More than 18 months into pandemic, physicians urge COVID-19 vaccinations, face masks
A dozen COVID-19 patients were hospitalized in Rice Hospital this week, part of a steady flow of patients since spring 2020. Two Rice physicians have recommended that people continue to wear masks while a substantial portion of the community remains unvaccinated.
WILLMAR, Minn. — During the last week of October, Carris Health-Rice Memorial Hospital in Willmar had 12 COVID-19 patients, who filled half the available staffed beds in the hospital.
“If it weren’t for that dozen patients with COVID that were hospitalized, we would have a dozen more beds for people with hip fractures or strokes, or things we normally admit and do a very good job for,” said Dr. Kenneth Flowe, physician director of acute care at Carris Health and a physician in the emergency department.
That this level of illness continues with effective vaccines available is frustrating and disheartening for health care workers, and it could get worse as winter approaches.
Dr. Lucio Minces, the infectious disease specialist at Rice, said the hospital has had a steady stream of COVID-19 patients in the past year and a half, and things are not getting better.
"I’d say this is one of the top five worst moments we’ve had, especially in the severity of disease,” Minces said. “We’ve seen a lot of unvaccinated people with pretty nasty infections — long durations of stay, people requiring high amounts of oxygen or being intubated.”
The delta variant of COVID-19 is much stronger as far as the damage it does to the body, Flowe said.
With so many unvaccinated people in the community and masking and social distancing rules being relaxed, Flowe said he expects to see influenza, respiratory syncytial virus (RSV) and other respiratory illnesses make a strong comeback in the coming months.
Minces agreed that it’s likely to be worse than a year ago, when there really wasn’t a flu season with strong social distancing and masking efforts in place.
This year, such precautions are much less common, leaving room for respiratory viruses like flu and RSV to circulate more freely.
Both physicians recommended that people continue to wear masks, as they do, when they are indoors away from their immediate household.
“I don’t think I’ll ever see patients in the Emergency Department again without wearing a mask,” Flowe said. “I might never go into a grocery store or a theater again without a mask.”
The coming winter could be made more difficult by people potentially confusing symptoms of one respiratory illness for another, he said. Many symptoms can seem similar in the beginning, and people who think they have colds could be spreading the coronavirus.
Minces said he commonly hears that someone gets COVID-19 when a younger family member who is unvaccinated brings the disease home.
“How many times can I say this — if you care about other people, you should be vaccinated so you don’t pass it on,” he said. Early on, vaccine supplies were limited, but they are readily available now, he added.
The continued circulation of the virus in society has contributed to the need for vaccine boosters, too, he said.
Immunity to respiratory viruses doesn’t last a long time, he said, and as long as it keeps circulating, people will need boosters.
“If we don’t get a lot of people vaccinated, or everybody, we’ll need a lot of boosters,” Minces said.
People who have had COVID-19 retain their natural immunity for only nine to 12 months, he said.
Minces said the science of the vaccines is clear, and having a full hospital would be avoidable. “The solution is right there, and people choose not to believe us on this.”
But people believe other things doctors say, including when it comes to treating COVID-19. Unfortunately, there is little effective treatment for it, he said.
Flowe agreed. “Many are perfectly happy to get monoclonal antibodies, which work sort of in the same way as a vaccine,” he said.
Plenty of beds, not enough staff
Flowe said he hears comments in the community about people being in the hospital and seeing “plenty of beds.”
Rice has 40 beds on its second floor — 32 adult health and eight ICU. However, in recent years, more and more patients have been treated as outpatients.
The hospital has hired staff for about 20 adult health beds and four ICU. During the pandemic, hospital staff members have missed work because of COVID-19 infections or exposures, too.
“It’s not about having enough physical beds,” he said. “It’s about having enough humans to take care of the people in the beds.”
Not having enough staff is an issue statewide, and staffed beds are in short supply everywhere.
Patients sometimes wait hours in emergency rooms while staff members search for a hospital with an open bed. Earlier this week, he was told that only one staffed ICU bed and five staffed adult health beds were available across the state.
After dealing with the novel coronavirus for more than a year and a half, many medical professionals are tired.
“COVID has consumed our lives,” Flowe said.
Flowe said he no longer approaches a new shift with the same excitement he did before the pandemic. People are worried they may not be able to do things for patients that they would normally do, because they need a higher level of care than is available at Rice.
Working in an ER has always been a high-stress job, he said.
Before the pandemic, he said, the estimate was that 40% of health care staff had some traits of being burned out. Now, that estimate is closer to 70%.
“That doesn’t mean they’re not functional or compassionate,” he said. “It means they aren’t dealing with the stress in a consistently productive way.”
Minces said he wasn’t sure burnout was the right term, but health care workers are definitely tired.
“Caring for patients who are very ill and starving for air with a preventable disease, you feel useless,” he said.