Consider This from NPR - The Delta Surge Keeps Getting Worse. What Happens When Hospitals Fill Up

Episode Date: September 2, 2021

Some states in the south are have more people in the hospital than at any point during the pandemic — fueled by the highly transmissible delta variant and low vaccination rates. Dr. David Kimberlin, co-division director of Pediatric Infectious Diseases at the University of Alabama at Birmingham, tells NPR the hospital system is Alabama is on the verge of collapse. He spoke to reporter Pien Huang. So what happens — for patients and the people who treat them — when hospitals are full? NPR put that question to two people in charge of hospitals: Dr. Aharon Sareli, Chief of Critical Medicine with the Memorial Healthcare System near Miami; and Dr. Adriano Goffi, a medical director at Altus Lumberton Hospital east of Houston.In participating regions, you'll also hear a local news segment that will help you make sense of what's going on in your community.Email us at [e-mail] more about sponsor message choices: podcastchoices.com/adchoicesNPR Privacy Policy

Support for NPR and the following message come from the Kauffman Foundation, providing access to opportunities that help people achieve financial stability, upward mobility, and economic prosperity, regardless of race, gender, or geography. Kauffman.org Alabama hospitals are overwhelmed and things are about to get even worse. Mobile, Alabama, last week had no ambulances. Doctors are doing CPR in the back of pickup trucks. Dr. David Kimberlin is a pediatric infectious disease specialist at the University of Alabama at Birmingham. He spoke to NPR last week. The ambulances, when they do finally

are able to pick somebody up, they take them and they either have to park them outside the emergency room and the ambulance stays tied up because the patient is on the stretcher in the ambulance, nowhere to go inside. Or sometimes if the patient's well enough, they'll put them in a chair, like a folding chair outside the emergency room and leave them there. In Alabama, there are just under 3,000 COVID patients in hospitals across the state. And by one projection from the University of Alabama at Birmingham, over the next three to four weeks, that number will grow to more than 5,000 patients. That means the wait for an ambulance will get even longer. Space in the emergency room,

even more scarce. Healthcare workers, even more exhausted. Our system in Alabama, and I use this word deliberately and carefully, it is nearing collapse. And I truly cannot overemphasize how terrible things are right now. And that's with almost 2,800 in the hospital, with a projection to go over 5,000. It is so unprecedented that I honestly don't know what it looks like on the other side of this. Consider this. Hospitals are buckling in a handful of low-vaccine states, and the Delta surge may not have peaked yet. From NPR, I'm Ari Shapiro. It's Thursday, September 2nd.

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Listen to our new season wherever you get your podcasts. It's Consider This from NPR. So let's compare how hospitals are doing now with how they were doing in the worst days of the winter surge. This was back in early January. Across the country, there were around 120,000 people hospitalized with COVID-19. That number fell throughout the spring and summer to a low of just 12,000 people in early July. But it soared back up over the past two months. And this week, according to the latest data from the CDC, it's around 90,000. Nearly 100 people are sitting in emergency rooms across Mississippi

waiting for an ICU bed that is not available. In Mississippi, hospitals dodged a bullet with Hurricane Ida and did not see major power outages, but ICU beds are still scarce. The case surge we saw in August most likely will follow us into September. In Moorhead, Kentucky. Earlier this week, health care teams expanded to a field hospital in the parking lot to combat the surge in COVID-19 cases. The National Guard is helping out at multiple hospitals. Here's what Major Michael Wayne told Spectrum One News. You know, what has struck my soldiers the most is when they hear over the intercom that there's a medical assistance needed on a COVID floor,

there's a medical emergency on a COVID floor, and you know at that time someone's having difficulty breathing. They're going to be intubated, they're going to be put on a ventilator, and we've heard that five times over the intercom already this morning. And in Alabama? 1,634 people in the state are needing COVID ICU care. However, there are only 1,542 staffed ICU beds. That leaves Alabama with an ICU bed capacity of negative 92. This week, Alabama became the first state to officially exceed its ICU capacity, according to CDC data. Here's Dr. David Kimberlin again in Birmingham.

You remember back in 2020, the emphasis was on preserving the hospital capacity. And it was pretty remarkable what we did as Americans during that time. Well, the sad part, there's a lot of sad parts, but one of the sad parts to where we are right now is that for all that we went through back then, we're now experiencing the very thing that we've been trying this entire pandemic to avoid. It's not like hospitals can put a no vacancy sign on the front door.

So what does it mean when they fill up? Well, NPR put that question to two people who run hospitals. We've converted conference rooms and cafeterias, offices, ultrasound rooms into units that house patients with beds and monitors. That's Dr. Aaron Sorelli, chief of critical medicine with the Memorial Healthcare System, a large public hospital system in the Miami area. They have space to expand, but space is not the only issue for some hospitals. There's also staffing. Our own nurses are developing COVID symptoms, vaccinated or not. They pop positive and they are out of the system for a few days. That's Adriano Goffey, a medical director at Altus Lumberton Hospital, a small rural facility

east of Houston. Both doctors say the COVID patients in their hospitals are overwhelmingly unvaccinated. They told NPR's Mary Louise Kelly just how hard things are right now and what happens when they don't have room for a patient and no one else does either. Dr. Goffey, when you're treating a COVID patient who needs the ICU, who needs a ventilator, and you're calling and no ICU will take them, what is that conversation? Your nurses are calling hospitals all day trying to find a bed, and they say what? Well, so we did not have a way to have like a waiting list. So we had to hire, we averaged around five secretaries calling hospital by hospital by hospital and even calling the same ones. It's almost like you just get lucky that a bed opened up and you were on the phone with them.

