Consider This from NPR - Florida ICU Could Hit Capacity 'In Days' As Health Care Workers Face Burnout

Episode Date: July 13, 2020

Governors in Southern states like Louisiana are starting to come around to mask mandates, but not all residents are following suit. On Sunday, Florida reported more than 15,000 positive coronavirus cases. At Jackson Memorial Hospital in South Florida, director of medical ICU Dr. David J. De La Zerda says beds are running and low — and so are nurses to staff them. And the NFL's Washington, D.C.-based team is officially changing its name and logo. Activist Crystal Echo Hawk says she cried when she heard the news. Find and support your local public radio station.Email us at [e-mail] more about sponsor message choices: podcastchoices.com/adchoicesNPR Privacy Policy

Over the weekend, Louisiana Governor John Bel Edwards, a Democrat in a largely red state, came around to something that he's been reluctant to do. We've already seen some wild and crazy things being said about mask and mask mandates. So be it. It's the right thing to do. It's the essential thing to do. Like a lot of places in the Deep South, cases in Louisiana are surging. So now, masks are required there. A lot of Republican leaders are still opposed to the mandate. One exception is Nick Hunter, who's the mayor of Lake Charles. He's having a really hard time trying to convince people in the community to wear masks.

God help us if we've come to a point in our society where during the middle of a pandemic, if we want to know medical or scientific information, we are trusting a meme on Facebook or what my brother-in-law heard, overheard at the supermarket. Also over the weekend, President Trump in a photo op at Walter Reed National Military Medical Center was seen wearing a mask for the first time since the pandemic began. Coming up, a Florida ICU near capacity. What doctors there say they need from the community. This is Consider This from NPR. Kelly McEvers is off this week. I'm Elsa Chang, and it is Monday, July 13th. Support for this podcast and the following message come from Integrative Therapeutics, creator of Physician's Elemental Diet, a medical food developed by clinicians for the dietary management of IBS, IBD, and SIBO under the supervision of a physician. So in late April, Florida was seeing fewer than a thousand daily cases of COVID-19.

And as the state prepared to enter its first phase of reopening, Republican Governor Ron DeSantis met with President Trump at the White House to talk about the state's progress at containing the virus. Everyone in the media was saying Florida was going to be like New York or Italy. And that has not happened. Well, on Sunday, the state reported a staggering 15,000 positive coronavirus cases. Cases topped 12,000 so far on Monday. That is thousands more than the daily peaks we were seeing even in Italy or New York at the height of their outbreaks.

Well, it's a function of two things. It's a function of letting cases grow out of hand. And it's also a function of not having a coordinated national strategy. Andy Slavitt worked for the Obama administration in public health. And he told NPR this week, when you have as many cases as the U.S. does, you can't do all the things that other countries around the world have proven can work to contain the virus. Vietnam to say that with the national strategy, which includes testing and masks and contact tracing, you can keep this virus very, very low to a very small number of cases. China was able to test 11 million people in one weekend. We're still on a path where we're only able to do five, six hundred thousand tests a day. Now, in cities across the South, hospitals are being stretched.

At Jackson Memorial Hospital, which is the largest hospital in South Florida, beds are running low and so are nurses to staff them. You know, I am really worried. We continue to see the influx we've seen in the last few days. We are going to reach our capacity in the next few days. Dr. David J. De La Cerda is the director of medical ICU there. A few days meaning by the end of the week. De La Cerda says nurses are burning out.

Non-ER doctors like dermatologists and urologists are helping to treat coronavirus patients now. And then at the end, you know, is that the convention center in Miami Beach is now, there has hospital beds. So I think we will be transferring patients soon when it's ready to get patients as well. I talked to Dr. De La Cerda about what makes those patients different from the ones he had been seeing in prior months.

And also about what his job is like right now. You know, last months are really tough for all the health workers here. So we've been here for six months already. So we are working many hours. So it's a big toll to our families. I don't get to see my kids that often, and also our nurses. So the burnout that we see in our ICUs is really high. Also, we would like to see more community support, you know, in the sense

like when you go out, people being wearing masks and so forth. And sometimes you don't see this here in Miami, unfortunately. So it's also the frustration of seeing the community don't do their part. And these patients that you're seeing in the ICUs today, are you noticing any differences from the COVID patients you were seeing just two months ago? Yes, very younger patients. I would say our age last time was probably around 65. Now, our average age is between 25 to 35, 45 years old. Oh, my. That's a big change. Much younger patients, pretty much healthy, not really major past medical history.

So now the mortality is not being a major issue because there are younger patients. But I think as the days go, we might also going to see a change in mortality. And what have doctors learned since the beginning of this pandemic that's helped you manage infections better and hopefully save more lives as this surge continues? I think we learned number one about medications. So we know which medications actually helping patients and which are not helping patients. That's one important issue we're learning now. The second one is when to put this patient in a breathing machine. So before we put in everybody right away in a breathing machine, Now we give him high flow oxygen,

meaning a special mask that is over the head of the patients and the face, and he's given a flow of oxygen. So there is no tube inside the patient's throat. It's just a flow of oxygen delivering 100% oxygen. But these systems are also resource supplies. We don't have like hundreds of these machines. So it's like the ventilators, you have to watch the numbers of how many of these machines we have. So that's the balance

we have to have. I see. Well, as you are looking ahead to try to keep managing hospital capacity, you know, the most recent testing data from Miami-Dade County, where you're based, says more than 15% of people tested for the coronavirus are testing positive where you are. So what does that number tell you as you continue to try to manage hospital capacity that the worst of the surge is not over? Oh, it's for sure not over. So we have our own predictions here in University of Miami, and we know we are going to reach a big problem in the next two weeks or so. So it's concerning. You know, one thing is when you test people in the community and you have more positive tests, so you know what we call in medicine prevalence, number of sick patients in

the community. But what I'm really concerned is the use of our hospitals. So it's not only seeing positive cases in the community, which is concerning, also is how many patients are coming to the hospital and being admitted. You know, now we have 387 patients this morning. This is the highest so far in the entire six months. So it's really concerning. Dr. David J. de la Cerda is the director of medical ICU at Jackson Memorial Hospital. Thank you very much for joining us and good luck to you. Thank you very much for the invite. It was really a pleasure to join. The NFL team based in Washington, D.C. has felt pressure to change its name for years.

That name is a racial slur against Native Americans, and the team owner had fiercely resisted a change. That is, until now. That's right. It took pressure from the team's financial backers, including FedEx, which sponsors the team's stadium, for that to finally happen. The team announced today it is officially retiring the name and logo and working on a new one. You know, the Movement for Black Lives has created a space now for a larger conversation about how systemic racism manifests itself and how it affects, you know, Indigenous peoples and different communities of color. Crystal Echo Hawk is a member of the Pawnee Nation of Oklahoma, an activist,

and said it was the energy around the Black Lives Matter movement that finally made the change possible. It was really emotional. Honestly, I had a good cry, tears of joy, but just really, really thought a lot about, you know, our Native leaders who've worked on this for, you know, decades. She said activists now will focus on other teams in cities like Kansas City and Atlanta.

When you look at this sort of the mockery, the mimicry, the culture appropriation that these teams are still supporting today, the Braves, the Chiefs, it can no longer stand. Crystal Echo Hawk spoke to my colleague Sarah McCammon on all things considered. Additional reporting for this episode was from our colleagues at Week in Edition Sunday and public health reporter Rosemary Westwood

from WWNO in New Orleans. For more news, download the NPR One app or tune in to your local public radio station. Supporting that station makes this podcast possible. We're back with more tomorrow. I'm Elsa Chang.