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The number of occupied intensive care beds has dropped to single digits this week as the Austin area weather the recent surge in COVID-19 cases.
As of Monday, Region O – which consists of 2.3 million people in 11 counties: Travis, Williamson, Hays, Bastrop, Blanco, Burnet, Caldwell, Fayette, Lee, Llano, and San Saba – had only six occupied intensive care beds attached to the Texas Department of State Health Services.
Across the 11 counties region, 647 patients are being hospitalized for the coronavirus, out of more than 3,700 inpatients across the region. The region only has enough staff to care for a little over 4,200 patients
“The problem with this is that outside of COVID-19, the risk of car accidents, heart attacks, or other health problems that require this type of care has increased,” said Matt Lara, a spokesman for Austin Public Health. “We’re asking people to get vaccinated, wear masks and stay home if possible. We need to make arrangements to help the hospitals.”
The driver of the increase in cases is the highly contagious delta variant of the coronavirus, which is spreading among the very young and unvaccinated.
On Monday afternoon, Austin area public health officials reported 445 new coronavirus cases and 74 new hospital admissions for COVID-19 in Travis County.
Of the 557 people currently hospitalized for COVID-19, 191 were in intensive care units and 116 were on ventilators.
“We are on a serious climb right now,” said Dr. Nancy Foster, president of the Travis County Medical Society and an internal medicine doctor at Ascension Seton Medical Center.
Too few staff, too few beds
Hospital staff, including doctors and nurses, work long hours. Foster said her average daily patient load is much higher right now and that meant she came in earlier and came home later.
“We’re all on deck,” said Foster. “It’s been hours and hours of hard work and we have few staff.”
Hospitals have asked to recruit staff from other parts of the country to cope with more beds, including intensive care beds.
However, the staff shortage existed before that surge and before COVID-19, she said.
A 2019 study by the Texas Center for Nursing Workforce Studies of supply and demand found that Texas had a shortage of 27,000 nurses in 2018, which is set to grow to 57,000 by 2032.
Nurses “don’t work at their optimal staffing levels,” said Cindy Zolnierek, executive director of the Texas Nurses Association, who is also a nurse.
Nurses are being incentivized to take extra shifts and nurse managers and directors are being called to the front lines, Zolnierek said, but nurses said, “I can’t do this anymore.”
Lara said local health officials are working with hospitals and the state to resolve the issue and avoid having to shut down certain levels of care as hospitals struggle to maintain staff.
“In the meantime, get vaccinated, wear a mask, stay home, and if you feel sick, get tested,” he said. “Do not wait.”
“They didn’t think they could get sick”
Public health officials in the Austin area last week adopted level 5 protocols reflecting the highest level of coronavirus threat to those at high risk of severe symptoms or death from the virus.
Level 5 encourages all residents to wear masks and return to social distancing practices, including those who are fully or partially vaccinated and have pre-existing health conditions. Residents should also use roadside and contactless delivery options for groceries and shopping, and avoid all travel and gatherings.
Level 5 recommendations:What should you know about Austin’s Level 5 COVID Restrictions as Delta Goes Up?
The community needs to know that hospitals have a high case volume, and as the positivity rate for COVID-19 tests increases, it will only lead to more hospitalizations, Foster said Monday.
“We had a brief false sense of security,” she said at the beginning of the summer when the cases were low. “We have to pay attention now.”
People need to follow what health officials advise them to: wear masks, avoid crowded activities, and get vaccinated, Foster said.
About 64% of Travis County’s residents age 12 and older were fully vaccinated as of Monday, of which 3.74% are black and 20.46% are Hispanic American, according to the Texas Department of Health and Human Services.
The people coming to Foster’s hospital are younger than in previous COVID-19 waves and often do not have the high risk factors that patients had in previous waves.
“They thought they were healthy and thought they couldn’t get sick,” Foster said of the current patients. Many patients have told her, “I will be vaccinated when I leave the hospital. I will call my family and tell them to get vaccinated,” she said.
Nurses watch much younger people die before them, Zolnierek said.
A nurse said to Zolnierek, “I watch my patients die slowly,” and that included a 20-year-old with no previous illnesses.
“We want to help people feel better, but there is a sense of hopelessness and knowing that it was preventable,” she said.
This recent surge has been particularly difficult because they see people coming to their hospitals unvaccinated.
It’s daunting and disheartening, said Zolnierek. “We were there for you. You have to be there for us. The most important thing is to get vaccinated,” she said.
As more people get vaccinated, the virus has fewer places to thrive and mutate, Foster said.
The vaccines are safe, with cases of serious side effects being around 1 in 1 million, she said.
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Vaccinated people also get sick
However, the vaccine is no reason to believe that you are immune to the delta surge.
“If you are vaccinated, watch out,” she said. “If they have a very high comorbidity (risk factor) they are still at risk.”
In the delta variant, asymptomatic people, including those who have been vaccinated, also spread it, and those who have been vaccinated get sick.
At her hospital, Foster has seen both unvaccinated and vaccinated people with COVID-19.
“The most important thing is that the vaccinated do not have the critical illness that unvaccinated patients are,” said Foster.
Of the vaccinated people who are now being hospitalized, some have been exposed to the virus and become sick, and some have high risk factors, she said, “but not all”.
Like many other diseases, COVID-19 and its Delta variant have left doctors in the dark. “Every case is different,” said Foster. “That makes medicine interesting. I can’t tell you which patient will get well and which will not.”
When you feel sick
Foster urges people not to wait until they’re really sick with COVID-19 and need to be hospitalized. Instead, they should get tested and contact their doctor.
Doctors now have options, including treatment with REGEN-COV monoclonal antibodies, which received emergency clearance from the Food and Drug Administration in July and which can and must be given in the early stages to prevent serious illness.
Early intervention can also help reduce the number of people hospitalized for COVID-19.
However, the increase and staff shortage should not be a reason for people to postpone hospitalization. In the past year, doctors have seen people procrastinate and get much sicker because of heart attacks and strokes.
“Don’t wait,” said Foster. “We take care of them.”
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