Hospitals across the South are nearing a breaking point as the COVID-19 delta variant surges, patients flood emergency rooms and nurses, doctors and respiratory therapists near exhaustion.  

In Mississippi, Alabama, Texas, Georgia and Tennessee, many hospitals are at or near capacity, ICUs are filling up, more and more young people are being admitted, and the vast majority of patients are unvaccinated. 

Mississippi hospitals stressed 

Mississippi hospitals reported this week having 1,490 COVID-19 patients, 388 in the ICU and 264 on ventilators. Of the nearly 1,500 patients, more than 1,300 are unvaccinated, according to the Mississippi State Department of Health.

 The hospital in Meridian is facing one of the more dire surges in the state. 

“We have seen a dramatic shift from three and a half weeks ago when we had almost no COVID patients,” Dr. Keith Everett, chief medical officer at Anderson Regional in Meridian, said. Numbers there are up significantly and more younger patients are being admitted at his hospital.

"We are seeing a lot of younger COVID positive patients during this surge, many in their 40s and 50s, who are getting very sick. About 90% of our hospitalized COVID-19 patients are unvaccinated,” he said. 

Hospitals across the state are operating at emergency capacity.

Gov. Tate Reeves on Thursday extended a state-of-emergency order, which was set to expire Sunday. The Mississippi Association of Educators and the Mississippi Chapter of the American Academy of Pediatrics urged Reeves to reinstate a mask mandate in K-12 schools.

That hasn't happened.

Alabama nearing ICU capacity 

Dr. Don Williamson, director of the Alabama Hospital Association, sounded the alarm in Alabama this week, saying only 5% of ICU beds in the state are available.

Williamson said there are 84 empty beds out of 1,600 statewide; adding there are no ICU beds available in Montgomery, Dothan, Huntsville, Baldwin County (Mobile) and there was only one available in Tuscaloosa.

Some hospitals are postponing elective procedures — such as some cancer surgeries, knee replacements, hip replacements — and are also having trouble finding beds for trauma patients. One south Alabama hospital had to transfer a patient to a Georgia hospital simply because there was no room. 

According to data from the Alabama Department of Public Health, there is no county in Alabama not seeing a high level of community transmission. 

Statewide data shows cases in every age group, from 0–4 years old to 75 and older, over the last four weeks. However, deaths are still primarily reported among the elderly, with those 75 or older making up 33% of COVID-related deaths despite only making up 7.1% of the state's population.

Cullman Regional Medical Center Chief Medical Officer Dr. William Smith said he’s seen a 100-year-old woman recover and 50-year-old man with no other health problems die. “We honestly don’t know how to pick out the people who are going to end up on a ventilator or who are going to die from it,” he said. “We just don’t know who is going to do badly.”

Alabama hospitals were already facing a nursing shortage that got worse during the pandemic. “Covid led them to decide to do something different,” Williamson said. And because Alabama is one of lowest paid states for nurses, many left to become traveling nurses elsewhere.

Texas hospitalizations up 632%

Several hospitals across the state of Texas are nearing capacity, with the epicenter of the delta surge in Dallas, Houston and Austin, but in recent days rural hospitals have been filling up. Since June 27, COVID hospitalizations have increased 632%, adding an additional 9,363 patients. In the vast majority of cases, hospitals are reporting, those patients are unvaccinated. 

The statewide vaccination rate in Texas is 53.72% fully vaccinated (over 12) and 64.14% one shot. Among older Texans, 75.49% of people over 65 have been vaccinated. 

Like many other hospitals across Texas, Palo Pinto General, a small 48-bed facility in Mineral Wells, has seen a significant rise in admissions and the hospital is near capacity. CEO Ross Korman said the hospital decided to postpone elective surgeries to have more staff available to care for the influx of COVID patients.

Dr. Steven Welch from the Parker County Health Authority said, “I can tell you that in general, there is a very small percentage of those ending up in the hospital who are vaccinated." He added there is less than a 1 percent chance of people dying who are fully vaccinated, according to data he has seen. 

Tom Sledge, CEO at North Texas Medical Center in Gainesville, said his hospital’s facilities and staff are stretched thin. NTMC is a 60-bed general hospital in a small community not far from Dallas. "Our resources at the hospital are being stressed," he said. At Navarro Regional the situation is similar and Anna Paul, director of marketing there said, “We encourage everyone to get the COVID-19 vaccination as soon as you can...Unless you are seeking medical care, please stay at home when you are sick.” 

Across the entire state of Texas at midweek there were 10,463, COVID-19 patients, with 7,772 hospital beds available, 368 open ICU beds and 6,848 unused ventilators. 

But the numbers can be deceptive because some pockets of the state are faring far worse than others. For example, in Austin, with more than 2.3 million people, as of Thursday there were only six ICU beds available. In the Houston area, with more than 2,500 people hospitalized with COVID-19, there were about 94 beds available but that number appears to be shrinking as the delta variant spreads. In sprawling Dallas / Forth Worth, with a population of 8.08 million, hospitals reported 2,503 COVID-19 patients, 93 ICU beds still available and 2,036 ventilators on hand.

