‘This surge is seemingly unending’: Hospitals are at breaking point with unvaccinated patients

Nov 22, 2021 at 9:55 am
click to enlarge A hospital patient. - Shutterstock.com
A hospital patient.

Dr. Rob Davidson had just finished his shift as an emergency room physician in West Michigan on Wednesday when he sank into the front seat of his car and hit record on his phone.

“The COVID numbers are putting us over the top, beyond capacity, everywhere,” Davidson, who also serves as the executive director of the Committee to Protect Health Care, said in a video he posted on Twitter. “Our [intensive care unit (ICU)] capacity I believe is 130% because we’re just making up beds in places where normally we don’t have ICU patients.”

“And as far as my patients today, they’re all unvaccinated,” Davidson continued. “Every single one of the people I saw who had COVID and was admitted are unvaccinated.”

This story — one of hospitals overflowing with unvaccinated patients being cared for by staff battered by a never-ending pandemic (and who have actually been physically assaulted) — is being told in record numbers by health care workers across the state. 

While COVID-19 cases have been steadily climbing in Michigan since July, those numbers have skyrocketed over the past two weeks in the fourth surge of the virus. Once again, Michigan is battling the highest COVID case numbers in the country, the Michigan Department of Health and Human Services reported earlier this week.

‘Significantly sicker than we’ve seen before’

Despite about 5.4 million Michiganders being fully vaccinated, Dr. Natasha Bagdasarian, the state’s chief medical executive, said at a Friday press conference that Michigan’s “case rates are virtually at the same point as last year.”

With Thanksgiving and the winter holidays “around the corner, this is especially concerning,” Bagdasarian continued, referring to the likelihood that people will attend large indoor gatherings.

“Our COVID-19 metrics are looking quite troubling,” Bagdasarian told reporters. “We reported over 10,700 cases in a single day yesterday. This number continues to trend upwards. … Fifteen percent of hospital beds are being used to care for COVID patients.”

Like cases, COVID hospitalization rates, including among children, are also soaring, with the overwhelming percentage of those patients being unvaccinated individuals. Bagdasarian said “pediatric hospitalizations are almost at [Michigan’s] highest level to date.” And Spectrum Health West Michigan President Dr. Darryl Elmouchi said Friday that “the pediatric cases we’re seeing on the west side of the state have been significantly higher and significantly sicker than we’ve seen before.”

Statewide, the percent of inpatient beds occupied by COVID patients increased for the 17th week in a row this week and was up 11.6% over last week, DHHS reported. 

This surge has spread to all corners of the state, state and local health officials said.

The medical director of a health care coalition representing 13 West Michigan counties, Dr. Jerry Evans, said in an interview with the Advance that the health care systems in Clare, Ionia, Isabella, Kent, Lake, Mason, Mecosta, Montcalm, Muskegon, Newaygo, Oceana, Osceola, and Ottawa counties are “at a tipping point” because they’re so overwhelmed with COVID patients, the majority of whom are unvaccinated. 

Officials from the Grand Rapids-based Spectrum Health System said during a press conference on Tuesday that it has more COVID patients now than at any other point in the pandemic — they, too, are almost entirely unvaccinated. In Detroit, the Henry Ford Health System reported Tuesday that it has seen a 60% jump in the number of COVID patients — again, largely unvaccinated individuals — being admitted to its hospitals this week compared to a couple weeks ago.

“Our [COVID hospitalization] numbers literally shot up in the past week and a half,” Dr. Matthew Sims, the director of infectious disease research at Beaumont Hospital, Royal Oak, said in an interview with the Michigan Advance. “We were on a slight uptick from the beginning of September through a week ago. Then it shot up almost double in the last week.”

‘What we’re experiencing today is unprecedented’

This dramatic jump in COVID patients combined with an increase in overall hospital admissions — which health experts said are often people who delayed care during the pandemic — and the potential for a wave of flu patients after influenza went largely dormant last year is further fracturing an already deeply beleaguered medical field, health care workers across Michigan said this week.

“We’ve all been at this for 20 months, and the word ‘unprecedented’ has come up so many times,” Elmouchi said Tuesday. “What we’re experiencing today is unprecedented.”

“We have not experienced anything like this throughout the entire pandemic — the combination of non-COVID acuity and volumes coupled with dramatically increasing COVID care,” Elmouchi continued.

That sentiment was expressed by everyone the Advance interviewed for this story. This fourth surge of patients are stressing the state’s health care system to the point of it breaking, doctors said.

This surge is seemingly unending, and we’re told it might not peak until Christmas. If people are waiting for the system to break, I’d argue we’re probably there. We’re caring for so many people in the ER that people are leaving the waiting room before they get seen. People are going to three different hospitals to be seen.

– Dr. Rob Davidson, West Michigan emergency physician and the executive director of the Committee to Protect Health Care

“We are at 85% capacity with non-COVID care,” Elmouchi said. “Hospitals are made to be at 80, 85%. The challenge is COVID is what throws our hospitals out of what’s manageable.”

