US Hospitals Prepare For Influx Of Covid Patients As Millions Travel For Thanksgiving

Labyrinthine Covid Reminder System Is The Real Reason For The Delays

As cases start to rise again in the United States, millions of people are expected to travel for the Thanksgiving holiday, and health workers and hospital systems are now bracing for an influx of Covid patients after having little time to recover. recover from the summer wave.

Last year there was a sharp increase in cases during the holidays. But this year, new tools could mitigate the spread – if adopted quickly.

U.S. scientific agencies on Friday recommended boosters for all adults six months after mRNA vaccination, and children over the age of five recently became eligible for the vaccines.

Existing treatments like monoclonal antibodies are very effective if given early, while two promising antiviral drugs from Merck and Pfizer may be approved in the coming weeks. But the new treatments may come against the backdrop of increasing cases during the holiday season.

“It’s a race against time,” said Kyle Enfield, assistant chief physician of intensive care at the University of Virginia Health.

More than 92,000 Americans now test positive for Covid-19 every day, and more than 1,000 people die from the virus every day, according to the United States Centers for Disease Control and Prevention. Cases are increasing in the majority of states, with hot spots in the Midwest, Northeast, and parts of the Southwest.

There have already been more Covid deaths this year than in 2020, due to the more transmissible Delta variant and low vaccination rates in much of the country, and the total number of Covid-19 deaths in the states -United could reach 1 million by spring.

Despite this, around 20 million passengers are expected to travel on Thanksgiving, the United States Transportation Security Administration (TSA) announced last week. These numbers come close to the record number of trips seen around Thanksgiving in 2019, when 26 million people were selected for flights.

“We anticipate that travel could be very close to pre-pandemic levels on this holiday,” TSA administrator David Pekoske said in a statement.

Given the cooler weather and the holidays ahead, “I think we’re probably going to see an increase in cases over the next couple of weeks,” Enfield said. “Winter can be a busy time in the hospital with regular flu and pneumonia [cases] that people are getting, but this year I think we’re going to add continuous transmission of Covid. “

But it’s hard to predict how big the next wave will be, he said – and much of those calculations depend on vaccination rates as well as existing and potential drugs.

Many hospitals in Massachusetts, a state with some of the nation’s fastest growing cases and hospitalization rates, are already at full capacity or overcapacity, said Emily Rubin, pulmonologist and intensive care physician at the Massachusetts General Hospital, at the Guardian.

It’s not just Covid that performs the services. “We have a large number of intensive care patients hospitalized for illnesses unrelated to Covid,” she said. Part of the reason has to do with delayed care during the pandemic which is leading patients to become sicker than they otherwise would have been.

Experts hope that even as Covid cases increase, vaccines will help keep hospitalizations and deaths lower than last year.

“It gives me some hope that we are seeing groundbreaking infections that are not as serious as the ones we have seen in the past,” Enfield said. “But I think the next few days and weeks will really tell what the real impact will be. “

In the meantime, hospitals are hiring as many nurses and clinicians as possible and increasing the number of patients who can receive monoclonal antibodies in infusion centers.

People with symptoms of Covid should be tested immediately, and those who test positive and are at high risk of serious illness should immediately undergo treatment with monoclonal antibodies.

But providing monoclonal therapy is difficult, as it usually requires an hour-long infusion in a specialized center.

“We have significantly increased capacity over the past two months, and we are doing everything possible to expand it to meet demand. But the demand has increased dramatically as we have seen the number of cases increase, ”said Rubin.

Having enough staff for these centers has been difficult, Rubin said, as health systems across the country face worker shortages.

“Since the entire system is under heavy demand, each step in this chain can take some time,” Rubin said.

New antivirals could be much easier to give to patients, and the Biden administration has set aside billions for the new drugs. However, they must first be cleared by the United States Food and Drug Administration and then distributed nationwide.

“We can’t wait to see them. We’re also looking forward to seeing the data in more detail, ”said Rubin. “We have of course not seen any published and peer reviewed data, but we will be eager to see it. “

Like monoclonal drugs, antivirals seem to work best early in an illness, so getting test results quickly and then receiving the drug soon after would be essential.

Easily accessible antivirals would also help in rural areas and places that do not have infusion centers, helping to address the inequalities that have plagued some communities – especially communities of color, which have been disproportionately hit hard. by the pandemic.

With “all of these therapies, there’s a concern that they’re not being distributed fairly and that different patient communities have different access, and that’s a big concern,” Rubin said.

But if the pills are easy to take anywhere in the country and work well in preventing hospitalization and death, she said, “that would kind of be the holy grail.”

Medications for the rest of the disease – when patients typically present to the hospital – have yet to be developed.

In the meantime, Rubin and Enfield are urging people to take as many precautions as possible: getting vaccinated against Covid and the flu, which is likely to be particularly serious this year, as well as wearing masks and keeping a distance. “There are a lot of things that every person in the audience can do right now to help,” Enfield said.

“All of us who have been doing this for a while are tired,” Enfield said. “We really hope that soon we will see the number of cases continue to decline and that we will have the chance to breathe a sigh of relief. “


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