Covid and Hospitals: How are things now?

[CrunchRN]

Just curious. Here in DFW I see hospitalizations are rising to 14%. How are things in the hospitals? Are things relatively normal? No more furloughs?

Please share. I am not in acute care, but I am of course very interested in the effects on acute care staff.

[subee, MSN, CRNA]

23 hours ago, Wuzzie said:

In my hospital system:

88 Covid patients

51 vents (includes recovered but still on ventilators)

35 in the ICU

In my state:

1929 hospitalized (down from nearly 5k)

395 in ICU

Positivity: 10.6

Case per 100K: 22.8

Mask mandates will likely be removed in the next 2 weeks. 

Wow Wuzzie"  That's a lot of patients on a vent.  We have about 68 patients in the system but only 3 (all unvaxxed, natch) still on vents.  Our inpatient numbers are down about 15% but positivity rates are only down to 21%.  Masks are unmandated.  I think we'll be OK with that since the positivity rates are lagging with what it happening the week ahead.  I'm not going to rush back into crowded venues just yet.  It's been lovely not having a cold for the past 2 years:)

[Wuzzie]

6 minutes ago, subee said:

Wow Wuzzie"  That's a lot of patients on a vent.

Just to clarify I work at a huge university hospital system and we are a tertiary center. Only 35 of those vented patients are acute. The rest are chronic and now in the PCU or the SNF that is located in-house. 

I forgot to bring a mask when I had to duck into the market last weekend. We are still under a mandate. Felt weird at first but then felt glorious. I'm ready to forge ahead. 

[subee, MSN, CRNA]

2 minutes ago, Wuzzie said:

Just to clarify I work at a huge university hospital system and we are a tertiary center. Only 35 of those vented patients are acute. The rest are chronic and now in the PCU or the SNF that is located in-house. 

I forgot to bring a mask when I had to duck into the market last weekend. We are still under a mandate. Felt weird at first but then felt glorious. I'm ready to forge ahead. 

Your positivity rate is half of ours.  At 10%, I'd feel twice as relieved:)  But can't do just quite yet since the unnamed "4th wave" of the 1920 pandemic was the most virulent but limited mostly to the big cities of the Midwest.  IMHO, that pandemic was even scarier since it efficiently killed so many young people.  It wasn't the kind of culling we expect and have now (elderly or obese unvaxxed people).

https://www.nature.com/articles/d41586-022-00471-2

Quote

A laboratory study1 of BA.2 suggests that its rapid ascent is probably the result of it being more transmissible than BA.1. And other preliminary studies suggest that BA.2 can readily overcome immunity from vaccination and previous infection with earlier variants, although it is not much better than BA.1 at doing so.

If real-world epidemiological studies support these conclusions, scientists think that BA.2 will be unlikely to spark a second major wave of infections, hospitalizations and deaths after Omicron’s initial onslaught.

“It might prolong the Omicron surge. But our data would suggest that it would not lead to a brand-new additional surge,” says Dan Barouch, an immunologist and virologist at Beth Israel Deaconess Medical Center in Boston, Massachusetts, who led the study of BA.2, posted on the medRxiv preprint server on 7 February.

Growth advantage

BA.2’s steady rise in prevalence in multiple countries suggests that it has a growth advantage over other circulating variants, says Mads Albertsen, a bioinformatician at Aalborg University in Denmark. That includes other forms of Omicron, such as a less-prevalent lineage called BA.3.

“From a scientific perspective, the question is why,” says Barouch. Researchers think that a large part of the reason Omicron quickly replaced the Delta variant is its ability to infect and spread among people who had been immune to Delta. So one possibility for BA.2’s rise is that it’s even better than BA.1 at overcoming immunity — potentially including the protection gained from a BA.1 infection.

So the new variants may not produce an additional surge but may just prolong the current surge...wonderful...

Quote

According to news reports, researchers in Israel have identified a handful of cases in which people who had recovered from BA.1 became infected with BA.2.

