• On Twitter, Dr. Craig Spencer shared the evolving reality of his experience treating patients with COVID-19, the disease caused by the novel coronavirus.
  • The volume and severity of cases hitting the emergency room is new to the doctor, who’s an emergency-room doctor at New York-Presbyterian/Columbia University Medical Center. “Our ERs are ICUs,” Spencer tweeted.
  • That’s taking a toll on the staff at the hospital. Spencer noted that every day he’s had colleagues calling him crying.
  • Visit Business Insider’s homepage for more stories.

The coronavirus pandemic has transformed everyday life in hospitals around NYC.

“Our new reality is unreal” Dr. Craig Spencer wrote in a tweet Thursday night. “The people and places we’ve known so long & so well have been transformed. Our ERs are ICUs.”

The reality is different than it was just a few days before.

“Just one week and it’s a whole different world,” he tweeted.

Spencer’s an emergency-room doctor and the director of global health in Emergency Medicine at New York-Presbyterian/Columbia University Medical Center. He has a unique perspective on the coronavirus pandemic, and has shared what a day in the ER is like amid the pandemic before on Twitter.

After caring for patients with Ebola in Guinea in West Africa, he became New York City’s first and only Ebola patient in 2014.

He thinks about that experience as he looks at the tents set up outside his hospital in upper Manhattan. The last time he worked in a tent was in West Africa, he tweeted.

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“In those same tents, I saw too much pain, loneliness, and death. People dying alone. I never thought I’d have to see or experience that ever again. I never wanted to. Once was painful enough,” he tweeted. “We have no other option now.”

Inside the emergency room, the only patients he’s seen have COVID-19, the disease caused by the novel coronavirus.

“Working in the ER means walking through a corridor of coughing,” he tweeted. “All a slightly different pitch & different frequency, but all caused by the exact same thing.”

Read more: A leaked presentation reveals the document US hospitals are using to prepare for a major coronavirus outbreak. It estimates 96 million US coronavirus cases and 480,000 deaths.

The volume isn’t the only new normal hitting Spencer. It’s also how severely ill the patients are, often in a state of respiratory arrest that requires being put on ventilators to help support breathing.

There’s also new challenges to the job, such as determining which patients might be stable enough to go home. There’s also heartbreaking interactions with families who over video chat have to make tough decisions about withdrawing care and saying goodbye to their loved ones. NYC hospitals aren’t allowing visitors to prevent the disease from spreading.

It takes a large emotional toll on the workers in the ER.

“You can’t help but cry. This isn’t what we do,” Spencer wrote.

Already, he wrote, he can tell his colleagues are tired from the physically draining shifts. The mental exhaustion, he wrote, is starting to set in as well. He said he’s had colleagues call him crying every day.

“How long will they hold? How long will I hold?” Spencer wrote.

Being on the front lines of the coronavirus pandemic puts healthcare workers at even greater risk of contracting the virus. Many have already fallen ill, and some told Business Insider they aren’t being tested.

“I’ve never seen my colleagues so afraid, so unsettled,” Spencer tweeted. “But I’ve also never seen them all work so well together. I’ve never seen us more unified, more focused, more sincere.”

The worry is there that they don’t have enough personal protective equipment as they need. The worry about lacking medications to care for patients is also there, Spencer said. “Yes, we worry about each other. But I’ve never seen so much sense of purpose. So much honor to do this job.”

It’s what he thinks about as he comes home from work, he said.

“Clothes in a bag. Hot shower. Look in the mirror. Indentations of the goggles still deep on my face. Blisters on the bridge of my nose,” he wrote.

“How long will we hold?”