Georgia ERs hit hard 

In Georgia, the Georgia Coordinating Center, which works with more than 140 Georgia hospital emergency rooms, reported 36% of those hospitals at “severe” status, more than 10% as “overcrowded,” and 17% were listed as “busy.” 

Georgia Department of Public Health reported 200 new hospitalizations in a single day. Statewide, of more than 13,000 inpatient beds, more than 86% are occupied—22 percent by COVID patients. More than 88% of an estimated 2,600 ICU beds are being used and 40 percent of 1,435 ventilators are in use.

"Cases are increasing dramatically in areas with low vaccination rates, about 99% of hospitalizations and deaths from COVID are in unvaccinated individuals," Nancy Nydam, a spokesperson for DPH, said.

Dr. Robert Jansen, chief medical officer for Grady Memorial Hospital, one of Georgia's largest hospitals and trauma centers, said while not unusual for the hospital to be near capacity, the jump from seven COVID inpatients in late June to now more than 100 is alarming. "We are beginning to see now an increase in demand for critical care and COVID patients.  I think there was an impression that with this most recent surge that people would not get as sick so your critical care needs would not be as great," Jansen said.

This week the rural hospital in Colquitt County exceeded its capacity. The 99-bed facility had 105 patients Thursday, with 52 COVID-19 patients.

Four of those patients are under the age of 12. Half of the hospital's ventilators are in use. 

Hospital officials at Colquitt Regional Medical Center said none of its ventilator patients had been vaccinated. 

In north Georgia, Hamilton Medical Center in Dalton saw a 65% increase in COVID-related hospitalizations and an 80% increase in COVID-19 patients on ventilators from Aug. 2-11. More than 20% of hospitalizations are in ICU and 80 percent of those in the hospital’s ICU are unvaccinated.

In Valdosta, near the Florida state line, the patient count has surged from 11 COVID-19 patients a month ago to 84 this week, nearly an eightfold increase in a month, at South Georgia Medical Center. At SGMC,  there are no patients under the age of 12. Among six patients on ventilators, the average age was 46. The average age of all other COVID patients as of Aug. 12 is 59. According to Chief Medical Officer Brian Dawson, 88-89% of the COVID patients in the hospital are unvaccinated.

In nearby Tift County, Southwell medical center has 73 COVID-19 patients, nine of whom are vaccinated and 64 unvaccinated. Sixteen of these patients are in the intensive care unit, of which two are vaccinated and 14 aren’t. Fifteen COVID-19 patients at Southwell are on ventilators and only one is vaccinated.

In a matter of seven weeks, Archbold Medical Center in Thomasville, Georgia went from having no COVID admissions to 52 hospitalizations among its four hospitals this week. Archbold CEO Darcy Craven said, “Our hospitals are full. Our ICU is full. Our emergency departments and waiting rooms are full. As you can imagine, this creates an environment at our facilities for our employees and frontline staff members that is highly challenging and stressful."

Hospital officials say out of the last 192 COVID-19 positive patients admitted to Archbold facilities, 175 had not received a vaccine. 

Among three Navicent Health facilities in Milledgeville, Warner Robins and Macon, eight of the 127 covid patients were vaccinated. Twenty-eight patients are in the ICU and 18 are on ventilators. Charles Brisco, president and CEO of Houston Healthcare said most hospitalized patients are unvaccinated. 

Tennessee child cases surging 

In Tennessee, 2,017 COVID patients are hospitalized with nearly 600 of them in ICU. More than 300 patients are on ventilators. An increase in the numbers of COVID cases in children has also been reported by some hospital officials, as the COVID-19 vaccine is not available to children ages 12 and under.

The state reports low availability of hospital bed space, with only 10% of all hospital beds, or 1,154, and only 150, or 7%, of ICU beds available statewide.

Tennessee Commissioner of Health Lisa Piercey said it was not surprising to see an increase in COVID-19 cases among children. They make up the largest proportion of unvaccinated individuals in the state — though rates are rising for teens — and it follows trends seen in neighboring states.

But COVID-19 infections are not wholly responsible for capacity issues at children’s hospitals, she said. Instead, the state is seeing an increase in other respiratory illnesses that are uncommon this time of year.

“We usually see them in the dead of winter,” Piercey said, specifying the virus RSV that typically infects young children. “We never saw that surge last winter. Now that kids are getting back together, families and babies are getting out and about, we’re starting to see that surge in kids.”

She also said hospitals have been hit hard by staffing issues. “When you add COVID hospitalizations on top of that, that’s just enough to tip the scales sometimes,” she said.

Tennessee hospitals report 40 pediatric hospitalizations due to COVID, with 14 of them in ICUs.

While back in Georgia, Anna Adams, senior VP of external affairs for Georgia Coordinating Center, said some hospitals in her state have had to adapt because of the increase in COVID cases among children. Though hospitalization data was not available, Adams said there is a large increase in the number of hospitalized children who have tested positive for the virus, with more than half of them in age range 10-17.

"It's really affecting kids differently from the other strains. Some of our hospitals have opened pediatric COVID wings, which is terrifying," she said.

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