, and double gloves, a gown, booties, the whole shebang,” Kent said. “We all had to get fitted for the N95, [to] make sure they actually fit right.”

At NIH, COVID patients are in negative pressure rooms. Negative pressure rooms are an isolation technique used to prevent cross-contamination. When entering, the door must be opened and closed extremely fast so that the air can continue to be sucked out of the room.

“If your patient is having an emergency, you can’t just run in a room,” Kent said. “You have to take a few minutes to put everything on.”

Around the country, hospitals are dealing with shortages of both PPE and certain medications.

“We used to throw out a mask every time we walked out of a patient's room, and now we keep them for weeks,” Kent said.

“We are running out of basic medications,” Armstrong said. “Every medication that [former president] Donald Trump touted at the beginning of this thing is still on backorder. Pepsin, which is a basic medication for an upset stomach, is still on backorder because Donald Trump said at one point during some press conference that maybe it would work.”

When not at the hospital, healthcare workers have developed vigilant safety precautions to avoid bringing anything home. Armstrong ensures that none of her belongings touch both the hospital and her home. She changes in the parking lot of her hospital and then again when she arrives home. All of her clothing is placed in a sanitizing solution for 12 to 24 hours before going in the washing machine. After taking a hot shower, she goes into the sauna to “sweat it out.”

“I don’t actually bring any food with me to the hospital because I don’t want to take my mask off long enough to take a bite,” Armstrong said. “I actually carry oxygen canisters with me. I can lift my mask up, take a head of oxygen real quick and then put my mask back on. It can get pretty claustrophobic under there for 12 hours.”

Enter the vaccine, a glistening ray of hope that the United States, along with the rest of the world, has been waiting for since mid-March.

While the time between last March and now has felt lengthy for those stuck at home, this is actually unusually fast for vaccine creation. The speed of this creation is not thanks to a subpar trial, as the trials were done with 30,000 participants; however elimination of “red tape” paperwork and processes, usually involved years before the trial begins, helped ramp up the pace.

“Everybody started working on the same thing and everybody started sharing notes,” Davis said. “The experiment itself, for the vaccine, which was about a six-month period, actually was a pretty decent life for an experiment. They just shortened all the lead up to it.”

The COVID-19 vaccines are the first mRNA vaccines licensed in the United States, according to an article published by the Center for Disease Control (CDC). Unlike vaccines such as the flu shot, an mRNA vaccine does not use an entire virus. Instead, it carries instructions for creating a unique COVID-19 spike protein. Spike proteins enable the virus to travel into cells without actually containing the virus themselves. Once created, the spike protein contains antigens which prompts the body to produce antibodies and fight off what it thinks is an infection.

“The mRNA vaccine is a new vaccine, but it’s been studied for years with other viruses,” Kent said. “It just hasn’t been effective [before now].”

Seeing as the vaccine is new, information about long term impacts are still unknown. However, due to the nature of vaccines, long-term side effects are unlikely. Antibody levels are being tested continuously from those vaccinated in early trials to learn more. According to Davis, it is possible that, at least in the beginning, the vaccine will be received annually, similar to a flu vaccine.

“The hope is, with time, either a) we develop a more robust version of the vaccine or, of course, the dream would be that COVID is eliminated the same way we eliminated polio,” Davis said. “But that didn’t happen overnight; that took decades of work.”

Another thing to note is that, while immune to serious impacts of the virus, it is very likely that those vaccinated can still spread the virus along to others. Therefore, some form of masks and distancing will still be necessary until herd immunity is reached.

“Herd immunity is when enough people in your environment have antibodies to a disease that it becomes less prevalent and it becomes more rare,” Jennifer Ponce, a registered nurse and Washington-Liberty parent, said. “In order to achieve herd immunity in any population you need about 60 to 80 percent of your people to be immune.”

Herd immunity can be reached in smaller populations as well as large ones, such as the entire country. For example, it is possible to reach herd immunity within certain workplaces or homes without having reached it in broader communities that may include some of the same people.

“The herd immunity of the greater population is what is key to letting us return to activities, letting us get back to normal,” Ponce said.

Currently, the Pfizer-BioNTech vaccine has been approved for people ages 16 and up while the Moderna vaccine has been approved for people ages 18 and up. However, it is said that trials will begin shortly in order to approve the vaccine for children.

“I actually plan on enrolling my kids as soon as I can,” Davis said. “I’ve got a one year old and a four year old.”

The details of distribution are specific to each state. Virginia is currently in stage 1B, which means that most Arlington Public Schools (APS) staff have been vaccinated and vaccinations are now open for those ages 16-64 with pre-existing conditions. Throughout the country, healthcare workers were at the top of the vaccination list.

“I just feel very privileged to have been one of the first people in the country to receive the vaccine,” Ponce said. “Certainly my job does afford me that privilege, but I also take it as a responsibility to spread the word about its safety and its efficacy, and hope that my experience will help people who may be deciding about whether or not it’s worth it.”

When receiving the vaccine, the first step is making an appointment. For Ponce, the CDC’s Vaccine Administration Management System (VAMS) allowed her to complete a pre-vaccine questionnaire and later notified her when it was time to receive her second dose. It is important to note that both vaccines require two injections, each a few weeks apart.

“[I] have been, over the last 20 years, involved in a lot of routine and travel immunizations,” Ponce said. “I know that immunizations are safe, I know that vaccine technology is safe and effective.”

For both Ponce and Davis, agreeing to receive the vaccine was a no brainer. Their work made it easy for them to witness the impact COVID-19 has had on families which made the decision easy.

“What we saw [where I work] was that all of the physicians immediately were of the ‘I will take the shot in my eyeball if that’s what you tell me I have to do’ opinion,” Davis said.

As an overall cautious person, Kent thought out her decision and ultimately decided the best decision was to receive the vaccine.

“Once I looked into it and read about it and educated myself more, I felt very comfortable,” Kent said.

Armstrong spent months going back and forth on receiving the vaccine. Her hesitations were largely due to distrust in what was the current government, namely the Trump Administration.

“What it came down to was the known versus the unknown,” Armstrong said. “[The three knowns are] I am high risk, I do high risk work and the vaccine works. The unknowns -- we may never know the answers to the unknowns for years, or ever -- … [so] ultimately it came down to three knowns and one unknown.”

For most, receiving the vaccine itself was pretty normal, in fact some said the pain was less than that of a flu shot. Kent’s vaccination, however, was unlike others, as she received the first shot televised alongside Dr. Fauci. Before receiving the vaccine, she was asked to make a public statement as well.

“It was a great experience and part of history, and to be there with Dr. Fauci was amazing,” Kent said.

Despite being an mRNA vaccine instead of a live virus vaccine, side effects including a low fever are still common and to be expected. Armstrong had what seems to be a more extreme reaction. After the first dose, she experienced mild symptoms of body aches and chills, while the second dose, as is usually seen, caused a stronger reaction.

“The next day I woke up and I had severe shaking, chills and body aches,” Armstrong said. “I was so weak and dizzy I couldn't get out of bed. I ended up not being able to go into work. I slept for like 12 hours.”

Despite this, Armstrong, as well as others, stands by her decision to receive the vaccine.

“So far, nobody has had life threatening [effects] from the COVID vaccine, but COVID itself is definitely life threatening,” Armstrong said. “I want people to know that there are some unexpected and pretty significant side effects, but [the vaccine is] still worth getting.”

All opinions of Nurse Practitioner Therese Kent are her own.