Social distancing. Vaccination. Masks. Quarantine.
They’re words we’re all tired of hearing. But they’re also words doctors are tired of saying.
An end doesn’t appear to be in sight, however, in vaccine-hesitant North Dakota, where COVID-19 cases — and hospitalizations — are climbing once again as the more contagious, and potentially more dangerous, Delta variant spreads. Hospital beds are filling up. Fast.
“You know, everybody’s flooded up here,” CHI St. Alexius Dr. Robert Kemp told the Williston Herald. “Our staff is getting very worn out and tired and emotionally exhausted beyond belief. And it’s extremely hard. People don’t understand it unless you’re doing the job. If you’re a nurse working with these patients, you’re shot. Your respiratory therapist, or the hospital doctors, they’re just exhausted over this.”
The reversal of the COVID-19 trend line in Williams County is hurting morale.
“I think everybody, including myself, thought we got through the big phase last winter. And that this wasn’t going to happen again,” Kemp said. “But nobody wrote this book before, so it’s being written.”
Meanwhile, it doesn’t help that morale to hear people continuing to claim there isn’t a pandemic or suggesting that doctors are just inflating numbers.
“Yeah, that destroys me,” Kemp said. “I’m probably losing friends over this whole concept in discussion. And I’m probably losing patients over this discussion, because I’m extremely dissatisfied with people that won’t listen to their doctor or nurse or pharmacist when they say you ought to get a good vaccine. These are great vaccines, they’re safe. Your tiny risk of problems versus the alternative of getting COVID and getting potential very, very serious complications and deaths. Why don’t people listen to the doctor any more? It’s extremely upsetting.”
Hospitalizations are getting younger
Kemp is seeing more younger patients than last time, and they’re getting hit harder than expected.
“Our brains are full of when we were dealing with the Alpha strain last winter when it was pretty rough,” he said. “It was fitting these categories real well. You know that all the young people seem to kind of not bat an eye at it. Now we’re seeing people that are younger getting hit pretty hard.”
COVID-19 is different from other cold viruses.
“How it starts isn’t necessarily how it ends,” he said. “Most (of the time) with a normal human cold virus, the first few days are kind of rough and then it’s just better better better. In this situation, your immune reaction can, you know, just like go fight the virus in a pathological manner where you get seriously ill.”
COVID cases tend to last longer than other hospitalizations, Kemp added. It’s a week, sometimes two.
And sometimes, despite having a seemingly mild case in the beginning, people find they are still experiencing symptoms like brain fog, tiredness, memory issues, and shortness of breath weeks and even months later. Some athletes in the 20 to 29 age group have not regained the vitality they had pre-COVID weeks later, despite having a fairly mild case in the beginning.
The possibility for what’s being called Long COVID is yet another way in which coronavirus appears to be different from the common cold.
Lack of hospital beds
COVID patients in Williston are transferred to other facilities when they need critical care like intubation or a ventilator. But they can’t be transferred until a bed is found in a bigger center that has the dedicated pulmonology and the intensive care needed. With cases spiking in so many cities and states at once, those centers are rapidly filling up. That’s extending the search for beds, often to other states.
“I mean you reach out as far as you can if you have a critically ill patient and he’s got a chance of surviving,” Kemp said.
Meanwhile, those larger hospitals have set up ethics committees, Kemp pointed out, to decide who will and who won’t get a ventilator, because supply is limited.
“People need to understand that if you have a heart attack right now and you show up in the ER, you might have a hard time getting shipped to get a stent put in your heart,” Kemp said. “You might have a hard time getting sent somewhere for a heart attack, or you have a surgery that cannot be done locally, you know that’s emergent, you might not have the option of getting out to where you have to go.”
Reversing the crisis
It is the strain on the health care system of all these COVID-19 cases at once that makes vaccination, or, failing that, COVID-19 protocols, more important than ever to avert a health care crisis in Williams County.
Everyone can play a role in ensuring there is hospital space for those who need it by simply following the oft-repeated protocols. Vaccinations. Or, failing that, social distance, masks, hand-washing. Stay home if you are sick. Isolate yourself from others if you suspect you have caught COVID-19.
“The vast majority of what we see (in the hospital) are non-vaccinated people,” Kemp said. “I totally, you know, understand, because I understand the science of vaccines, and there’s no perfect vaccine so people can and do still get COVID infections despite being vaccinated.”
But the safety data so far shows that the vaccines are very safe and very effective when it comes to preventing hospitalizations and deaths, Kemp said. On the flip side, he has yet to see a single person hospitalized as a result of taking the vaccine.
“The risk reduction (with the vaccine) is remarkably good, unbelievably good,” Kemp said. “And it’s thanks to the prior administration that we have this vaccine. It’s just now the people who supported that administration tend to be the people that don’t want to get the vaccine, and that’s where I don’t get it.”
For his patients with underlying conditions who still refuse to be vaccinated, Kemp urges them to be tested early if they have cold symptoms.
“Come in and get tested as soon as possible, and make sure you tell them you’re diabetic (or whatever the underlying condition is) when you come get tested,” Kemp said. “You’ll get a rapid test. And if you’re positive, let me know as soon as possible, and I’ll get you orders for monoclonal antibody very quickly.”
Monoclonal antibodies have been shown to reduce hospitalizations 70 percent in a Mayo Clinic clinical trial. But they have to be administered very early to do any good, and that means the COVID test needs to be given at the first onset of cold symptoms.