As we head into winter weather, COVID and the flu are major concerns, as Genesis Health System has seen a surge in COVID cases in the past month.
Kurt Andersen, M.D., who is Genesis senior vice president, physician operations and chief medical officer, said Tuesday that two-thirds of the intensive-care unit (ICU) beds now are occupied by COVID patients, limiting their ability to serve a whole host of other very serious cases.
“Anytime we go through a surge like we are now, it becomes increasingly difficult to have the resources to care for all the patients we need to,” he said.
Even with people getting vaccinated against COVID, Genesis anticipated another virus surge this winter, Andersen said. “We’re more indoors, we’re more around each other in close quarters. I think because of vaccinations and overall level of comfort with COVID this year compared to the previous year, we’re seeing more gatherings of families at holidays, getting together.”
For patients who haven’t been vaccinated, that exposure can result in serious illness. The majority of hospitalized patients with COVID are unvaccinated, he said.
In recent months, they’ve seen more breakthrough cases of vaccinated patients in the hospital. Most of them have some underlying chronic condition, Andersen said. They’re at higher risk, and that’s also true with the flu every year.
“Even with vaccination, certain high-risk patients can get a severe enough case of influenza where they end up hospitalized,” he said. “The same thing can happen with COVID in vaccinated population. But the vast majority of patients we’re admitting to our intensive care units and our hospitals have not been vaccinated.”
People who have been vaccinated should also get a booster shot to strengthen protection, and lower transmission in the community, Andersen said.
COVID hospitalizations double in month
“The number of cases in the community has greatly increased over the last several weeks,” he said of COVID, noting over 50 people are currently hospitalized at Genesis with the virus, compared under 20 in early November.
“It follows what we’re seeing nationally right now,” Andersen said, noting last year at this time, there were about 130 hospitalized patients a day with COVID.
“The problem is the number we’re at, even though it’s less than half of last year, it’s a significant challenge when it impacts high-intensive resources like our ICU,” he said. “There is a finite number of ICU beds, ICU staff, and trained nurses that can manage those very sick patients.”
When there are COVID surges that put people in the ICU for days or weeks, “that consumes those resources and makes it hard for us to care for everything else – patients who have heart disease, other lung disease, patients who have severe injury from a trauma,” Andersen said.
He implored people to do everything we can as a community to limit COVID cases, to protect access to health care for everyone. Beyond vaccination, there’s a lot people can do – like masking indoors, maintaining physical distancing, and hand washing.
“We saw that last year, and the good news about last year was it also prevented flu,” he said. “We did not see a significant influenza season at all, because we were wearing masks out in the community, when we were indoors. We were using good hand hygiene, being more careful about large gatherings. All those things reduced our COVID cases last year, helped us bring down the surge we were in, but they also eliminated our influenza cases.”
The medical community is concerned that since people are getting vaccinated, they’re not as concerned with those other preventive measures to stop COVID spread. That could also lead to a more serious flu incidence this year, Andersen said.
The peak of the flu season is January and February, he said. “We’re certainly going to have a more severe flu season than we did last year.” Currently, 65 percent of residents 12 and older in Rock Island and Scott counties have been fully vaccinated for COVID, and health officials recommend a third booster shot six months after the second.
Health impacts the entire community, since when people are sick, they’re not at jobs that need to be done, Andersen said. “Everything we can do to protect ourselves against the flu and COVID, it protects us all as a community.”
New variants create challenges
COVID variants create new challenges, but the new omicron variant (originating in South Africa) has not yet appeared in the U.S. There are questions on whether variants make people more or less sick, whether it’s more contagious, and if the vaccine works against them, he said.
Health departments analyze samples of COVID to see if the new variant is present, which will be reported, Andersen said, noting it continues to be the delta variant that’s the most common strain.
There is some hope on the outpatient side, for oral COVID medications that have been submitted by Merck and Pfizer for FDA approval, he said. Tuesday, an FDA advisory group was scheduled to meet on the Merck proposal.
“If those become available, we’ll certainly start using them in the outpatient setting, to try and prevent progression of illness and hospitalization,” Andersen said. “The challenge is going to be, those aren’t going to be widely available. Like we saw with vaccines, the amount available is slow at first and increases over time. We will be getting an allotment most certainly from the state for those oral treatments, and we’ll have to triage those to the patients who are the highest risks for complications from COVID.”
He expects having that option later this winter. Andersen said Genesis looks every day at balancing resources, judging its surgical volume.
“It’s definitely things people need to get done,” he said. “We try to manage that as best we can. There are times we have to pause certain types of surgeries we know are going to require resources like an ICU bed. We’re having to intermittently pause those surgical cases because of ICU capacity. Overall, we’re trying to maintain as much of the services as we can to the community, because everything is important.”
The longer surgeries are delayed, the more likely patients will have worsening health, Andersen said. “Those cases really cant be delayed for too long,” he said. “It’s really challenging when we have increasing numbers of COVID patients. It becomes a real strain on our resources. The thing we’re most concerned about is the strain it puts on our staff.”
The Rock Island County Health Department reported two new COVID deaths since Nov. 25: two men in their 70s who had been hospitalized. The total number of deaths is now 385.
The health department also reports 207 cases of COVID-19, from Thursday, Nov. 25 to Monday, Nov. 29. The total number of cases is 20,300. Currently, 40 patients are hospitalized in the county with the virus. The average age of newly infected patients is 36. Nationwide, 779,293 people have died from COVID, including 29,349 in Illinois and 7,354 in Iowa.
You can visit vaccines.gov to find your shot. RICHD offers walk-in vaccines on Tuesdays (Moderna and Johnson & Johnson) and Fridays (Pfizer). The hours for both days are 9 a.m. to noon and 1-4 p.m. Boosters or third doses for immunocompromised people are available on the same day as first and second doses. They offer vaccines for children ages 5-11 by appointment on Fridays.
Pediatric clinics are full until Dec. 17. The link for the Dec. 17 clinic will be posted at 10 a.m. Dec. 15 on the health department’s Facebook page. Many area healthcare and pharmacy partners also are offering vaccines for children.
“The most frustrating part of this for healthcare providers is, many of the patients in the hospital could have avoided hospitalization through vaccination,” Andersen of Genesis said.