“There’s been a lot of language around ‘we’re right on the edge of entering crisis capacity,’ but what I’m worried about is that there’s kind of a blurred entry,” says Dr. Kate Butler, a nephrologist and acting instructor at the University of Washington School of Medicine.

Butler has studied how health care workers dealt with these clinical dilemmas during the spring COVID-19 surge.

“Everybody gets a little bit of bad care,” said one worker she interviewed, referencing shorter dialysis sessions for patients when the machines were in high demand.

In an interview with NPR, Butler said, “there’s been far less preparation for this gray zone where resources are limited, and we’re seeing impact on patient care — potentially people dying — because they’re not getting the care that would otherwise be offered to them.”