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At the start of a shift, Juana Mejia gathers with the other nurses in the intensive care unit at Memorial Hospital Miramar closes her eyes, and prays.
“We ask for strength and courage,” said Mejia, nurse manager of the ICU, which is filling up quickly with COVID patients. “Our job is to save lives. That’s what we are here for.”
With younger patients now struggling to breathe on their own, Mejia faces each shift trying to keep one more COVID patient alive. “We are the ones right in front of them. We get personal with them and when they don’t make it, we cry.”
The newest wave of COVID patients into Florida’s hospitals hit hard and fast, bringing mostly people between ages 25 and 55 who are unvaccinated and often have no underlying health conditions. As of Tuesday, more than 11,377 people were hospitalized for COVID-19 in Florida, a new record.
The shift to a younger, healthier patients caught Meija off-guard after previous waves filled the ICU with mostly seniors or residents with other types of risk factors such as obesity, diabetes, hypertension, and heart failure.
According to hospitals in Florida, today’s COVID patients have some common factors:
- They are 98% unvaccinated.
- About 70% are between 12 and 65 years old; 50% are between 25 and 55.
- A majority have no pre-existing conditions.
- They are filling COVID wards rapidly, although only between 25-30% of all ICU beds in Florida are occupied by COVID patients.
- They are more likely to be a minority. (During the pandemic, Black Americans have been hospitalized at nearly three times the rate as white Americans.)
- Many patients are related — husband and wife, parent and child, brother and sister.
- Their health deteriorated faster than patients in previous coronavirus waves.
- More of them are children.
- They mostly are infected with the Delta strain.
- Unless sick enough to land in the ICU, most are hospitalized for 5 to 7 days.
While little data on who fills hospital beds in Florida is published regularly, some information is collected and released by the Centers for Disease Control and Prevention. Some information has been provided by healthcare leaders to Florida’s hospital associations or to the Sun Sentinel.
Aharon Sareli, chief of critical care medicine for Memorial Healthcare System, said patients reflect the demographics of the community that surrounds each hospital district in the state — particularly the residents who are unvaccinated.
“What we are seeing now is even more tragic,” Sareli said. “It’s even harder for healthcare workers than in the past because we are seeing people dying from what is a preventable disease. Our patients are so sick by the time they come to the ICU that they are not able to speak, and they are fighting for their lives.”
ICU nurse manager Mejia — like many other healthcare workers — thought the pandemic had subsided in May and June when only a trickle of COVID patients arrived at the hospital. Now she moves between the intensive care unit with 18 beds and an overflow second unit with another 18 beds for COVID patients, caring for young parents, pregnant women and middle-aged vaccine skeptics who need a ventilator to breathe.
For Mejia, a shift feels endless, as if COVID patients seemingly never stop arriving. She can no longer predict who will live or die from the disease.
“I watched a young man in his 30s come in with the virus, have multiple cardiac arrests and saw his family devastated. He was the parent of two young children,” she said, tears forming in her eyes as she peers out from above a blue mask.
According to information published by the Department of Health and Human Services on Tuesday:
- Hospitals in Florida had 1,759 confirmed adult admissions, up from 1,689 the previous day.
- Hospitals in Florida had 40 confirmed pediatric admissions, down from 41 admissions on the previous day. (Florida leads the nation in children hospitalized with COVID-19, according to the CDC.)
- Hospitals in Florida have 11,377 adult COVID patients, up from 10,271 the previous day. The total including suspected COVID patients is 11,863.
- Hospitals in Florida have 138 reported COVID pediatric patients, including NICU, newborn, and nursery, up from 118 the previous day.
“I am expecting continued increases in everything, but I could be wrong,” Salemi said. “I do believe what happens in the future depends at least in part on the actions we take.”
The surge in COVID hospitalizations has happened as new cases have risen dramatically in recent weeks, fueled by the more infectious Delta variant of the coronavirus. As of the second week of July, 63% of a sampling of COVID-19 patients in Jackson Memorial Health System and University of Miami’s UHealth Tower had the Delta strain of the virus, according to UM researchers.
Dr. David Andrews, UHealth associate professor in the Department of Pathology and Laboratory Medicine, said most likely 80% to 90% of hospitalized COVID patients now have the Delta strain.
Some hospitals around the state report their COVID admissions have surpassed last summer’s — before a COVID vaccine became available. On Tuesday, Alberto Garcia, chief nursing officer for Memorial Hospital Miramar, said. “We are twice as busy as last summer. What we are seeing now makes that look easy. Before it was a slow incline of patients. This time it’s rapid. Patients are coming non-stop.”
At a news briefing in Miami on Tuesday, Florida Gov. Ron DeSantis said the state vaccination strategy has kept older people out of Florida’s hospitals and prevented deaths. He dismissed the hospitalization crisis as media hysteria.
“Since we did our ‘seniors first’ vaccination effort at the end of last year, beginning of this year, we’ve seen a 70 to 75 percent reduction in mortality year over year compared to last summer’s wave as well as the January peak,” he said.
DeSantis said although Florida has seen 25,000 fully vaccinated people test positive, seniors aren’t going to the hospitals and dying from COVID as they did in prior surges.
“Hospitals are seeing a much lower median age, and I think it’s because we protected the vulnerable very quickly,” he said.
“Going forward, to me the best indicator is the emergency room visits for COVID-like illness,” DeSantis said. “When you see that go up, you know you are going to see an increase in prevalence and an increase in hospital admissions. When that level offs or goes down, all the other indicators follow that.”
“Everyone is exhausted managing COVID. It’s been a year and a half, and we don’t see an end in sight.”
Alberto Garcia, chief nursing officer for Memorial Hospital Miramar
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DeSantis said ER visits went up sharply in July then started to stabilize at the end of the month. “We have basically been at a plateau. We are looking to see that roll over, and when that rolls over, I think you are going to see some of the other indicators roll over as well. I think we are going to settle in either this week or next week.”
The governor said there will be no lockdowns again in the state and his seniors-first strategy will help keep the pandemic under control in the state.
“Would I rather have 5,000 cases amongst 20-year-olds or 500 cases amongst seniors?” he said. “I would rather have the younger, because of the effect it has. I think protecting the vulnerable is the right way to go.”
IF ER visits are an indicator, Garcia at Memorial Hospital Miramar said his hospital has seen no easing of patients coming in. The hospital has been admitting about half of the 50 patients a day who show up in the ER, which is taking a toll on staff. “Everyone is exhausted managing COVID. It’s been a year and a half, and we don’t see an end in sight,” he said.
Garcia said it has been heart-wrenching to see spouses or siblings admitted for COVID, and only one survives. “These are people in their 30s. I can’t help but think we could have prevented this if they had been vaccinated.”
Sun Sentinal health reporter Cindy Goodman can be reached at email@example.com.