160% Over Capacity Is Too Much

I have found myself increasingly discouraged, disheartened, and frustrated because of the pandemic again.  I had so much hope back in January when the vaccine was rolling out.  It seemed as if the worst was behind us at last.  Now our local hospitals report that, actually, things have never been worse than they are right now.  In the first 22 days of September an equal number of county residents have died from COVID.  This is unprecedented here.  We averaged 18 deaths per month leading up to this.  These people ranged in age from their 20s to their 80s.  Some had been in ICU for months.  Imagine those poor nurses who cared for them all that time only to have it end in such disappointment, not to mention their helpless families standing by.  Over and over and over again.

The ICU at our primary hospital is operating at over 160% capacity this week.  I'm not sure about the other hospital.  According to the weekly infographic provided by the health department, two-thirds of those in the ICU at both hospitals are on ventilators.  More than 80% of COVID patients at both hospitals are unvaccinated.  At least one of these hospitals has started planning for the horrifying prospect of resorting to "crisis standards of care" in which staff have to decide who is most likely to benefit from the limited resources available if they don't have enough to help everyone.  “We are at the point where we are not confident going forward that we can continue to meet all patients’ needs,” Dr. Nathan Allen, the medical ethicist for the larger hospital, was recently quoted. “And that’s heartbreaking.”  Idaho had to resort to this last week.  Meanwhile, hallways are serving as makeshift hospital rooms.  Plus, Brad Von Bergen, the ER manager, recently stated, “The problem is we are running out of hallways.”  Hospital personnel is overtaxed and so they called in the National Guard to help.  Again.  In just one single day last month, 30 ambulances hoping to transport patients here for advanced treatment were turned away because of lack of space.  Still, Dr. Allen fears we haven't seen the worst of the surge yet.

When I heard all that the first thing that jumped to mind was our hospital experience when Ryan almost died several years ago.  I genuinely believe that if Ryan's heart had malfunction now instead of back then, he probably wouldn't have made it.  The attentive level of care he got at the hospital...the way his family and friends were able to surround him--fill his room up!-- with love and prayer and crystals, playing the music he enjoys, talking with him and encouraging him to come back to us...the way we could call for a nurse and promptly get one when we saw something not right on his monitors or his ventilator...the amount of time he was permitted to occupy an ICU bed and ventilator before they even talked about transferring him to extended care...none of that would likely be the same if it had happened right now.  It drops a leaden stone into my stomach just to think about it.  It is a terrible time to have a medical problem, COVID or otherwise.  It breaks my heart.

The local paper also reported on Tuesday that Montana is leading the country as a "a national hot spot" for COVID infections, "recording the highest percentage increase in new cases over the past seven days."  Look at us.  We're number one.  (Forgive my sarcasm there.)  It seems like some people in our state are actively trying to drag this thing out as long as possible* and I just don't understand.

I know there are a tiny minority of people who genuinely cannot take vaccines safely.  People doing chemo, say.  However, by and large, I blame our current COVID spike on the folks who are just not willing to wear a mask or get a shot.  People that think they're fit and healthy, like Matt's cousin, and so aren't worried about it.  Or because they have a demanding job, like my buddy who just can't seem to make time for an appointment.  Worse still are the people who are anti-vax and are actively protesting masks because they've twisted what is an international health crisis into some sort of national political drama conspiracy.  It makes me sick.  No hospital should have to post signs telling patients not to mistreat their medical staff for heaven's sake.  The paper quoted Dr. Sara Nyquist, an emergency medicine physician here, saying she was asked by a patient whether she was a Republican or a Democrat.  “I said, ‘I am your doctor,’” she recalled. “You do wonder how we got here.”

And I really do.  

It makes me sad and mad and, honestly, feel like there is no real end in sight now.  The vaccine was, finally, a light at the end of the tunnel.  Even if we didn't totally eliminate COVID, future outbreaks could be manageable.  It never occurred to me that people would think these vaccines, culmination of decades of scientific research, were a trap or a con.  Or that there would be so many people who just couldn't be bothered to go get one even though they really didn't have any opposition to the idea.  Even people I know and love, to my disappointment. 

When the vaccine was finally released after that long, long year I was excited that we finally had a solid tool to help check this thing, to get ahead of the virus.   I never imagined so much vaccine resistance and hesitancy, let alone the outright hostility toward this public health initiative.   It seems like we--locally, statewide, countrywide--didn't get the buy in that we needed at that critical moment in time.  It's like Dr. Fauci said this July, “If we had the pushback for vaccines the way we’re seeing... we’d probably still have smallpox and we’d probably still have polio in this country.”  It is unacceptable to me that we'd let this happen.  People are dying.  I'll never forget my nurse friend, Kelly, telling me how painful it was watching someone essentially drowning right in front of you as they gasped for breath.  We can and must do better.  For those patients, for those who love them, and for those who are trying to save them.  

From Wikipedia:  A CT scan of a person with COVID-19 shows lesions (bright regions) in the lungs.

Last year I convinced myself that this wouldn't be forever.  It was like mantra.  I thought people could band together enough on something that affects us all.  Now I am not so sure.  Perhaps we have missed our window now and the masks will be a part of my life forever.  I must admit I am even a little uncomfortable sharing this post because I know what a charged issue it has become for so many people.  It is certainly a deviation from my more happy-go-lucky-cats-and-gardening motifs.  I've decided it is important enough to risk it.  If we want businesses to keep their doors open--and so many have closed already--we have to figure this out.  

If we want people to stop needlessly dying--and we've lost too many already--we must do better by each other. 

Despite my current pessimism I'll close with an encouragement to anyone who can, but hasn't yet, to please get vaccinated.  It's easy.  It's free.  As my man Phil says "It really is for all of us."  In addition, I encourage following the advice of trusted medical and epidemiological experts, including wearing a mask in public indoor spaces in locations that are having substantial outbreaks.  None of it is a guarantee, but it all helps.  Lastly, if you know any nurses, doctors, etc. do something extra nice for them.  They're working so very hard.

Screenshot of transmission rates in the US by county.  Take on CDC website 9/23/2021.

*Montana politicians have even passed laws that seem designed to help prolong the pandemic.  This includes drastically curtailing the ability of local health departments and municipalities to implement mask mandates and other public health measures and making it illegal to "discriminate" based on vaccine status by doing things like requiring an employee to get vaccinated or a private business requiring patrons to provide proof of vaccination for service.  Not just COVID vaccines either.  It is now illegal in Montana for an employer to require their employees to get any vaccine, including the flu shot.   The law even includes those who work with sensitive populations such as hospitals and nursing homes, albeit with additional provisions.  It is madness.  There was a 10,000 person indoor concert in town this week and, because of these laws, even if the promoters had wanted to require vaccination or proof of a negative test they couldn't.  Same for masks.  It strikes me a tremendously irresponsible when the ICUs are beyond capacity.