In general, case and hospitalization numbers are down again this week, but the viral load in the wastewater in Hampshire county has stopped decreasing. A few MA counties have moved into the CDC's yellow / medium risk category, and while the hospitalization rate decreased again in Hampshire county, there was an increase this week in the percent of beds occupied by COVID-19 patients.
The current status of COVID-19 is positive, especially in comparison to late November of 2021. The COVID-19 scenario is not a complete depiction of the challenges facing the US healthcare system right now. The decreased rates of COVID-19 have not altered the overall hospital capacity issue we're currently facing. Hospitals are heavily burdened with RSV and influenza cases - and even though COVID-19 cases aren't as high as they've been in the past, there are still a proportion of hospital beds needed for COVID patients.
The most telling sign of this crisis comes from two letters from healthcare professionals organizations in the past week or so.
- First, the Children's Hospital Association (CHA) and the American Academy of Pediatrics (AAP) sent a letter last week to President Biden and Health Secretary Becerra describing unprecedented levels of RSV and influenza among children pushing the pediatric departments of hospitals to the brink of rationing care (and in some cases, rationing care). For example, the rate of severe RSV requiring hospitalization among infants under 6 months is more than 7x the rate in 2018, before the COVID-19 pandemic. Flu hospitalizations are already at the highest level they've been in 10 years both in children and in older adults. The letter estimated that at least 75% of all pediatric hospital beds are already occupied across the US. Almost 100% of pediatric hospital beds are occupied in Arizona, the District of Columbia, Maine, Minnesota, Rhode Island, Kentucky and Utah. The letter urges President Biden to declare RSV a public health emergency, which would allow for flexibility in staffing, bed creation, and funding to make sure children receive the care they need. Oregon has already declared RSV a public health emergency, the first state to take that action so far.
- Second, the American College of Emergency Physicians also sent a letter to President Biden, describing the situation in emergency rooms as a public health emergency. Emergency departments throughout the US are at a "breaking point" because patient volume exceeds bed capacity. Patients have to wait in the emergency department until a bed is available. Locally, we've seen wait times of 12 or more hours just to be evaluated, let alone get assigned a bed and admitted if necessary. The ACEP is urging President Biden to declare emergency medicine a public health emergency for the same reasons the CHA and AAP cited in their letter.
The White House has responded to the healthcare challenges with a proposal for increased funding. President Biden has requested $10 billion in public health funds, most of which would go to efforts to deal with COVID-19 (including increasing the percent of Americans who have received the updated bivalent booster and research on new and more effective antiviral treatments).
A booster campaign can't come soon enough - just 12-13% of Americans ages 5-64 and 31% of Americans 65+ years old have received the updated bivalent booster. Massachusetts has about double the vaccination rate (20-25% of those ages 5-64 and 50% of those 65+ years old). Even the MA rates are alarmingly low, given the additional protection the booster provides against severe disease and death. If there's one place you definitely don't want to be right now, it's in the hospital (if you can avoid it).
The best way to avoid getting severely ill from COVID-19, RSV, influenza, or any other viral disease, is to practice the mitigation measures we've all learned in the past few years - masks work great against viruses! Being up-to-date on vaccines is the best way to protect yourself - make sure you're up-to-date on your COVID-19 vaccine, the yearly influenza vaccine, and other recommended vaccines for your age group.
Megan W. Harvey, PhD (she/her)