And we're calling thousands of places a day. We've literally air flown somebody from Lumberton to North Dakota to Tennessee, just because those were the only beds available. Have you had people die while waiting? Yes, we have. It's very difficult. And it takes a big toll on us, even my family here, because you come home and there's no way not to take that home. Yeah, I think that's such an important point. The amount of death that healthcare professionals are seeing on a daily basis is so many orders of magnitude higher than anything we could have ever imagined. Working in critical care, we deal with death on a regular basis, but not in these quantities and not this regularly. And the staff has just been

emotionally pulverized is the only way that I can describe it. Emotionally pulverized. Yeah. Dr. Goffey? I think that's one of the best ways to put it, Dr. Sorelli. And the other part, the other component that really is difficult for us as physicians is as we're caring for these patients, there's the other side, which these are mostly unvaccinated. You have a lot of vaccinated individuals come into my emergency room, for instance, and there are non-COVID related issues such as a heart attack. I was going to ask, what does all this mean? If I have a heart attack and I need to come to your hospital for urgent care, there's huge, yeah, please. And it's very difficult for us as physicians because we have a certain amount of things that we pride ourselves in the United States of being able to do.

You come in with a heart attack and we can get you the treatment that's life-saving within 90 minutes. And that's kind of out the window with everything going on now. And now they're waiting three, four, or five days. And it's not just the heart attack patients. It's cancer patients that need a biopsy. And I think that's very important to understand that people need to get vaccinated also to prevent others from having serious complications of other illnesses.

Is there a discussion underway at either of your hospitals over prioritizing, over if resources are finite, who deserves the bed? Yeah, I think that is a discussion that no physician in a first world country ever wants to be part of. We are committed to providing care to both our COVID populations and non-COVID populations. And as physicians, we're always going to do the best that we can with the resources at hand. But there's no question that in modern history, healthcare system in South Florida, and I'm sure in the rest of the country, has never been under

so much pressure for such a long period of time. Our society and all of us have our part to play, and we all have to get vaccinated. Because as you said, there is an impact not only on the people that have COVID, but on every one of us. Every one of us is going to need healthcare at some point in our lives. And having the system so overburdened, we are going to pay the price and we are paying the price. Both of you have mentioned the vast majority of the COVID cases coming in are unvaccinated people. What are those conversations like? When you see somebody come in, they need urgent care, it's critical, and you think this was so preventable? Yeah, I think from my perspective, the only real word that comes to mind is tragic.

It is an absolute tragic conversation to have with patients before they get intubated, when you know it's too late, when you know that they've missed that opportunity not to have with patients before they get intubated, when you know it's too late, when you know that they've missed that opportunity not to have had their lives devastated by this virus and you know that when they land up on mechanical ventilation the overwhelming chances are that they're going to die and we then have an intimate relationship with their family members. No one dies in the ICU from COVID in a short period of time. It takes weeks and months. Every day I speak to their families. I hear their kids in the background. And it's very hard to explain to someone who's not there the magnitude of the tragedy. Dr. Goffey. This has probably been

the most difficult part of my career. Going through residency and seeing other areas of medicine like NICU, where there's some sad cases there. This one's really tough because I'm not upset with patients because a lot of it is the misinformation that Dr. Sorelli's mentioning. It's getting information from all the wrong places. And I think that's the part that hurts the most is that they feel that they're educated on this subject and they're not because it's coming from Facebook or a variety of avenues that is just not real. Can I say one other thing? Can I share one other piece that we didn't get to today? You know, I just wanted to mention that one of the challenges of this last Delta wave compared to the last summer when we were hit by a massive surge as well

is that last summer, everyone seemed to be in the battle against COVID together. Businesses weren't operating. It's almost like the world was holding its breath. And I think one of the challenges with this surge is that if you're in the hospital, if you're a physician, if you're a healthcare giver, or if you're a patient that is seriously ill or dying from COVID, you're in it and you're faced by what we've been talking about. But for the rest of the community, if you step outside of even Florida hospitals, life goes on.

People are driving around. People are in the streets. People are going on about their lives. And I think that we've almost become numb as a community to what COVID is doing to those patients that chose not to become vaccinated and are now paying the price. Dr. Aaron Sorelli of Memorial Healthcare in South Florida and Dr. Adriano Goffi of Altus Lumberton Hospital in Texas. Finally, there's some good news. Back in mid-July, the U.S. was averaging 500,000 vaccinations per day. Today, we're averaging 900,000. And crucially, White

House COVID coordinator Jeff Zients said this week the number of people getting their first shot is going up. In August, we got over 14 million. That's almost 4 million more first shots in August compared to the prior month, July. For those who still remain unvaccinated, well, this week the CDC recommended they do not travel this Labor Day weekend. Earlier this episode, you heard from Dr. David Kimberlin in Alabama. He spoke with NPR science reporter Ping Huang. It's Consider This from NPR. I'm Ari Shapiro. Support for NPR and the following message come from Carnegie Corporation of New York,

working to reduce political polarization through philanthropic support for education, democracy, and peace. More information at carnegie.org.