When the novel coronavirus first began sending patients to Rose Medical Center two years ago, providers there “had no concept” of when the pandemic would end.

New information was discovered and reported on a near-daily basis. The situation was day to day, sometimes hour to hour. A new normal was setting in, at Rose and at hospitals across Colorado and the country.  

Beyond the present moment, “it was impossible to think,” said Erin Jenkins, Rose’s director of infections prevention.

Back then, national leaders were thinking in weeks, maybe months: temporary shut downs, flattened curves, students back in school a week or two after spring break. Providers may not have been thinking that way, but many also weren’t thinking in years.

“I wouldn’t have imagined it would last for two years,” said Monica Wininger, Rose’s director of clinical care.

Over the past 25 months, the passage of time has frequently been marked by new, often grim moments: rising death tolls, measured in the thousands; new variants, heralding new waves of illness; new public health measures, a reminder of how temporary progress against the virus could feel.

But on March 25, 12 weeks after Rose’s hospital census peaked at 39 patients during the omicron wave, the hospital reached a threshold it hadn’t for two years: zero COVID-19 patients.

The number of pandemic patients at Rose and in hospitals across Colorado had steadily fallen for weeks since mid-January, when the omicron wave peaked. The descent was prolonged and brought record-low case rates and the fewest hospital patients since the pandemic began. It’s given state leaders the chance to begin to close down mass testing and vaccination sites, for counties to end mask mandates, for the city of Denver to call off its vaccine requirement, for life to return to a normalcy that many had not seen since March 2020.

For the providers at Rose, the slowdown has given them a moment to begin processing the effects of the past two years. Treating COVID-19 patients and living within the pandemic’s effects became the norm, said Angela Milano, Rose’s manager of medical oncology. Now, providers have to switch back to a time before COVID-19 while simultaneously dealing with its effects: fewer providers, sicker standard patients, changed protocols, the readiness that it could flare again.

“It just was cyclical,” Milano said of COVID-19 surges. “‘This is what we’re doing, everything is changing, we’re doing it, we’re jumping in.’ Then for it to stop – now, I think, all of what we went through is now catching up to us. So we’ve had more time to process, and there have been a lot of moments where people sit back and say, ‘What did we just do?'”

Milano, Jenkins and Wininger all said they were proud of how they and their teams handled the past two years. It proved that providers had each other’s backs. They’re now on the other side, knowing, Milano said, “that we did that together.”

“We can’t even talk about it without tearing up because our team functioned together and just made it through every shift, every intubation, everything we had to do,” Wininger said. “Not just nurses, respiratory therapists, physicians -we were just all there, all day, day and night, working together.”

There had been signs before that the emergency was subsiding: Vaccines arrived in force in the first half of 2021, bringing with them months of declining cases and, some thought, the beginning of the end. But then the delta variant arrived, triggering an increase in cases that continued – with brief breaks – from July through early December.

“When we started seeing surges after (vaccines),” Jenkins said, “that’s when I think the culture shifted a little to, ‘Woah. … This isn’t going to end.’ And that’s when this different reality set in.”

Even now, when a much more tangible sign of an ending has arrived, the providers said relief hasn’t set in. The “elation” isn’t there, at least not yet, Milano said, because they’re still trying to process what happened six or seven months ago. That has to happen before they can begin to look forward.

Hospitals say they’re acutely aware of what their staffs went through over the past two years. Many have announced various wellness programs to focus on providers’ mental health, particularly in the wake of a significant thinning of the health workforce. Shaking off two years of constant readiness and near-constant strain is not an overnight process that comes when certain metrics hit a certain point.

“Yes, it’s exciting to think it’s really sustaining low levels of COVID in the city and we haven’t had any in our ICU in a while now,” Wininger added. “But I also have that feeling of like, ‘We’re still ready to go.'”

Asked if the current moment felt surreal after two years, Jenkins said: “That’s one word to use.”

“I think disorienting is another word you could use because coming out of it so quick almost with the downward trajectory and being at zero or near zero for a while, now we’re catching our breath,” she said. “This strange feeling of disorientation of, ‘Wait where are we?’

“We want to get back to normal operations,” she continued, “but it can be a lot to take in, to process all of what just happened and be ready to pick up the next day and go back to another world, of a hospital without COVID.”