For the first time since the COVID-19 pandemic struck in March 2020, the men and women who run Birmingham’s hospitals and the head of the Jefferson County Department of Health appeared jointly before the news media to discuss the latest surge in cases.
But all were unified in one message that’s been repeated many times in the past few months: If you haven’t been vaccinated for the virus, it’s time to get the shot — and quickly.
In the online press conference, the heads of Ascension St. Vincent’s, Brookwood Baptist, Children’s of Alabama, Grandview, Hill Crest Behavioral Health, Medical West and UAB hospitals answered questions about the latest surge in the COVID virus. New cases have skyrocketed to more than 3,000 per day for the past few days, and hospitalizations have jumped from less than 200 statewide to more than 1,700 in less than a month.
There was plenty of agreement among the group that the latest surge was ramping up much more rapidly than the original outbreak and more rapidly than the peak last winter. But there are several characteristics that are different this time, and there’s a way to bring the new Delta variant of the virus down to manageable levels — if the public will cooperate.
“Our hospitalizations are doubling every seven to 10 days and our overall volume has increased over 500% in the past month,” said Dr. Jeremy Rogers, the director of clinical services at Grandview Medical Center, where he is also an emergency room physician. Rogers added that the victims in the first two waves of the pandemic were mostly age 60 or older, “but now the majority of patients are younger than 60. It’s absolutely heartbreaking — and largely preventable. (At Grandview) 92% of our patients are currently unvaccinated.”
“We’re feeling the surge, and it’s real,” said Dr. Timothy Bode, the chief medical officer for Ascension St. Vincent’s Medical System. “Our census is continuing to go up, and we have a looming sense of what occurred back in January. We’re approaching 100 COVID patients in all of our hospitals, and 88% of those patients are unvaccinated. On ventilators and in critical care, it’s 93%. We’ve seen in our hospitals a 700% increase in COVID cases in just the last three weeks. … It is having a significant impact on us and on our community.”
The influx of unvaccinated COVID patients also is having an effect on hospital staffs, most of which were already stretched thin because of heavy patient loads in all categories and the general shortage of workers in many industries. Some, like Children’s of Alabama, are seeing increases in infections among their staffs.
“We’ve seen an uptick lately in our staff testing positive, as many in the last week as we had in the months of May and June combined — 25 employees testing positive. So that’s also frightening,” said Tom Shufflebarger, Children’s CEO.
The increase in COVID hospitalizations is beginning to concern officials about available space in intensive care units, though several hospitals experienced far greater ICU patient loads during the winter surge.
UAB Hospital CEO Anthony Patterson said his facility has multiple ICUs with 219 beds for different purposes. Forty-two are now dedicated to COVID-infected patients. “You simply have to keep going to the next ICU or equivalent space” if demand grows, Patterson said. “All of us have surge strategies, where we have marked out how we’re going to consume hospital space for COVID care.”
Rogers added that increasing numbers of COVID patients cause capacity problems for other units at Grandview. “It’s almost like a vise grip on the hospital, and it really hinders your capacity to take care of every other patient that comes in. … It puts a lot of strain and stress on an already stressed and strained system.”
So far, resources at most local hospitals have not been strained enough to force limits on other elective or non-emergency procedures — but everyone is keeping a wary eye on the possibility that such restrictions may be needed, given how quickly the current surge has ramped up.
“We’re hoping we don’t get there,” Ascension’s Bode said. “When you’re in the middle of a pandemic, you have to realize that everything is on the table … . We’re not there now, but I’m worried that with the rapid increase we’re seeing, we might be at some point in the near future.”
The Delta variant is affecting many people differently than the original COVID virus, partly because younger people are being infected. Dr. Elizabeth Ennis, chief medical officer at Brookwood Baptist Health, said that COVID-related pneumonia is appearing in many of those younger people.
“We are seeing COVID pneumonia that requires very aggressive, intensive therapy in people that are young that we didn’t see before — 20-year-olds, 29-year-olds in ICUs on ventilators with … ECMO, where machines oxygenate the blood so that their lungs can rest,” Ennis said.
Jefferson County Health Officer Dr. Mark Wilson said he has no plans to reissue an order for face masks, but he does strongly recommend that everyone wear masks when they are indoors with other people, no matter whether they are vaccinated.
“We are talking with elected officials about encouraging everyone to get on board and do the right thing and encouraging businesses to put the signs back on their doors to ask people to wear masks,” Wilson said.
COVID testing is still available at many pharmacies, and JCDH is looking at increasing testing capacity again in other ways. Over-the-counter tests are also available for purchase, but Wilson said that those who get a positive result from such tests should let his department or their health care provider know “so that it can be reported, because contact tracing is very important.”
Anyone who tests positive by any means still needs to isolate themselves for 10 days, Wilson added, and those who come in contact with someone who’s COVID-positive should also quarantine to prevent further spread.
There are still no vaccines available for children 12 and under, but Children’s is not yet experiencing a large number of children infected with COVID, according to Shufflebarger. Only two current patients went in specifically with COVID, while several others tested positive when they came in with other medical issues. Instead, Children’s is seeing an outbreak of respiratory syncytial virus, or RSV, which is a common virus that affects children during winter. Right now, RSV is more of a strain on Children’s than COVID.
The best-case scenario for the pandemic in the next few weeks, in the opinion of most of the panel, was that vaccinations would increase and hold the current surge at bay. The worst-case scenario, though, could be a mutation of the virus made possible by the rapid spread of the Delta variant, one which would be more difficult to stop with stronger vaccines.
“That would be potentially devastating to the public and to hospital facilities,” Ennis said. “That’s one of the things we’re trying to mitigate by having people get vaccinated — to tamp down the pandemic before a variant that we can’t control, and that is not protected by the current vaccines, becomes a reality.”