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Metro East Doctors Vent Their Frustration As COVID Surges, Hospital Beds Fill

Memorial Hospital, Belleville.
Derik Holtmann
/
Belleville News-Democrat
Memorial Hospital, Belleville.

As COVID-19 once again surges in the Metro East, area hospitals are seeing hospital beds fill with new cases. But patients this time around have been younger — many under 10 years old — and area doctors say the vast majority are unvaccinated.

At Belleville Memorial Hospital, ICU Medical Director Dr. Jiggar Hindia has seen a complete turnaround in COVID-19 cases from around May and June, when the hospital had few cases and, at one point, none at all.

Almost all of the severe cases are people who aren’t vaccinated.

When he asks patients who are about to be put on ventilators why they didn’t get vaccinated, their answer is almost always the same.

“I like to talk to them and try to alleviate some of their worries because they’re always scared,” Hindia said. “I always ask ‘is there a reason you weren’t vaccinated?’ The most common answer I hear is ‘I didn’t think I needed it.’ And by that point, it’s too late.”

“They’re terrified,” he said. “But had they two months ago been vaccinated they very likely wouldn’t be in that situation. ... But it’s too late.”

ICU availability dwindles, hospitals fill

Since July, COVID-19 cases and hospitalizations have exploded in the Metro East and elsewhere.

According to the Illinois Department of Public Health, on July 1, 37% of the intensive care unit beds were available in the Metro East, or Region 4, as it is referred to by the state. ICU availability hadn’t been that high since October 2020.

Now the rate stands at 19%, a level not seen since February. Under Gov. J.B. Pritzker’s Restore Illinois plan rolled out during the virus’ first surge, that level of capacity would have triggered harsh mitigation mandates.

Additionally, on July 1 there were 21 patients with COVID-19 in Metro East hospitals, according to data from IDPH. That number has skyrocketed up to 110 people hospitalized with the virus as of Thursday.

Hindia said that he worries that ICU availability will only increase and the number of COVID-19 patients entering hospitals is increasing every day.

“We’re not necessarily off the rails yet but we’re headed in that direction,” he added.

But Dr. Hilary Babcock, an infectious disease specialist at Washington University and BJC Healthcare’s Medical Director for Infection Prevention, said the current expectation is that COVID-19 will continue to surge due to low vaccination rates and new more infectious variants entering the region.

“We were on a nice path towards a safer society and a safer situation and we are definitely off that path now,” Babcock said. “I think the concern is we’ll continue to see cases rise, we will continue to see our hospitals overflowing and overrun with COVID cases and we really need people in the community to do their part so hospitals are not in this situation.”

Babcock said it’s estimated 90% of severe COVID-19 cases at BJC hospitals are from people who were unvaccinated and that those who do get COVID-19 after being vaccinated typically have minor symptoms.

Cases have quadrupled since June

Babcock said the total number of cases in BJC hospitals has more than quadrupled since early June. In some hospitals, more than 50% of ICU capacity is taken up by COVID-19 patients. It’s even higher in smaller hospitals, she said.

For her, it’s clear the region is in yet another surge of COVID-19 and the expectation is that things will only get worse.

“We’re not quite at the level we were during our biggest surge in November and December of last year but we’re approaching those levels,” Babcock said.” And the predictions — the models that our teams have put together — show that our numbers will continue to rise over the next month at least so we may be back at that level soon.”

“We’re clearly in the middle of another surge,” Babcock added.

In the Metro East, COVID-19 positivity right has skyrocketed since early June. On June 1, the region’s 7-day rolling average stood at 1.6%, as of Thursday it stood at 10.4%, the highest the rate has been since mid-January when vaccines were just beginning to roll out.

The region’s average positivity rate is the percentage of positive COVID-19 tests taken in a week.

COVID patients getting younger

The same explosion of cases is being seen at HSHS St. Elizabeth in O’Fallon, Illinois, where Dr. Jeff Shafer, the hospital’s emergency room physician and EMS medical director said cases are reaching troubling levels.

“We are now as busy as we were at the height of the pandemic in January. It happened in a matter of perhaps a week or two,” he said during St. Clair County’s weekly press conference Wednesday.

The irritation in his voice was most evident as he talked about the exhaustion overwhelmed nurses are experiencing.

“To see these people suffering and it was entirely preventable, particularly whenever you have a virus the knowledge of which is tainted by so-called professionals on Facebook who know little about what they’re talking about and hearsay, and political reasons and whatever else ...” he said. “Unfortunately, the nurses don’t have much time to decompress between patients. The nurses are lucky to even get a lunch break.”

During the press conference, Shafer discussed the delta variant, noting how quickly it exploded and the significant uptick in younger patients getting infected.

According to data released by the health department Wednesday:

  • Over the last four weeks, 63% of county cases have been individuals under the age of 40 and 26% of the cases have been people under the age of 21.
  • Over the seven days, cases for under the age of 10 increase by three percentage points.
  • 12% of the cases currently in the county are children 10 and under.
  • 15% of the cases currently in the county are individuals 11-21.
  • Only 4% of the cases in the county are individuals 71 and above.

“And while it is statistically true that the younger patients, as a whole, do better than the older patients, the cases that we do see are tragic. We’re talking children, people in their 30s, 40s, 50s on ventilators with little chance of survival,” Schafer added. “The mortality rates for children are quite low. But, again, one small child dying from COVID-19 is a tragedy.

“And it’s happening certainly more than once. It’s happening over and over again.”

More people need to be vaccinated

Babcock, Shafer and Hindia agree, more people need to get vaccinated in order to stop COVID-19 from continuing its spread.

Currently, 113,925 people have been vaccinated in St. Clair County, roughly 43.64% of the 261,059 people who live there. That’s not enough, Hindia said, and it lags behind state-wide vaccination rate of 51.26%.

“Our vaccination rate in St. Clair County still isn’t where it should be,” he said. “If that trend continues — if people continue to not get vaccinated — I don’t necessarily see it getting better any time soon.”

It’s hard not to be frustrated, as the “tool” to fight COVID-19 is readily available, especially in St. Clair County, Hindia said.

The county and much of the region began seeing vaccination rates drop steeply after March. On March 18, the weekly average of new vaccinations stood at 2,551. As of Thursday, the weekly average had stooped to 628.

“This is a largely modifiable disease now because we have tools to try to prevent it. The biggest risk factor for getting severe COVID-19 is being unvaccinated,” Hindia said. “We have a great tool in our toolbox which is to get vaccinated and give yourself the best chance of avoiding severe COVID, avoiding being in the ICU on a ventilator, avoiding death — that is the best strategy.”

Babcock added that the number of deaths has doubled in the past few weeks at all BJC hospitals. Since July, in St. Clair County 14 COVID-19 deaths have been reported.

However, since cases began to surge again in July, the weekly average of vaccinations has begun to grow again in the region. In every Metro East county, the weekly average of people vaccinated has grown since July.

In St. Clair County the weekly average stood at 572 people vaccinated on July 1, as of Thursday that average had grown to 628. In nearby Madison County, the July 1 average stood at 659 people vaccinated a week. As of Thursday, the average had grown slightly to 686 a week.

That’s a good sign, Babcock said, but there’s still more to do. She urged people to go get vaccinated and said in the meantime people need to wear a mask and avoid large gatherings.

“It’s not a huge rise and there’s plenty of room for improvement,” she said.

Kavahn Mansouri and Garen Vartanian are reporters for the Belleville News-Democrat, a news partner of St. Louis Public Radio.

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