 

[subee, MSN, CRNA]

2 hours ago, toomuchbaloney said:

https://www.nature.com/articles/d41586-022-00471-2

So the new variants may not produce an additional surge but may just prolong the current surge...wonderful...

 

Not what we want to hear but predictable.

[subee, MSN, CRNA]

COVID Rates Jump After Denmark Lifts All Restrictions (medscape.com)

Death rates are up to 67% of pervious totals.  What they don't mention is the burden on the hospitals which is the most important factor for me.  Their vaccination rate is around 90% so this rise in cases only proves the point the CDC has made from the beginning:  Vaccines are only part of the solution and we can't forget the rest.

1 hour ago, subee said:

COVID Rates Jump After Denmark Lifts All Restrictions (medscape.com)

Death rates are up to 67% of pervious totals.  What they don't mention is the burden on the hospitals which is the most important factor for me.  Their vaccination rate is around 90% so this rise in cases only proves the point the CDC has made from the beginning:  Vaccines are only part of the solution and we can't forget the rest.

Apparently modern humans are convinced that there is a quick fix to every problem we face. 

1 hour ago, subee said:

COVID Rates Jump After Denmark Lifts All Restrictions (medscape.com)

Death rates are up to 67% of pervious totals.  What they don't mention is the burden on the hospitals which is the most important factor for me.  Their vaccination rate is around 90% so this rise in cases only proves the point the CDC has made from the beginning:  Vaccines are only part of the solution and we can't forget the rest.

https://www.webmd.com/lung/news/20220217/covid-rates-jump-denmark-no-restrictions

Quote

Since Denmark became the first major country to lift its remaining coronavirus restrictions at the beginning of February, it has recorded more COVID-19 cases per capita than most other places in the world.

COVID-19 hospitalizations and deaths have jumped by nearly a third, signaling a warning to the U.S. and other countries that are now easing mask mandates, vaccine requirements, and limits for crowded spaces such as bars and nightclubs, according to Yahoo News.

“Not looking good in Denmark. Deaths are now 67% of peak with a steep ascent,” Eric Topol, MD, director of the Scripps Research Translational Institute, wrote in a Twitter post this week.

 

[travelingrn2001, ASN, BSN]

I am still afraid to be acutely Ill in a hospital these days. I still feel that care has not returned to pre-pandemic standards. Procedures continue to be delayed or not performed at times. Rooms are not cleaned as regularly, ancillary services are not provided with same intensity. 
When all aspects of acute hospital care return, I will say that things are improving in my area. 

[CrunchRN, ADN, RN]

We have not had any mask mandates other than what different stores etc may have had and none of those for a long time. Our positivity rate is now 10% thankfully. The only place I have worn a mask in the last 6 months are at work because we are in a big clinic building and my MIL's assisted living. At first it felt very strange and almost scary not wearing a mask at Walmart and theatres etc, but that passed quickly.  I do expect though that things will go back and forth a lot as far as numbers. Unfortunately, I do not have contacts at the local hospitals to see what things are really like form that perspective.

 

[JBMmom, MSN, NP]

On 2/18/2022 at 9:43 AM, subee said:

It wasn't the kind of culling we expect and have now (elderly or obese unvaxxed people).

Fortunately, I think we're through the worst of it in my area. One hospital I'm at is down to 3 positive patients, none on vents (170 beds). My other hospital is down to 15 total and 2 on vents (190 beds).

My quote of subee was included because this most recent wave, for us, was NOT all people that I would have identified as at risk- other than being unvaccinated. We've had MANY patients, under 50 years old, that died and I'd estimate that almost 40% weren't really that high risk by history/exam. Yes, some were obese, some had hypertension or diabetes, but a number of them just got really sick for what appeared to be no reason. That was the hardest part, I think, because people just got so sick and almost everyone died. If I never experience anything in my career again like we did in Nov-Jan, I'll be a very happy person.

[CrunchRN, ADN, RN]

Thank you for that update JBMmom. It is interesting to hear about the younger and less "at risk" illness. You just do not hear much about that and it is pretty scary.