Morning Medical Update Friday 10-15-21

The University of Kansas Health System reports higher numbers of COVID patients today. 16 with the active virus are being treated, up from 14 yesterday. Only three of them are vaccinated. Seven patients are in the ICU, up from six yesterday. Five are on ventilators, down from six yesterday. 33 other patients are still hospitalized because of COVID but are out of the acute infection phase, down from 34 yesterday. That’s a total of 49 patients, up from 48 yesterday. HaysMed has 19 total COVID patients, up from 15 yesterday. They have had one COVID death in the last 24 hours.

On today’s Morning Medical Update, Tiffany Clark, an Emergency Department supervising nurse, joins us during this Emergency Nurses Week to talk about life in the ED. She also helps Steve Stites, MD, chief medical officer at The University of Kansas Health System and Nathan Bahr, MD, infectious disease physician, answer community questions.

Before getting to today’s guest and community questions, doctors commented on the higher numbers from HaysMed, saying it’s likely from low vaccinations, fewer mask mandates and less preventive measures. They also feel the news on boosters is good, especially the most recent recommendation of half a dose for the Moderna vaccine. They believe the final approval for vaccinating kids 5 to 11 will come in early November.

Tiffany Clark says COVID has been a big challenge for the Emergency Department. At the beginning of the pandemic, people stayed away, afraid they’d catch the virus there. But accidents, heart attacks, strokes and other medical emergencies didn’t stop, and now the department is bursting at the seams with people having worse problems from delayed care and with COVID patients. She says they’ve had to be creative in where they put some patients, and said while they won’t turn anyone away, you’ll need to be prepared to wait longer unless you have a life-threatening condition. She worries about an increase in flu patients this year and an increase in COVID patients when masks are allowed to come off. She says everyone in the ED is staying positive and all have maintained their compassion toward each patient who comes in.

Here are the media and community questions in the order the panel addressed them, followed by the short answer. The time code for the question is in parentheses. See the video for their full answers and comments.

(18:30) We say that masks work, then why do we seem to see a higher number of kids getting COVID? There is no question masks work when worn correctly, covering both the nose and mouth. Kids don’t always wear them correctly and Delta is much more transmissible.
(22:00) What happens if a patient refuses to wear a mask in the ED and how do you know if they’re vaccinated? They are asked if they are vaccinated and offered the vaccine if they are not. They are not allowed inside without a mask.
(23:20) What are your thoughts about using vaccine status when prioritizing patients? All patients are taken care of the same, regardless of vaccination status.
(24:30) Should I get my flu shot in preparation for the masks coming off? Yes!
(25:00) How do you handle patients who come to the ED and don’t speak English? There are a variety of interpreters available around the clock both in person and by phone.
(25:40) If I get the booster, how long will I be protected? It’s too soon to know for sure, but the thinking is for at least six months. The hope is for a very long lasting immunity.
(26:50) I currently have a breakthrough case of COVID. I’m also eligible for the booster. Should I get that now or just rely on my natural immunity. You should still get the booster.
(27:30) Should we be concerned about the new C.1.2 COVID variant? We don’t know yet how all of the variants will balance each other. We need to be aware of it, but so far none have out-competed the Delta variant.
(29:00) Is there ever a slow day in the Emergency Department? There are slow moments, but hardly ever slow days. The lightest time is usually just before dawn, while the busiest tends to be after lunch until about 10 p.m. But it can be busy at all hours.
(31:10) Is it hard to recruit nurses to work in the Emergency Department? It’s not hard to recruit nurses, as many thrive in that atmosphere. Sometimes it’s harder to keep them, and the best are flexible and extremely creative.
(32:50) Do you see a time in the future when we will all not be walking around with masks on? Absolutely. Masks won’t be forever. But it’s going to take a while because we’ve got to keep working on the 84 million Americans who have decided not to get vaccinated. They are the key to getting us all unmasked.
(34:20) I currently have Bell’s palsy, believed to have been caused by the shingles virus. I’m about 65 percent recovered. Is it safe for me to get my COVID vaccine now? Yes.
(36:10) I’ve had both vaccinations, a breakthrough COVID illness and antibody infusions. How long should I wait until getting the booster? The overall recommendation is to wait three months after getting monoclonal antibodies. But if you are in a high risk category, you might be able to get it sooner. Definitely check with your doctor first.
(37:10) How do you define breakthrough COVID illness? The problem is that term makes it sound like a vaccine failure. You can still get COVID even with a vaccination, but your rate of getting it is so much less and the rate of death is reduced by 99 percent. So is your risk of serious illness and hospitalization.
(40:10) How do you counter the argument by some that “masks are nothing but Petri dishes” when it comes to kids getting COVID? Any germs in your mask are the same germs you’ve breathed out and are already in you. They won’t hurt you. Masks keep you from spreading COVID to someone else and help prevent you from getting the disease. Kids are getting it more often because Delta is highly transmissible, and kids are back together in school and in after school activities.
(44:00) Do you get a lot of emergency patients who were hurt while texting and not paying attention? Yes, “texting trauma” is very common. Especially among people riding those scooters all over downtown.

