Virus has nation’s hospitals bulging
Records set; care rationing seen near
Kentucky and Texas joined a growing list of states that are seeing record numbers of hospitalized covid-19 patients in a surge that is overwhelming doctors and nurses, and afflicting more children.
Intensive care units around the nation are packed with patients extremely ill with the coronavirus — even in places where hospitalizations have not yet reached earlier peaks.
The ICU units at Phoebe Putney Memorial Hospital in Georgia typically have room for 38 patients, and doctors and nurses may have only two or three people who are very sick, said Dr. Jyotir Mehta, medical director of the ICU. On Wednesday, the ICU had 50 covid-19 patients alone, with roughly half of
them relying on ventilators to breathe.
“I don’t think we have experienced this much critical illness in folks, so many people sick at the same time,” Mehta said.
He said talking to family members is difficult. “They are grasping for every hope, and you’re trying to tell them, ‘Look, it’s bad,’” he said. “You have to tell them that your loved one is not going to make it.”
In New Mexico, top health officials warned Wednesday that the state is about a week away from rationing health care. The number of coronavirus patients needing care at hospitals jumped more than 20% in a day.
“We’re going to have to choose who gets care and who doesn’t get care,” state Health and Human Services Secretary Dr. David Scrase warned. “And we don’t want to get to that point.”
In Idaho, state leaders called on residents to volunteer to help keep medical facilities operating.
Texas and Kentucky on Wednesday reported more covid-19 patients in their hospitals than at any other time since the pandemic began, 14,255 and 2,074, respectively. The Texas figure is based on U.S. Department of Health and Human Services data.
At least six other states — Arkansas, Florida, Louisiana, Hawaii, Mississippi and Oregon — have already broken their hospitalization records.
In Texas, nearly 47% of the population is fully vaccinated — below the national average of almost 52% — and Republican Gov. Greg Abbott has banned mask and vaccination mandates. Many counties and school districts have defied his mask ban.
In Kentucky, just under 48% of the population is fully vaccinated, and public health officials have blamed the lag in part for the state’s surge. Democratic Gov. Andy Beshear’s covid-19 restrictions expired in June, and the GOP-controlled Legislature has blocked him from issuing new mask requirements or capacity limits.
Nationwide, covid-19 deaths are running at more than 1,100 a day, the highest level since mid-March, and new cases per day are averaging more than 152,000, turning the clock back to the end of January. As of early this week, the number of people in the hospital with the coronavirus nationwide was around 85,000, a level not seen since early February.
The surge is largely fueled by the highly contagious delta variant among people who are unvaccinated. In areas where vaccination rates are particularly low, doctors have pleaded with their communities to get inoculated to spare overburdened hospitals.
They have also sounded the alarm about the growing toll of the variant on children and young adults.
Children now make up 36% of Tennessee’s reported covid-19 cases, marking yet another sobering milestone in the state’s battle against the virus, Health Commissioner Lisa Piercey said Wednesday. She said the state had 14,000 pediatric cases in the past seven days — a 57% increase over the previous week.
In South Carolina, students will again be required to wear masks on school buses starting Monday as covid-19 cases among children and students rise rapidly.
Nearly 30% of new cases in South Carolina in the past two weeks have been in people 20 and under. During the same time in 2020, about 17% of cases were in children and teens, according to state officials.
Anderson Lopez Castillo, a nurse who cares for seriously ill covid-19 patients at UAB Hospital in Birmingham, Ala., said treating people as young as 16 in critical care has become an additional strain on top of a nearly yearlong ordeal that left him questioning his choice of a profession.
“Initially we saw a lot of older people getting it. It was like, ‘OK, we can tackle this. Even if it is stressful, even if it’s a dangerous virus, it’ll probably not be that bad on us as nurses taking care of these older patients,’” he said.
Castillo, 24, said he now sees the virus making young people very sick, and it makes him and other young nurses think of their own mortality.
“There’s definitely a little subconscious thought in the back of all of our heads going, ‘You know, that could be us,”’ he said.
BEHAVIOR KEY
The U.S. is projected to see nearly 100,000 more covid-19 deaths between now and Dec. 1, according to the nation’s most closely watched forecasting model. But health experts say that toll could be cut in half if nearly everyone wore a mask in public spaces.
“Behavior is really going to determine if, when and how sustainably the current wave subsides,” said Lauren Ancel Meyers, director of the University of Texas covid-19 Modeling Consortium. “We cannot stop delta in its tracks, but we can change our behavior overnight.”
That means doubling down again on masks, limiting social gatherings, staying home when sick and getting vaccinated. “Those things are within our control,” Meyers said.
The projection says deaths will rise from about 1,100 a day to nearly 1,400 a day by mid-September, then decline slowly.
But the model also says many of those deaths can be averted if Americans change their ways.
“We can save 50,000 lives simply by wearing masks. That’s how important behaviors are,” said Ali Mokdad, a professor of health metrics sciences at the University of Washington in Seattle who is involved in making the projections.
Already there are signs that Americans are taking the threat more seriously.
Amid the alarm over the delta variant in the past several weeks, the slump in demand for covid-19 shots reversed course. The number of vaccinations dispensed per day has climbed around 80% over the past month to an average of about 900,000.
