Those ICUs are also filling with younger patients, in their 20s, 30s, and 40s, including many with no underlying health problems. In part, that’s because elderly people have been more likely to get vaccinated, leaving Delta with a younger pool of vulnerable hosts. While experts are still uncertain if Delta is deadlier than the original coronavirus, every physician and nurse in Missouri whom I spoke with told me that the 30- and 40-something COVID-19 patients they’re now seeing are much sicker than those they saw last year. “That age group did get COVID before, but they didn’t usually end up in the ICU like they are now,” Jonathan Brown, a respiratory therapist at Mercy, told me. Nurses are watching families navigate end-of-life decisions for young people who have no advance directives or other legal documents in place... That they are in this position despite the wide availability of vaccines turns difficult days into unbearable ones. As bad as the winter surge was, Springfield’s health-care workers shared a common purpose of serving their community, Steve Edwards, the president and CEO of CoxHealth, told me. But now they’re “putting themselves in harm’s way for people who’ve chosen not to protect themselves,” he said. While there were always ways of preventing COVID-19 infections, Missourians could have almost entirely prevented this surge through vaccination—but didn’t. “My sense of hope is dwindling,” Tracy Hill, a nurse at Mercy, told me. “I’m losing a little bit of faith in mankind. But you can’t just not go to work.”... The grueling slog is harder now because it feels so needless, and because many patients don’t realize their mistake until it’s too late. On Tuesday, Hill spoke with an elderly man who had just been admitted and was very sick. “He said, ‘I’m embarrassed that I’m here,’” she told me. “He wanted to talk about the vaccine, and in the back of my mind I’m thinking, You have a very high likelihood of not leaving the hospital.” Other patients remain defiant. “We had someone spit in a nurse’s eye because she told him he had COVID and he didn’t believe her,” Edwards said.