Monday, October 18 at 8:00 a.m. is the next Morning Medical Update. We’ll look at Halloween safety during COVID. The medical director of our Poison Control Center joins us to talk about whether trick or treating will look different this year than last. Plus, another episode of Sunnye Says, showing how kids can be safe that night.

NOTE: Journalists should rejoin the Morning Medical Update at 8am as doctors are growing too busy again for individual interview requests. Please bring questions or send to medicalnewsnetwork@kumc.edu until further notice. Thanks for all you do and helping to keep the community safe with your reporting.

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(18:30) We say that masks work, then why do we seem to see a higher number of kids getting COVID? There is no question masks work when worn correctly, covering both the nose and mouth. Kids don’t always wear them correctly and Delta is much more transmissible.
(22:00) What happens if a patient refuses to wear a mask in the ED and how do you know if they’re vaccinated? They are asked if they are vaccinated and offered the vaccine if they are not. They are not allowed inside without a mask.
(23:20) What are your thoughts about using vaccine status when prioritizing patients? All patients are taken care of the same, regardless of vaccination status.
(24:30) Should I get my flu shot in preparation for the masks coming off? Yes!
(25:00) How do you handle patients who come to the ED and don’t speak English? There are a variety of interpreters available around the clock both in person and by phone.
(25:40) If I get the booster, how long will I be protected? It’s too soon to know for sure, but the thinking is for at least six months. The hope is for a very long lasting immunity.
(26:50) I currently have a breakthrough case of COVID. I’m also eligible for the booster. Should I get that now or just rely on my natural immunity. You should still get the booster.
(27:30) Should we be concerned about the new C.1.2 COVID variant? We don’t know yet how all of the variants will balance each other. We need to be aware of it, but so far none have out-competed the Delta variant.
(29:00) Is there ever a slow day in the Emergency Department? There are slow moments, but hardly ever slow days. The lightest time is usually just before dawn, while the busiest tends to be after lunch until about 10 p.m. But it can be busy at all hours.
(31:10) Is it hard to recruit nurses to work in the Emergency Department? It’s not hard to recruit nurses, as many thrive in that atmosphere. Sometimes it’s harder to keep them, and the best are flexible and extremely creative.
(32:50) Do you see a time in the future when we will all not be walking around with masks on? Absolutely. Masks won’t be forever. But it’s going to take a while because we’ve got to keep working on the 84 million Americans who have decided not to get vaccinated. They are the key to getting us all unmasked.
(34:20) I currently have Bell’s palsy, believed to have been caused by the shingles virus. I’m about 65 percent recovered. Is it safe for me to get my COVID vaccine now? Yes.
(36:10) I’ve had both vaccinations, a breakthrough COVID illness and antibody infusions. How long should I wait until getting the booster? The overall recommendation is to wait three months after getting monoclonal antibodies. But if you are in a high risk category, you might be able to get it sooner. Definitely check with your doctor first.
(37:10) How do you define breakthrough COVID illness? The problem is that term makes it sound like a vaccine failure. You can still get COVID even with a vaccination, but your rate of getting it is so much less and the rate of death is reduced by 99 percent. So is your risk of serious illness and hospitalization.
(40:10) How do you counter the argument by some that “masks are nothing but Petri dishes” when it comes to kids getting COVID? Any germs in your mask are the same germs you’ve breathed out and are already in you. They won’t hurt you. Masks keep you from spreading COVID to someone else and help prevent you from getting the disease. Kids are getting it more often because Delta is highly transmissible, and kids are back together in school and in after school activities.
(44:00) Do you get a lot of emergency patients who were hurt while texting and not paying attention? Yes, “texting trauma” is very common. Especially among people riding those scooters all over downtown.