The number of COVID patients at The University of Kansas Health System is down today. 54 patients with the active virus are being treated, down from 62 yesterday. Only 11 of those 54 are vaccinated.16 of those patients are in the ICU, down from 21 yesterday. 10 of those patients are on ventilators, down from 14 yesterday. HaysMed has 14 total patients today, up from 10 yesterday.
Today, another episode of Open Mics With Dr. Stites. Guests were Chris Brown, MD, a hospitalist at The University of Kansas Health System, and Casey Pickering, ICU nurse manager, who have been on the front lines of the COVID pandemic since the beginning. They shared what makes this current surge different from the last.
Steve Stites, MD, chief medical officer at The University of Kansas Health System, began by showing the updated New York Times heat map of COVID cases. He pointed out the dramatic difference in the spread of the Delta variant in just two weeks. He says the low rate of vaccination, plus the lack of masking and social distancing “have brought so much of this country to its knees.” He describes the current surge as two different pandemics. Those who are vaccinated have one set of risks while those who are unvaccinated and most vulnerable have a different set of risks. He thinks we’ll know in two to four weeks the impact schools opening will have on the pandemic. He reminds us that will be just the beginning of the impact not the end because it can take a while for the virus to ripple through the school system, especially among unvaccinated kids. He says relatives and friends have noticed his increasingly darker tone on the program and he says it’s frustrating because “We’re all tired of COVID. But you’ve got to look in our nursing staff’s eyes, especially on the COVID units, and you’re going to see much more than you’re tired of COVID. You’re going to see a little bit of anger, a little bit of despair, and just a whole lot of, ‘Oh my God, what’s happening now?’ And that’s because, as a nation, we have failed to address this crisis in the way we should, and it is costing people their lives.” He said the front lines in the Emergency Department are “getting pummeled and stretched pretty thin.”
Casey Pickering says when the ED backs up, it affects the whole hospital, and often the ICU staff must go down there to treat patients on gurneys in the hallways because there are no beds available. Once they get to the ICU, most COVID patients are there for weeks, rather than days. Many can’t talk but their families, for the most part, say they wish they and they and their loved one had taken COVID more seriously. Sadly, some, even when seeing extremely sick and dying relatives, blame it on something other than COVID, and refuse to accept the truth, making decisions on misguided information. Casey says, “I think it’s morally distressing, frustrating and sad.” Casey adds the impact on the ICU staff is huge, with people burning out at different rates. “People thought there was a glimmer of hope with the vaccine, a light at the end of the tunnel. Turns out that light was a train.” Casey noted they’re just being pushed to the point where they thought the end was in sight and now it is not in sight, and for many it’s too much and they can’t do it anymore. The ICU work family is getting smaller because of those leaving. In Casey’s words, “Part of our hope for the vaccine was also our hope in humanity. We thought the world was behind all of us like they were at the beginning and everybody’s going to do this and we’re going to get through it. Now it feels like so many people are almost against us, that it’s hard to continue to bring your heart to this work every day. When it feels like the odds are just stacked against us and it doesn’t feel like there’s an end in sight, it’s hard. We’re struggling with the moral injury that feels like so many in the general public are not willing to do their part to help us all survive, literally and figuratively, at all costs.”
Dr. Brown agrees everyone is stressed by the surge. He notes the biggest difference from the last surge is the younger unvaccinated patients. He says, “There’s a lot of misinformation that is guiding, I think, some good people.” He finds himself having to keep his own personal feelings out of conversations with those who don’t believe in masks and vaccinations and stick to the science. He says the Delta variant is much more transmissible in a shorter period of time and it’s frustrating because masks and vaccinations make ICU stays completely avoidable. He says one thing we’ve learned in the last 18 months is that COVID loves dissention and divisiveness. He says people have to realize if a patient decides they have the freedom to skip their medications, it has consequences, but just for that patient. Those who think they have the freedom to skip masking and vaccinations must realize that also has consequences but for all of society. He calls that thinking “selfish.” Like others in the profession, he needs time to decompress from what he sees every day.
Dana Hawkinson, MD, medical director of Infection Prevention and Control, commented on the Spring Hill School District voting to allow parents to sign a medical exemption form allowing their kids to not wear a mask at school. He agreed with Dr. Stites that is not a medical exemption but a parental exemption, and there are very few medical reasons for a child not to wear a mask in class. He says it’s a shame that, “A lot of parents can barely help their children with fifth grade math but yet all of them are now infectious disease experts.” He argues that having schools close from COVID and isolating kids at home is the worst possible outcome and can lead to mental health problems. He also says double masking for kids is not necessary and says indoor air purifiers don’t replace masks.
Thursday, August 19 at 8:00 a.m. is the next Morning Medical Update with guest Mario Castro, MD, from the KU School of Medicine. He’ll bring us the latest on COVID research and treatments.
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