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(INDIANAPOLIS) – Indianapolis hospitals are warning their patient load is approaching crisis levels, and pleading with Hoosiers to take coronavirus precautions seriously.

COVID hospitalizations statewide are down 11% this month, but Indy hospitals say their numbers haven’t gone down. Even across the state, there are twice as many patients as there were in the pandemic’s first wave in the spring, and five times as many as there were at the low point four months ago.

Hospitals say it’s not just the increased number of patients that’s creating strain on the system. Eskenazi Health chief nursing officer Lee Ann Blue says the patients in the current wave are sicker. And IU Health vice president Michelle Saysana says illnesses are more widespread than the first wave. Back then, she says, IU’s patients were concentrated at its hospitals in downtown Indianapolis and in Avon. Now, all 18 hospitals in the IU system are flooded with patients.

Franciscan Health vice president Christopher Doehring says there’s less staff to care for patients because hundreds of staffers are quarantining because of exposures away from the hospital. And Blue says the relentless drumbeat of watching patients die on a daily basis is physically and emotionally exhausting.

The Indianapolis Coalition for Patient Safety, which comprises the city’s five hospitals, the Roudebush VA Hospital, and a dozen suburban hospitals, issued a public plea for people to follow coronavirus precautions: mask up, wash your hands regularly, avoid large gatherings, stay home if you feel sick, and maintain your distance from others. Saysana says the approval of a vaccine offers a light at the end of the tunnel — but, she says, “That tunnel is long.”

Saysana adds the need to mask up won’t even go away when there’s widespread vaccination. While drugmakers are confident the vaccine can keep you from getting sick, it’s not established whether you can still infect others.