Delta-driven Covid surge puts renewed strain on US hospitals

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US hospitals in some states are once again strained by the latest surge in Covid-19, illustrating the heavy toll taken in parts of the country as infections near levels last seen during the heights of the pandemic in January.

More than 78 per cent of hospital beds are occupied currently, according to data from the US Department of Health and Human Services. Covid-19 patients occupy more than 100,000 beds for the first time since January 30, representing 13 per cent of available capacity.

The latest wave of the crisis, which the country’s top health officials have described as a “pandemic of the unvaccinated”, has been underpinned by the highly contagious Delta variant of Covid-19, particularly in communities with low levels of vaccination coverage or lax public health restrictions.

The US on Friday reported 1m new Covid-19 cases over a seven-day period for the first time since late January, according to Centers for Disease Control and Prevention data. Infections are trending higher in nearly every state, and with levels of daily testing about two-thirds of their peak rate during winter, additional cases may be going uncounted.

The number of patients hospitalised with Covid-19 has doubled since the end of July, stretching hospital resources in some states in a worrying echo of previous waves of the pandemic.

In Florida, one of the worst affected states, 17,370 patients were hospitalised with Covid-19 on August 18, a record for the state, according to the HHS.

That has compounded a backlog of patients seeking treatment that had been delayed due to the pandemic, resulting in 85 per cent of Florida’s hospital beds, and 95 per cent of its intensive care unit beds, currently being in use.

“Our bed availability is as low statewide as I have seen it throughout the pandemic,” said Mary Mayhew, chief executive of the Florida Hospital Association.

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Younger individuals are more prevalent among coronavirus hospitalisations compared to previous points in the pandemic, and “90 per cent or more” were unvaccinated, Mayhew said. That has piled even more pressure on staff, who have been dealing with the pandemic for the past 18 months and are physically and mentally exhausted.

“Seeing younger individuals in the hospital, the trauma of these experiences, seeing young individuals die, the severity of illness we’re seeing among pregnant women — all of this is intensifying the challenges within the hospitals,” Mayhew said.

At Ochsner Health, which serves south-east Louisiana, the number of Covid-related hospitalisations across its network eased below 1,000 for the first time in a fortnight, but 88 per cent of these patients are unvaccinated.

“Even though the hospitalisation numbers are going down, the ones who are staying in the hospital are getting sicker,” said Robert Hart, Ochsner’s chief medical officer. “They’re going to the ICU, getting sicker and winding up on ventilators,” thereby requiring more hospital resources than regular patients.

Ochsner had redeployed more than 800 people within its system to help cope with the surge in cases and more than 5,000 procedures for patients have been cancelled in recent weeks to free up hospital resources, Hart said. “We’re still trying to do our regular business, and when I say that, you can imagine that’s impossible.”

Louisiana has been one of the main hotspots for the Delta variant over the summer and has one of the lowest levels of vaccination coverage in the US.

When it struggled with prior surges in March and April of 2020, hospitals were able to draw nursing staff and resources from other parts of the country that had not been overwhelmed by the coronavirus. That is now less feasible because several other parts of the US are grappling with their own surges.

Hawaii, Kentucky, Mississippi, Oregon and Washington this week set their highest seven-day averages for patients currently hospitalised with Covid-19, according to a Financial Times analysis of HHS data. Texas is also on track to top its record from January of 14,218 hospitalisations, according to state data.

The Delta variant, now the dominant strain in the US, is having a range of effects on states that may not necessarily be explained by seasonal factors or policy decisions.

Bar chart of Covid-19 hospitalisations per 100,000 people for states with the 10 highest and 10 lowest proportions of fully vaccinated residents showing Levels of hospitalisation tend to be low in well-vaccinated states

Generally, states with the lowest levels of vaccination coverage are reporting among the highest-population adjusted rates of new infections, hospitalisations and deaths, while those with the best-progressed vaccine rollouts appear to be in much more robust shape, particularly in terms of avoiding the more adverse outcomes.

Several states in the south, despite boosting their vaccination rates in recent weeks, are still dealing with elevated hospitalisations and fatalities, which tend to follow infection trends.

By contrast, the north-east region, where vaccination rates have been higher, has fared better. States including Massachusetts, New Jersey and New York have some of the lowest rates of per capita hospitalisations in the country.

In a sign of the recent effect on younger people, the population-adjusted rate of new hospital admissions for Covid-19 patients aged 49 years or younger across the US are higher than they have been during at any point in the pandemic, according to federal data. Admission rates for people aged 50 and older have also jumped, but remain below their peak levels in January.

Recent research continues to underpin the additional protection that vaccines offer against Covid-19 and also shed more light on the threat posed by the Delta variant. A CDC study released earlier this week showed the hospitalisation rate among unvaccinated individuals was 29.2 times that among fully vaccinated persons.

A study published on Friday in the Lancet Infectious Diseases journal found the risk of hospital admission or need for emergency care was higher in individuals infected with the Delta variant than compared with the Alpha strain. Outbreaks of the Delta variant in unvaccinated populations could therefore put a higher burden on healthcare services, compared with other strains, researchers from Public Health England and the University of Cambridge said in the report.

In Florida, the rate at which hospitalisations were increasing has begun to flatten, said Mayhew. While she was encouraged by that trend, she added: “We have a way to go before we emerge from this current surge.”

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