By Katie Kerwin McCrimmon and Erin Emery
COVID-19 hospitalizations at UCHealth facilities have spiked to levels as high as the first peak of the pandemic in the spring of 2020 when the coronavirus first rampaged around the U.S. and the world.
While 75% of Coloradans are vaccinated against COVID-19, nearly 9 in 10 patients who are sick enough now to need hospital care are unvaccinated, according to new data from UCHealth. The metrics show that health care workers are caring for a tsunami of unvaccinated people who are severely ill from COVID-19.
The spike is hitting as health care workers are exhausted.
“Everybody who’s on the front lines of COVID right now feels like they have been redeployed to a never-ending war and they just want it go away,” said Dr. Richard Zane, executive director of emergency services and chief innovation officer for UCHealth
“This is a pandemic of the unvaccinated and it’s a spike caused by the unvaccinated,” said Zane, who is also a professor and chair of the Department of Emergency Medicine at University of Colorado School of Medicine on the Anschutz Medical Campus.
Delta variant attacking people who are refusing vaccines, increasing COVID-19 hospitalizations
During the first wave of COVID-19 cases, when vaccines were unavailable and social distancing, mask-wearing and handwashing were the only defense against the new, deadly virus, the number of COVID-19 patients in UCHealth’s 12 Colorado hospitals peaked at 263 on April 1, 2020.
The number of COVID-19 patients in UCHealth hospitals recently surged to that same number on Sept. 1. And, COVID-19 hospitalizations could climb even higher in the months ahead since the delta variant is extremely contagious and can cause breakthrough cases among vaccinated people as well, Zane said.
Across Colorado, more than 75% of adults are now vaccinated against COVID-19. Inside UCHealth’s 12 hospitals, the 25% of Coloradans who are unvaccinated are making up the vast majority of patients hospitalized with COVID-19.
The Colorado Department of Public Health and Environment recently released data showing those most at risk for breakthrough cases are those who are 80 or older or between 20 and 49. Elderly people may be more at risk for COVID-19 because their immune systems are weaker.
COVID-19 hospitalizations hit an all-time high at UCHealth facilities on Dec. 1, 2020, when 469 COVID-19 patients needed to be hospitalized. The recent spike in numbers comes at a time when the mu variant – a new strain of the coronavirus – has been found in states across the country, but not in Colorado, where the number of deaths due to the delta variant has been steadily rising.
Younger and younger patients in hospital Intensive Care Units
With no end of the pandemic in sight, health care workers are weary and frustrated.
Erin Bennett, a charge nurse in the intensive care unit at UCHealth Memorial Hospital Central, has been an ICU nurse for 13 years.
“Traditionally, when patients came to the ICU, we were able to use machines and medications to improve and treat their illness and they were able to transfer out of the ICU . The majority of patients left the ICU, and now it doesn’t seem that way,” Bennett said.
Taking care of COVID-19 patients, she said, is labor-intensive and emotionally taxing.
“We are getting patients who are younger and younger, they’re in their 20s,30s and 40s. The youngest patient I’ve had is 18. Some have co-morbidities and some don’t. Early on, the media portrayed COVID as a disease that only affects older people, but we have young people who require a ventilator in the ICU because they are so sick,’’ Bennett said.
Medical workers mourn people who are suffering unnecessarily
COVID-19 patients are placed on a specialty mattress that helps protect their skin against breakdown. Those who need a ventilator often receive paralytic and sedation medications.
“We are trying to ventilate them and sometimes, their lungs are so sick and inflamed and damaged that we have to paralyze them to get them to be compliant with the ventilator so we can deliver the volumes of oxygen to their lungs,’’ Bennett said.
Medications have to be closely monitored as does blood pressure and heart rate. Nurses frequently take a patient’s pulse to check for blood flow since blood clots form in the lungs of COVID patients. Patients receive nutrition – and their normal regimen of medication – through tube feedings.
Bennett said that as tough as it is, she loves her job and cannot imagine doing anything else.
“I love what I do, even though it is hard. It’s hard to see people suffering every day but we do have those incidences where we have people we are able to help,’’ she said. “We have patients who we were able to see leave the ICU. We know that there’s still a long road ahead for them, but we have moments when we see that we have helped someone get out of the ICU.