Eighty-six percent of the 359 COVID patients across Spectrum’s 14 hospitals on the west side of the state are unvaccinated, as are 90% of the 81 COVID patients in the health system’s intensive care units, Elmouchi said.

Now, with just a little over half of Michigan’s population fully vaccinated, the onset of winter and more people gathering indoors, the winter holidays, and school districts dropping mask mandates — if they were ever implemented — because vaccines are available to younger children, health experts don’t expect those numbers to go down any time soon. And, those interviewed by the Advance this week, those numbers are likely poised to worsen, worrying health care workers who are bracing for the likelihood of flu and COVID cases surging simultaneously.

“This surge is seemingly unending, and we’re told it might not peak until Christmas,” Davidson said. “If people are waiting for the system to break, I’d argue we’re probably there. We’re caring for so many people in the ER that people are leaving the waiting room before they get seen. People are going to three different hospitals to be seen.”

Why is this surge happening — and how do we stop it?

Put simply, all of the health experts interviewed by the Advance for this article, agreed: This is a surge rooted in people not getting vaccinated.

Lynn Sutfin, a spokesperson for the DHHS, said Thursday that “those who are not immunized contribute disproportionately to hospitalizations and deaths due to COVID-19 in Michigan.”

Currently, just under 90% of Michigan’s COVID cases, hospitalizations and deaths are unvaccinated individuals, according to data from the DHHS. From January through this October, unvaccinated Michiganders accounted for 93.1% of COVID cases, 90.7% of hospitalizations, and 90.5% of deaths, according to state officials.

That there are millions — about 4.8 million — of Michiganders who are either entirely unvaccinated or not fully vaccinated — meaning they haven’t gotten both doses of the Pfizer or Moderna vaccine — combined with the overwhelming dominance of the fast-spreading Delta variant, which now makes up nearly 100% of COVID cases in Michigan; the loosening of mask requirements in the state; the need for people to get booster shoots in the wake of waning vaccine immunity due to the Delta variant; some schools resuming in-person classes without mask mandates; and more people gathering indoors because of colder weather have culminated in Michigan’s current surge, Sims said. 

“The fact of the matter is we’re not doing enough to protect ourselves as a population,” Sims said. “When the [Centers for Disease Control and Prevention] made the announcement that people who were vaccinated didn’t have to wear masks anymore, it made sense because we were dealing with [the Alpha variant] at the time. The vaccine works incredibly well against Alpha.

“The second Delta hit, they should’ve said everybody needs to wear masks again,” Sims continued. “I’d love to see more requirements of wearing masks, especially indoors. We need multiple layers of protection; no one layer is going to do it by itself until we get this under control. We need vaccination rates in the 90%. Seventy percent is not going to cut it.”

The second Delta hit, they should’ve said everybody needs to wear masks again. I’d love to see more requirements of wearing masks, especially indoors.

– Dr. Matthew Sims, director of infectious disease research at Beaumont Hospital, Royal Oak

Josh Petrie, a research assistant professor in the Department of Epidemiology at the University of Michigan School of Public Health, also emphasized the fact that the Delta variant is far more transmissible than previous COVID strains — leaving those who are unvaccinated particularly vulnerable to contracting the disease that has killed a 23,104 Michiganders as of Thursday, Nov. 18, and 767,000 people in the United States.

“And only 54% of the population is vaccinated, so we have a lot of susceptible people,” Petrie said.

About 5.2 million Michiganders are fully vaccinated, and federal health officials earlier this month said children ages 5 to 11 could get the vaccine — paving the way for that number to grow by as much as 825,000. And while that is a lot of people, it still translates to about 54.7% of the state’s population that is five years and older being largely protected against COVID. Approximately 70% of state residents ages 16 and up have received at least one shot of the vaccine, state officials announced this week.

This means about 4.8 million Michigan residents are either not vaccinated at all or have had just one shot of the Pfizer or Moderna vaccine, which significantly decreases its ability to keep someone from becoming seriously ill with COVID.

Some workplaces in the state have mandated that employees get vaccinated — such as the University of Michigan and Michigan State University — and the Biden administration has been pushing for a vaccine mandate for larger companies by early January, which Michigan Senate Majority Leader Mike Shirkey (R-Clarklake) called “the death knell of the American dream” and is currently being held up in federal court. But vaccine mandates need to become far more ubiquitous if we are not only going to end this surge but prevent future surges, Davidson said. 

“We’re tired of asking nicely,” Davidson said. “The vaccines are safe; they’re effective; they’re not going to cause mass harm. We need to stop asking people and say, ‘If you want to hang out with the rest of us in a restaurant or in an airplane, you have to be vaccinated to go into those places.’”

What about mask mandates?

The health experts interviewed by the Advance this week all agreed that, while not as effective as the vaccine in battling the pandemic, mask mandates are a crucial tool to curb the spread of COVID.

