For Dr Rina D’Abramo of the MetroHealth System in Cleveland, it’s difficult when patients in the emergency room tell her they have not been vaccinated.
“You can hear it in their voice when you say, ‘Are you vaccinated?’” said D’Abramo, who works at a hospital in the Brecksville suburb. “They shrink down and are like, ‘No. Now I know why I need to be vaccinated.’ ”
Unfortunately, there are plenty of people in Ohio and the rest of the US too who have not yet learned that lesson, even as infection rates nationally start to surge again amid fears of the possibly highly contagious new Omicron variant.
Ohio is one of the states that has seen the largest recent increases in hospitalizations due to Covid as the number of cases climbs across the country. There has been 19% increase in hospitalizations over the past two weeks in the United States, according to a New York Times analysis of data.
Ohio has a daily average of more than 4,400 people hospitalized due to Covid, which ranks fourth among states and represents a 29% increase over the past two weeks.
While the increased number of people vaccinated against Covid had inspired hopes that Americans would be able to experience a relatively normal winter, the rise in Covid cases; holiday gatherings; and unanswered questions about the Omicron variant have sparked fresh concerns and warnings from doctors and public health officials in the US.
“The yellow caution light has gone on because I think our progress in vaccination has slowed,” said William Schaffner, an infectious diseases expert at Vanderbilt University School of Medicine.
Forty percent of the US population has not been fully vaccinated, and the number of doses administered each day has decreased from about 3.3m in April to about 1.7m today, according to the Times.
Ohio is surrounded by states that have also seen a recent surge in Covid cases and hospitalizations. Pennsylvania and Michigan each have a daily average of more than 4,500 patients hospitalized, representing a more than 20% increase over the past two weeks. Illinois and Indiana have seen a 49% increase in hospitalizations.
D’Abramo diagnoses about 10 patients daily with Covid, and about 98% of them are unvaccinated, she said.
That trend has strained the capacity of hospitals in the Cleveland area. MetroHealth, Cleveland Clinic and University Hospitals announced last week that the surge has forced them to postpone some non-urgent surgeries.
“This action frees resources for patients with immediate and life-threatening needs and manages the demands on frontline caregivers, who have served with distinction throughout the pandemic,” reads a joint announcement.
At Beaumont Health, the largest healthcare system in Michigan, the emergency room and other parts of the hospital are full, primarily with patients who are not vaccinated, said Dr Matthew Sims, a Beaumont physician and director of infectious disease research.
“With Covid patients, they have to be in rooms. You can’t go into overload conditions where you turn conferences rooms into emergency rooms or hallways into wards. You can’t do that sort of thing when it’s a contagious disease,” said Sims.
Beaumont, like other hospitals in Michigan and across the country, has also had to contend with a staffing shortage. The federal government recently agreed to send 22 healthcare providers to a Beaumont facility in Dearborn and 22 providers to Spectrum Health in Grand Rapids, the Detroit News reported.
In addition to the shortage, “everyone who works in healthcare is getting very tired. We have been dealing with this for two years straight, and it wears on us,” said Sims.
Doctors continue to not only urge people to get vaccinated against Covid – and for those who are eligible to get a booster shot – but also to encourage people to wear N95 or KN95 masks during indoor gatherings and if possible, to gather outdoors or open doors and windows to improve filtration, said Dr Celine Gounder, an infectious disease specialist and epidemiologist at New York University.
Gounder also suggested that people take rapid Covid tests before holiday gatherings.
“I think we have chosen one of the most painful paths through the pandemic in this country” because of people’s refusal to get vaccinated, Gounder said. “I think we have prolonged our pain unnecessarily.”
Gounder and others now wait for more data on the Omicron variant, which has been detected in 19 states and 50 countries, National Public Radio reported Tuesday.
Researchers in South Africa have reported that Omicron may be more infectious but less severe than other forms of the virus.
While Schaffner emphasized that we are still awaiting more information, if the variant proves more infectious and much less likely to produce hospitalization, “then Omicron might actually be a bonus because we would be vaccinating, but Omicron would also be spreading among the unvaccinated, making them mildly ill and offering them some protection.”
That “would get us closer, faster, to so-called herd immunity, which would lead us to a more endemic circumstance,” rather than a pandemic, Schaffner said.
In the meantime, D’Abramo, the Ohio emergency physician, continues to grapple with the pandemic inside and outside her hospital. Two unvaccinated friends with a 10-year-old child recently became very sick with Covid, she said.
The wife remains on an ECMO life support machine; the husband was hospitalized for two weeks and is now home.
“To me, that’s a tragedy. There is no way to say she wouldn’t have gotten sick if she was vaccinated, but most likely, she wouldn’t have,” D’Abramo said.
At the hospital, she routinely has Covid patients waiting for beds in the intensive care unit. D’Abramo must decide whether to intubate them and connect them to a ventilator.
“I don’t ever come home from a shift and be like, ‘That was a nice, normal shift.’” D’Abramo said. “It’s nonstop and it does kind of feel like you get beat down because you are getting beat down by something that I thought would maybe be over this winter.”