Bennett said that even when a patient doesn’t survive, “they have family members and we can be as supportive for their family as we can be and hopefully make a difference in their lives.’’
Life-saving vaccines can halt new variants
Zane, who has been treating severely ill COVID-19 hospitalized patients since March 2020, says more people need to get vaccinated.
“What people who refuse COVID-19 vaccines don’t understand is the gravity of their decisions and the consequences beyond their individual health,” Zane said. “Viruses mutate. That’s what they do. They mutate in unvaccinated hosts. And they can get more lethal. Delta is more lethal.”
Other variants – including the new “mu” variant – are now on the horizon and they are destined to be dangerous. Otherwise known as B.1.621, the mu variant was first sequenced in Columbia in January 2021 and has since been found in 45 countries. All but five of them have reported fewer than 100 cases, and 24 of them have reported fewer than 10 cases. The United States has reported 2,300 mu cases, by far the most globally. But mu accounted for just 0.2% of those U.S. cases over the past four weeks, during which several million COVID-10 cases were diagnosed, the vast majority of them the delta variant. Colombia, where mu was discovered, reported zero mu cases in that span.
The World Health Organization designated mu as “variant of interest” on Aug. 30. Variants of interest have genetic changes that are predicted to or are known to affect disease transmission, severity, and treatability and have spread in clusters in multiple countries. Mu joins four other variants on the WHO’s “variants of interest” list. The “variants of concern,” in contrast, include alpha, beta, gamma, and delta, all of which clearly demonstrated some combination of the above and spread widely.
At a news briefing on Thursday, Sept. 2, Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, said mu is not yet considered a threat.
“It is being seen here but it is not even close to being dominant,” Fauci said, adding that the delta variant comprises more than 99% of U.S. cases. He added that mu “has certain mutations that suggest that it would evade certain antibodies, not only monoclonal antibodies but vaccine and convalescent serum-induced antibodies, but there isn’t a lot of clinical data to suggest that – it is mostly laboratory and in-vitro data.”
Fauci said U.S. health officials are taking the variant seriously, but that vaccines have proven effective even against mutations of the sort mu seems to have, and that “we don’t consider it an immediate threat right now.”
Zane and his colleagues are bracing for new variants.
“It is inevitable that we will have a variant that is more or even completely resistant to current vaccines,” Zane said.
More children and other vulnerable people are at risk now
There will be other consequences, Zane said.
“Our tests may not work. Therapies like monoclonal antibodies may not work. These are the implications of people deciding not to get vaccinated,” he said.
Zane wants people to understand that vaccine refusal is not a personal decision. Rather, it harms communities.
“Getting vaccinated is not just a personal decision. It’s a societal responsibility. We all have a responsibility to put a wall between this pandemic and the vulnerable, like sick people and our children. Children and those with chronic illness. What more motivation to participate in society could one need than to protect the young and the weak?”
While the number of COVID-19 hospitalizations is soaring, it doesn’t include hundreds of patients who are seeking care online, at their doctors’ offices, or in urgent care centers and ERs.
Zane recently cared for a vaccinated dad whose two children could not get vaccines and got COVID-19 at their daycare center.
“They brought it home and he got COVID-19. Even those who are fully vaccinated are vulnerable now. He felt lousy, but luckily, because he is vaccinated, he’s going to be OK,” Zane said. “That was preventable. None of them should have gotten this illness.”
Zane said: “Operation Warp Speed (the effort that brought us COVID-19 vaccines) is one of the most impressive things that government has ever done. It’s like D-Day or the Manhattan Project.
“The same level of science and thinking that went into the vaccines has gone into monoclonal antibodies and now, people who are refusing vaccines are coming in and are begging for monoclonal antibodies.”
As the number of COVID-19 hospitalizations steadily rises, ICU nurses come to work to help patients in any way they can. The best way to help slow the pandemic, Bennett said, is for people to get vaccinated.
In the ICU, visitors are asked to watch a video that instructs them on how to don PPE, before visiting a loved one who has COVID-19.
“I do feel that when they get to the hospital and they are able to get in there, and they see all the machines and the beeping and everything … they see that this is real, that we are doing everything we possibly can for them.’’