ICU Nurse Discusses Coronavirus Prevention and Treatment | Steve Ernst |. Vance Crowe Podcast

About this episode

Vance interviews Steve Ernst, an ICU nurse at a major St. Louis medical center (and Vance's Brazilian jiu-jitsu instructor), for his coronavirus-perspectives series. Ernst gives a clinical, largely apolitical walkthrough of what COVID-19 looks like at the bedside: respiratory decline, altered mental status as an early warning sign, and the mechanics of proning patients to improve lung ventilation. He describes a vivid real-world example of glove-wearing gas station customers who inadvertently contaminate every surface they touch — illustrating that PPE without technique offers false security — and pairs it with a step-by-step explanation of proper hand hygiene. Much of the middle section covers hospital operations under strain: PPE rationing as demand outpaces manufacturing, a medical ICU converted into a dedicated COVID unit within hours, and the referral chain from community hospitals to major trauma centers as capacity fills. Ernst is notably calm and technical throughout, describing his own emotional distance from the crisis ("small fish in a big pond") in contrast to newer colleagues who broke down crying when the unit conversion was announced. He dismisses hydroxychloroquine questions (not familiar with it) and expresses distrust of sensationalized news coverage, quoting Mark Twain on newspapers. He closes with an unscripted, striking final point: that COVID mortality risk concentrates almost entirely in people with multiple comorbidities (diabetes, hypertension, obesity, COPD) — framing this as society being "victims of our own success" in extending lifespans via modern medicine while creating a population uniquely vulnerable to a new pathogen.

Key moments

• **[00:06:50–00:09:12]** Vivid gas-station anecdote showing glove-wearers contaminating every subsequent surface they touch, illustrating that PPE without correct technique is largely theater.
• **[00:11:28–00:13:06]** Description of PPE rationing at the hospital and the formal doffing protocol being modified under supply pressure.
• **[00:13:51–00:14:48]** Contrast between Ernst's own calm and newer nurses breaking down in tears when their unit was converted to a dedicated COVID unit.
• **[00:18:08–00:21:44]** Technical explanation of intubation, sedation, and "proning" patients to improve lung ventilation and oxygenation.
• **[00:30:06–00:30:47]** Ernst's distrust of sensationalized news coverage, quoting Mark Twain on newspapers misinforming vs. uninforming.
• **[00:32:24–00:34:52]** Closing unscripted point: COVID severity concentrates in people with multiple comorbidities, framed as society being "victims of our own success" in medical advancement.

Notable quotes

“Everything that you touched was on those gloves... the gloves are only as effective as the person wearing them.”

“We are the fattest culture in earth... we're almost kind of victims of our own success, of our own advancements in medical care.”

“Mark Twain nailed it. If you read the newspaper, you're misinformed. If you don't read the newspaper, you're uninformed.”