With schools holding in-person classes, the emergence of the flu — the state’s first large outbreak this year just happened at University of Michigan — and more people gathering indoors because of the colder weather, it’s even more crucial to have mask requirements now, Sims said.

“Until we can prevent the spread [of COVID] with the vaccine, we need other methods to prevent spreading — social distancing, masking,” Sims said. “I don’t want to lock down the world again; we need the economy to move forward; we need restaurants to be functional; we don’t want runs on toilet paper again. But we need to be cautious and implement methods that will prevent the spread while we have an essentially normal life.”

The pandemic regulations that Sims cited, however, are far less strict than they were last year, when Gov. Gretchen Whitmer had implemented a statewide mask mandate — including for schools. COVID mandates like social distancing requirements and masking were fought tooth-and-nail by the GOP-led state Legislature, and Republicans continue to battle COVID policies like vaccines and face coverings, including a failed attempt to pull funding from local health departments that instituted mask policies. In July, Republican lawmakers rescinded Whitmer’s emergency pandemic powers. Those powers had allowed the governor to institute statewide mask mandates.

DHHS remains able to implement COVID restrictions like statewide mask requirements but has not done so. On Friday, the department announced it was issuing a mask “advisory” that encourages all Michiganders over the age of two to wear face coverings at indoor gatherings, regardless of vaccination status. An advisory is not the same thing as mandates, which Whitmer and DHHS issued during the pandemic last year; it has no teeth and exists as a plea for residents rather than a directive.

When asked why the DHHS would issue an advisory and not a mandate, Hertel issued the message the health department and Whitmer administration have repeatedly said in recent months: Michiganders can fight the pandemic by getting the vaccine. 

“At this point, we feel it’s most prudent to make sure people are aware of how serious this COVID surge is right now and give them the information to protect themselves and others through a public health advisory,” Hertel said.

When asked if the state would consider issuing a state mask mandate in light of the recent surge, Whitmer spokesperson Bobby Leddy echoed Hertel’s statement that Michiganders should get vaccinated.

“We continue to encourage Michiganders to get vaccinated as this is the best way to keep people safe and ensure that businesses and schools can safely operate,” Leddy wrote in an email. “The vast majority of Michiganders have done the right thing to protect themselves and their families by getting vaccinated, wearing a mask in indoor gatherings, getting tested and quarantining after exposure, or staying home if feeling unwell.

Our health care workers are tired — really, really tired. They are tired of being called names. There’s a tremendous amount of anger. Social media is full of people calling health care workers liars. I can tell you that health care workers are on the frontlines working their tails off. They’re tired, and they’re working hard.

– Dr. Jerry Evans, the medical director for the Region 6 Healthcare Coalition

“For those who aren’t vaccinated, it’s even more important to take these scientifically proven precautions to reduce the risk of catching the virus and minimize possible symptoms in the event of exposure,” he continued. “We all have the tools at our disposal to slow the spread and keep ourselves safe.”

Whitmer and state health officials also have said they are focusing on local health departments and school districts implementing mask policies because they believe residents will be more likely to follow those requirements than if they came from the state.

Davidson said while he wants to see “more people wearing masks,” Whitmer has been forced to the sidelines on masking and other COVID restrictions because of the Republican Legislature. 

“I wish Gov. Whitmer could [issue a mask mandate] and people would just listen,” he said. “The reality is her powers to do that have been taken away, so it falls on state or county health departments. Even in counties where they’ve mandates [masks], there aren’t that many people actually doing it. It comes to a point of how do you enforce all of this? The people who are listening to that guidance are the people who are already vaccinated.”

Local health and school officials have said the state deferring to them on COVID restrictions has left them to deal with an increasingly irate public, members of which have threatened the lives of public health officials. In the wake of this, public health officials in Michigan and countrywide have been leaving their jobs. 

That anger has also made its way into health care, where nurses, doctors and other staff have faced an increase in violence and threats against them. Such vitriol, which doctors and nurses previously told the Advance is largely rooted in patients angry over pandemic policies and longer wait times in crowded emergency rooms, is leaving health care workers deeply fatigued, said Evans, the medical director for the Region 6 Healthcare Coalition.

“Our health care workers are tired — really, really tired,” Evans said in an interview with the Advance. “They are tired of being called names. There’s a tremendous amount of anger. Social media is full of people calling health care workers liars. I can tell you that health care workers are on the frontlines working their tails off. They’re tired, and they’re working hard.

“If you take care of someone for two weeks on a ventilator and then they die, that’s a heartbreaking thing,” Evans continued. “You did your best to save that person’s life.”

To address this anger in the state, as well as those who refuse to get vaccinated or wear masks, Davidson said, “We need Republicans to step up in the state.”

“We need folks nationally and on Fox News to get on the same page” with regards to backing the vaccine and masks, Davidson said. 

Combining increased vaccination and booster rates with “education in all silos of news and media on why vaccines are safe and work, that’s how this [pandemic] is going to stop,” Davidson said.

Originally published November 21, 2021 on Michigan Advance. It was shared here with permission.

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