'If you trust us to take care of you, trust us to vaccinate you,' and Other Thoughts from Stressed, Strained, and Frustrated Physicians Upstate
Dr. Paras Malhotra, a critical care physician at the Medical University of South Carolina’s Lancaster campus, closes our Zoom interview with this thought:
“If you trust us to take care of you, trust us to vaccinate you.”
It’s a message that’s equal parts plea for help, swirl of confusion, and wall of frustration. Upstate hospitals like MUSC-Lancaster, just as any other hospital in South Carolina right now, is having to figure on the fly how to accommodate more and more seriously ill COVID-19 patients.
At MUSC-Lancaster, COVID patients are pushing the hospital’s staff and resources so far past capacity that they’re spending days in the emergency room because ICU beds are topped out.
The plea for help in what Dr. Malhotra said was actually the preamble to his final Zoom words: “We’re here to help everybody, but we need your help. Please get vaccinated.”
The confusion and frustration of what he said hang on the fact that almost every critical care patient in the hospital in South Carolina right now is an unvaccinated COVID patient. Their illnesses, Dr. Malhotra says, were overwhelmingly preventable.
Frustration and weariness weighs on doctors and nurses Upstate even more than it did nine or ten months ago. Back then, vaccines were not widely available. But now, in a reality in which residents need to be offered rewards to get them to consider vaxing up, doctors agonize that so many people still think the coronavirus is no big deal.
“It’s not a flu,” says Dr. Chris Lombardozzi, chief medical officer at Spartanburg Regional Healthcare System.
Dr. Lombardozzi is just as frustrated as Dr. Malhotra. Spartanburg Regional, as of mid-September, has close to 300 emergency care patients. Almost all are COVID patients, and all but a few are vaccinated.
The rare patient who is vaccinated and still in the ICU (or the ER, where more than a dozen patients past Spartanburg Regional's ICU capacity are spending their visits) is “typically of significantly older age with multiple medical comorbidities,” Dr. Lombardozzi says.
Across the board, this is a repeated reality in South Carolina’s hospitals right now – there are breakthrough infections, some of which lead to hospitalization, but these serious cases are almost entirely among severely compromised people.
“These are the kind of people we’re trying to protect,” Dr. Lombardozzi says. “These are the sickest folks to begin with, who have lots of medical problems.”
His words evoke the message state Department of Health and Environmental Control (DHEC) officials are trying to get across: That vaccination “is not just about you,” says Dr. Jane Kelly, DHEC’s assistant state epidemiologist. “It’s about protecting your family … your community.”
Whether anyone should or should not get vaccinated is, to some degree, a moot argument inside hospital ERs and ICU wings right now. The catastrophe might have been preventable, but the reality is, it’s now a situation that needs dealing with.
The problem, says Dr. Malhotra, is that after nearly two years of watching patients die from COVID infections, medical staffs are starting to wear out.
“[Medics are] reaching a point where they can’t do it anymore,” he says. “They’re pulling extra shifts, they’re picking up extra patents to provide care, but at the same time they’re spending a lot of time in the hospital, away from their families to take care of these sick patients, and unfortunately not many of [those] are surviving. It’s not a satisfying experience.”
So far, MUSC-Lancaster and Spartanburg Regional (the former of which mandates vaccination for staff and the latter of which currently does not) say they’re not losing much of their staffs. Doctors Lombardozzi and Malhotra praise their staffs for working so hard, but both are also deeply concerned about the toll it’s taking to watch increasingly younger people get sick and never make it out alive.
Dr. Lombardozzi chokes up with the same weary frustration as his counterpart in Lancaster when he thinks of how often he and his staff to keep telling patients there’s nothing they can do but insert a breathing tube and pray.
“It’s really, really tough for our team to talk to a patient or a family … in their worst possible hour, and they say, ‘What can you do? Can I get the shot?’” he says. “And we say, ‘Well, you’re in the hospital now, it’s too late.’”
If there is one bright spot, such as it were, the doctors both say they are seeing more family members of unvaccinated, gravely ill, and intubated patients come around on the vaccine.
“Spartanburg County was at a 43 percent vaccination rate,” Dr. Lombardozzi says. “I believe we’re up to 48 or 49 percent.”
Actually, Spartanburg County is up to 51 percent with one vaccination. The average of one-and two-dose percentages is almost 47.5.
Forty percent of Lancaster County's vaccine-eligible residents have completed their COVID schedule, but 52 percent (as of Thursday) have received at least one shot.
Not ideal, but Dr. Lombardozzi says he's encouraged to see the numbers ramping up. He does find it a shame that it took a calamity of this scale to bring people around, but he hopes vaccination rates continue to climb, as the state officially reached the 50 percent fully vaccinated mark Thursday.
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