Roy Exum: Our Hospitals Are Full

Thursday, July 29, 2021 - by Roy Exum
Roy Exum
Roy Exum

Physicians in Hamilton County have been asked to release inpatients at Chattanooga’s largest hospitals as soon as medically feasible, this after a raging ‘variant’ of COVID 19 pandemic is buckling the South. Chattanooga’s Erlanger, Memorial and Parkridge Hospitals are each “at full capacity” due to the powerful ‘delta variant’ yet they are hardly alone. The latest information obtainable from the Johns Hopkins coronavirus dashboard Thursday night show six of the most infected states in the country are located in the South and – stunningly -- epidemiology experts are saying “this (fourth wave) of the disease is just getting started.”

What’s more unbelievable is that virtually every person now hospitalized has not been vaccinated; did not take advantage of the massive vaccination program that has been widely available since February in this newest tragedy that is now being called “the pandemic of the unvaccinated.”

One Chattanooga doctor said that of the number of patients under her care who are now ‘COVID positive,’ there are three who were fully vaccinated but who have been stricken with this latest wave as well. 

“There are some cases where those who received the vaccine have become infected but, in my case, the three patients of mine all have mild symptoms, and none require hospitalization. I have some patients who opted not to take the vaccine who are really sick right now. I believe it is a personal decision each person should make, and not under pressure from anyone,” the doctor added, “but if there ever was a study to determine the worth of the vaccine, look no further than the hospital admissions right now.”

The Johns Hopkins Coronavirus Dashboard lists the Most Active States where the COVID-19 has now spread like wildfire from Florida. On the list below you will see ‘new cases,’ which is actually an average over seven days. Mind you, every day this changes, as a new day takes place and the oldest day of the seven days is eliminated.

The current ‘Top 10’ in the United States:

No. 1 -- TEXAS: 9,288 new cases, with 227.9 tests per 100K, and a 10.7% positive rate.
No. 2 – CALIFORNIA:  7,689 new cases, with 398.4 tests per 100K, and a 4.6% positive rate.
No. 3 – LOUISIANA: 4,699 new cases, with 438.7 tests per 100K, and a 17.5% positive rate.
No. 4 – GEORGIA: 3,828 new cases, with 243.3 tests per 100K, and a 17.4% positive rate.
No. 5 – MISSOURI: 2,835 new cases, with 212.7 tests per 100K, and a 18.9% positive rate.
No. 6 – ALABAMA: 2,726 new cases, with 89.9 test per 100K, and a 44.0% positive rate
No. 7 – NORTH CAROLINA: 2,633 new cases, with 185.0 test per 100K, and a 10.1% positive rate.
No. 8 – TENNESSEE: 2,226 new cases, with 143.3 tests per 100K, and a 16.1% positive rate.
No. 9 – IOWA: 2,158 new cases, with 36.6 tests per 100K, and a 20.8% positive rate.
No. 10 – ILLINOIS: 2,082 new cases, with 309.0 tests per 100K, and a 4.0% positive rate

MISSISSIPPI, at No. 11, is a simmering cauldron; 1,875 new cases, with 104.5 tests per 100K, but with 42.6 positive results. ARKANSAS has 1,703 new cases and was 20.5 percent positive on 262.1 tests per 100K. KENTUCKY shows 1,549 new cases with 13.5 percent positive testing and SOUTH CAROLINA reports 1,439 new cases with 12.8 percent positive.

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Dr. Michael Saag is professor of medicine and infectious diseases and virology at the University of Alabama at Birmingham. In Thursday’s Editions of the Washington Post, he penned an op-ed post that merits sharing.
BY MICHAEL SAGG M.D., Birmingham, Ala.

Through the spring and into the early summer, owing in large part to large-scale vaccine production and distribution, every American age 12 and over had access to the vaccine. Many received their “jab” as soon as it was available. As a result, the number of COVID cases plummeted, the grip on our hospital systems relaxed, death rates fell, and we began to see the light at the end of the tunnel.

But in many regions of the country, including the Southeast where I live, up to two-thirds of the population chose not to protect themselves. I’ve heard all the reasons: “The vaccines are experimental.” “I am young and healthy; I don’t need the vaccine.” “So what if I get covid?” “The epidemic is over.” “The vaccine will destroy my fertility.” “The vaccine is a government plot.” “I have the freedom to choose.” “Nobody can tell me what to do.” “The doctors are lying to me.”
Like most of my fellow health-care workers, these comments stunned and stung me. We had spent a year fighting a raging pandemic. We suspended activities in our usual disciplines of medical care, rolled up our sleeves and provided care to the more than 30 million people who showed up in our ERs, clinics, and hospitals. Covid was more than disruptive; it was exhausting. Most of us survived. But we were also fatigued and battle worn.
Enter delta. We knew variants had emerged elsewhere in the world. The alpha variant entered the United States as the vaccines were rolling out and, fortunately, was well neutralized by the vaccine’s immune response. Delta, we thought, would be similar. It is not.
As we entered into the July Fourth weekend, many Americans celebrated as if the epidemic had ended: traveling in record numbers and engaging in large gatherings with no masks and no social distancing. All the while, many of those celebrating were unvaccinated and immunologically vulnerable. With the delta variant going from zero cases in March to 60 percent of cases by mid-July, we were approaching a near-perfect storm.
Now we are in it. Cases are exploding. Here in Alabama, the state with the lowest vaccination rate (less than 35 percent), rates of infection have risen from less than three cases per 100,000 people four weeks ago to more than 54 cases per 100,000 this week. Suzanne Judd at the University of Alabama at Birmingham School of Public Health generated models that show, by Labor Day, cases will skyrocket to two to three times the peak we experienced in January. At our 1,157-bed hospital in Birmingham, Alabama’s largest, we have risen from three cases in-house in mid-June to more than 67 cases on Wednesday. Statewide, the rise exceeds 500 percent since July 4.
These trends are terrifying and, as a virologist who had covid-19 last spring, I can say they induce a kind of pre-traumatic stress in our health-care workers. We know what’s coming. We’ve experienced this trauma before. We don’t want to do this again, but the die is already cast. My fellow health-care workers are being thrown back into the fire, like servicemen and women going back for a third tour of duty in a war zone. This week alone, one infectious-disease colleague and four ER physicians, all fully vaccinated, have become ill with the variant. This is very different from what we experienced before. Delta is different.
With the current spike of cases, 99 percent of deaths are occurring in unvaccinated people. Almost all of these are preventable. That is particularly troublesome to health-care workers who struggle valiantly to save the lives of those who now present to the hospital, the vast majority of whom chose not to be vaccinated.
Making it worse is the hate we experience from a small, but very real, group of people who seek to undermine our efforts through the steady release of misinformation in social media and elsewhere.
I received an inquiry this week from a person who claimed to be a CNN reporter, initially asking me for information about delta and then demanding “proof” that delta is here. Despite my best effort to explain, I was berated with accusations that I was making this up. (He later posted most of the exchange on Facebook.) I am not alone in suffering these types of attacks. It is this sort of behavior that has led to poor vaccine uptake among many people and resulted in this new spike of cases.
Despite the static and misinformation, we will get it done. It will be helpful, however, if this time around we pull together as a country, ignore those who spew hate and sow mistrust of those trying to serve the public. The virus is a formidable enemy and terrifying enough. We can’t afford to be fighting a two-front war.
* * *
For information on vaccine availability and appointments, go to the Hamilton County Health Department website

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