The Corner

Health Care

Hospitals in Even the Most-Vaccinated States Are Starting to Feel the Squeeze

A healthcare worker prepares the Moderna coronavirus vaccine at a vaccination center in El Paso, Texas, May 6, 2021. (Jose Luis Gonzalez/Reuters)

Last week I observed that between July 6 and August 31, the number of active cases of COVID-19 infection in the state of Vermont increased 23-fold — from 114 to 2,668. But I noted the state is not really in a public-health crisis — hospitalizations and daily new deaths remain low in Vermont, in large part because the state is heavily vaccinated, and in part because Vermont is one of the least-populated states in the country.

There’s a notable update to that conclusion, because in the past few days, Vermont — vaccination-filled Vermont, where more than 86 percent of those eligible for vaccination have at least one shot! — is experiencing concerns about hospital capacity.

The state’s largest hospital is straining to care for “a very high number of patients” amid Vermont’s rising coronavirus cases, according to information the hospital provided on Friday afternoon.

The rise of Covid-19 cases “as the Delta variant spreads,” plus other critically ill patients and those seeking care that was delayed earlier in the pandemic, has prompted staff at Burlington-based University of Vermont Medical Center to reschedule some non-urgent procedures to make space, according to an email from spokesperson Neal Goswami.

The hospital is “utilizing a high percentage of inpatient beds at this time,” he said, although the number varies throughout each day.

Mind you, as of this morning, Vermont has just 33 people in hospitals because of COVID-19, and just 13 in the ICU. Then again, having 30-some people in Vermont hospitals can still be a lot for a tiny state; the worst date appears to have been February 7, when the state had 65. The state had less than 12 people in the hospital on any given day from May 14 until August 6.

It is worth noting that there is some evidence that University of Vermont Medical Center had capacity issues before the Delta variant.

Eighteen months into the pandemic, the situation has reached a crisis point. Now, patients sometimes wait up to a year to see specialists.

Seven Days asked UVM Medical Center for the average number of days new patients wait to be seen in each of its 85 specialties. The hospital refused to provide data for all but two areas: urology, which is now scheduling two months out; and ear, nose and throat, where the current delay ranges from 20 days to see a pediatric specialist to 175 days for an ear specialist.

So perhaps the situation in Vermont represents a tiny state with 14 hospitals attempting to handle the health-care needs of roughly 623,000 people, where even a mild increase in the number of people who need hospitalization can leave hospitals carefully counting the remaining unused beds.

But the situation in nearby Maine — where as of August 25, 80 percent of eligible people have received at least one dose — shows that once again, even highly vaccinated states can find their hospitals feeling squeezed by patients coming in because of the Delta variant.

The sharp rise in serious COVID-19 cases over the past few weeks has forced Maine hospitals to think once again about capacity, highlighting the continued challenges the pandemic poses for health care providers as long as the virus is broadly circulating.

On July 23, there were just 25 patients hospitalized in Maine with COVID-19. Five weeks later, that figure had increased more than fivefold. Similar trends have played out in other highly vaccinated states — Vermont, which saw hospitalizations drop into the low single digits in June, was up to 34 patients hospitalized as of Monday, according to the state’s health department.

In both states, more than 70 percent of critical care beds were occupied as of last week, according to federal data, a trend that led Maine hospital leaders to call on residents to take precautions and get vaccinated to prevent additional spread of the disease.

The lesson is not that vaccinations don’t work; the lesson is that even a very small sliver of the population being unvaccinated and thus vulnerable to SARS-CoV-2 can fill up a hospital’s beds pretty quickly. Avoiding scenarios of crowded hospitals in any given state would require a near-universal eagerness to get vaccinated.

One other minor point of concern: While it is still generally true to call this a pandemic of the unvaccinated, the latest numbers in Massachusetts illustrate that the percentage of COVID-19 patients in Bay State hospitals that are fully vaccinated is . . . not quite as minuscule as past rhetoric might suggest: “Data shows that 160 of the 601 hospitalizations are people who were fully vaccinated — about 26 percent of all COVID hospitalizations. The vast majority — 74 percent — are among unvaccinated individuals, despite the fact that they account for a minority of the population. Data from the state shows the percentage of vaccinated people hospitalized for COVID has dropped in the past week after hitting around 30 [percent].”

So if Vermont and Massachusetts and Maine have problems like this . . . every other state is going to have problems with overcrowded hospitals, too.

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