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Hospitals seeing COVID-19 plateau, expect it to worsen

Flu season, staff shortages a concern

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Severe hospitalizations for COVID-19 complications have plateaued in recent weeks, but local health experts say that’s likely a short-lived phenomenon.

The upcoming flu season, continued staffing shortages and a surge in COVID patient transfers from rural hospitals across the state, owed largely to low vaccination rates and the transmissible delta variant, are proving concerning for health care organizations.

“We are not out of the woods yet, but we are cautiously optimistic about the downward hospitalization trend we are seeing,” said Banner Health’s Chief Clinical Officer Dr. Marjorie Bessel during a Wednesday news briefing. “However, this is not the time to let our guard down. The delta variant is still in our communities and it spreads rampantly. If you’re vaccinated, you have a very small chance of landing in the hospital. If you’re not vaccinated, the chances of you becoming critically ill and needing to be hospitalized increase substantially.”

The Arizona Department of Health Services reported 2,106 new COVID-19 cases on Wednesday, as well as 74 additional deaths. Approximately 1,009 and 24 were from Maricopa County. Just 57.5% of the state’s population has been vaccinated against the virus, compared with 42.4% in Maricopa County. As of Wednesday, 75,979 cases were hospitalized statewide. Approximately 48,042 were hospitalized in the county.

At Banner, Bessel said as of Sept. 6, 89% of its COVID patients were unvaccinated, or 605 out of 685. And she said the health care system’s internal forecasting tools predict an increase of hospitalizations next month as we enter what she said will be a “severe” flu season.

“It’s flu season, so make sure you get the flu vaccine,” said Bessel. “We are anticipating a severe flu season this year, so we want to protect ourselves and others, just like with the COVID vaccine.”

Bessel also expressed hope the Pfizer vaccines will soon be expanded to 5- to 11-year-old children. The pharmaceutical company announced earlier this week the vaccine works for the younger age group and that it will seek swift approval from the Food and Drug Administration.

“Banner Health is always hopeful for anything that can help us during the COVID-19 pandemic,” she said. “We also rely upon other agencies at the federal level to make sure that they are looking at appropriate data to guide those decisions. If and when approval is given for individuals in that age group to be safely and effectively vaccinated against COVID-19, we will bring that information forward and would be supportive of that when it is officially approved.”

Banner, like most hospitals in the area, is working closely with the Arizona Surge Line, which allows hospitals across the state to communicate and work on patient transfers, especially of its sickest COVID patients from rural areas who need higher levels of care than those hospitals can provide.

According to ADHS spokesperson Steve Elliott, the surge line, which was formed during the pandemic by executive order from Gov. Doug Ducey, has facilitated 303 transfers during the past month and 52 in the past week. Demand has declined slightly over the past month, he said.

“The state is working to help hospitals augment staffing so more beds can be made available,” said Elliott. “ADHS also provides real-time critical care consultation to hospitals with patients awaiting transfer to facilities offering higher levels of care.”

Elliott also added Ducey’s $60 million pledge to help hospitals providing vaccines and monoclonal antibodies to patients is working to fill staffing shortages: a total of 400 out-of-state nurses have been booked so far, and 189 of them are scheduled to start between this week and month’s end.

Bessel said that, in addition to flu and COVID-19 vaccines, expanding vaccine eligibility could alter the forecast for severe cases and hospitalizations.

Dr. Michael White, chief medical officer at Phoenix-based Valleywise Health, agreed that metrics surrounding the pandemic are heading in a better direction, but warned Arizonans to remain vigilant. He added the number of COVID tests returning positive at Valleywise’s medical center is around 10%, down from 15% or 20% as recently as two weeks ago.

“This is one of those areas, what I call a leading indicator,” he said. “This will see us, hopefully, see a decrease in the utilization of hospital beds and a decrease in the utilization in health care resources for the treatment of COVID-19 disease.”

White said there currently are 28 patients in the main medical center, down from the high of 35 in the last five or six weeks; nearly all of them are unvaccinated. The hospital also is 15 to 20 nurses short of a full staff on a daily basis.

Like Banner, Valleywise is watching for news on vaccine eligibility expansion to younger children, as well as booster shots, in order to relieve some burden on its staff. More information is expected on the latter this week.

“We continue to watch very closely within Valleywise Health the ability to vaccinate our pediatric population, that 5 to 11 age group,” said White. “We certainly are watching data as it’s been submitted to the FDA and hope to hear news from them soon and then we’re able to vaccinate that pediatric population as well. It will be a significant benefit for us to continue to have the majority of people vaccinated if they’re eligible to be vaccinated.”

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