White House covid-19 coordinator Jeff Zients said Tuesday that in Alabama, Arkansas, Louisiana and Mississippi, “more people got their first shots in the past month than in the prior two months combined.”
Early signs suggest behavior changes may already be flattening the curve in a few places where the virus raged this summer.
An Associated Press analysis shows the rate of new cases is slowing in Mississippi, Florida, Louisiana and Arkansas, some of the same states where first shots are on the rise. In Florida, pleas from hospitals and a furor over masks in schools may have nudged some to take more precautions.
However, the troubling trends persist in Georgia, Kentucky, South Carolina, Tennessee, West Virginia and Wyoming, where new infections continue to rise steadily.
Mokdad said he is frustrated that Americans “aren’t doing what it takes to control this virus.”
“I don’t get it,” he said. “We have a fire, and nobody wants to deploy a firetruck.”
TEXAS RULING
The Texas Supreme Court on Thursday temporarily blocked a mask mandate issued by San Antonio and Bexar County for their public schools — a blow to efforts by some cities, counties and school districts to defy Abbott’s ban on such measures.
The ruling came in a lawsuit by San Antonio and Bexar County, one of at least nine that have been filed by cities, counties and school districts against the governor over his ban on mask mandates. At least 11 counties and cities, and 63 school districts or systems in Texas have imposed mask mandates to slow the spread of covid-19.
Abbott has argued that the Texas Disaster Act gives him broad power in deciding how best to respond to emergency situations, including whether to ban mask mandates during a pandemic.
The counties, cities and school districts say Abbott has exceeded his authority. Dallas and Harris counties, two of the state’s most populous counties, are among those that have imposed mask mandates.
Last week, a judge granted Bexar County and San Antonio a temporary injunction that put Abbott’s ban on hold pending trial in that lawsuit. The Texas attorney general’s office asked the state high court to stay the injunction. The Texas Supreme Court had previously stayed temporary restraining orders issued in favor of Bexar County, San Antonio and Dallas County.
In its order Thursday, the court said oversight of decisions on mask mandates has been up to the governor and “that status quo” should remain in place while the courts examine the issue.
“This case, and others like it, are not about whether people should wear masks or whether the government should make them do it. Rather, these cases ask courts to determine which government officials have the legal authority to decide what the government’s position on such questions will be,” the court said.
The court has not yet made a final determination on the legal issues surrounding mask mandates.
In a statement on Facebook, San Antonio Mayor Ron Nirenberg said, “We’re not going to let an ongoing court battle distract us from the real fight against COVID-19. Get the vax. Wear a mask.”
ILLINOIS MANDATES
Illinois Gov. J.B. Pritzker doubled down Thursday on his efforts to deal with the delta resurgence as schools reopen by requiring all educators from kindergarten through college to be vaccinated along with higher-education students and all health care workers in the state.
Additionally, Pritzker imposed a statewide mandate requiring the masking of people age 2 and above in indoor locations as the variant has led to increasing hospitalizations among younger people and the unvaccinated, along with increasing reports of “breakthrough cases” among those who are vaccinated.
“Let’s be clear, vaccination is the most effective tool we have for keeping people out of the hospital and preventing deaths. Nearly all Illinoisans who are hospitalized with covid are the Illinoisans who are not vaccinated. And those hospitalizations are only increasing,” Pritzker said.
Citing an increase of intensive care unit usage that has multiplied by seven and data showing that from January through July 98% of positive cases, 96% of hospitalizations and 95% of deaths are among unvaccinated people, Pritzker said, “You don’t need to be an epidemiologist to understand what’s going on here. This is a pandemic of the unvaccinated.”
Educators who do not take the vaccine effective Sept. 5 will be required to undergo testing at least once per week.
The Democratic governor’s announcement came only days after he said he had no plans to expand a vaccine mandate beyond state and private workers in congregate settings, such as nursing homes, prisons and veterans homes.
Illinois House Republican leader Jim Durkin of Western Springs called on the governor to call a special legislative session to get his health experts before the General Assembly to “examine their data and plans, review the results of your many previous mandates and together plot a course of action that will work” to curb the covid-19 resurgence.
“You are willing to negotiate with your biggest supporters, the public sector unions, on the pandemic response, but still will not listen to the General Assembly or the residents of Illinois most impacted by your actions,” Durkin wrote in a letter to Pritzker.
Republicans have chafed over a lack of input into Pritzker’s executive actions amid a Democratic controlled General Assembly.
Pritzker earlier this month said schools and districts that did not comply faced sanctions, including the possible loss of state funding and participation in Illinois High School Association athletics.
Pritzker’s requirement for workers in congregate settings has been challenged by the American Federation of State, County and Municipal Employees Council 31, the state’s largest employee union. The union, which has supported vaccination, has said the issue is a matter of collective bargaining. Pritzker said his administration is in negotiations with AFSCME on the issue.
Officials for the state’s largest public teachers’ unions — the Illinois Education Association, which represents primarily suburban school districts, and the Illinois Federation of Teachers, whose ranks include the Chicago Teachers Union — embraced Pritzker’s new mandate.
Information for this article was contributed by Sudhin Thanawala, Jay Reeves, Carla K. Johnson, Nicky Forster, Juan A. Lozano and others of The Associated Press; and by Rick Pearson and Lisa Schencker of the Chicago Tribune (TNS).