In the throes of an unprecedented surge in Covid-19 patients at Cleveland hospitals, Kristin Englund, an infectious disease specialist at the Cleveland Clinic, listened to one of her bedridden Covid-19 patients as he called his family, urging them to get the vaccine.
“It’s terribly sad to see people when they get to the point of desperation,” Englund said. “You see them in the intensive care unit, and they’re realizing that they’re about to be intubated, and this was something that potentially could have been avoided.”
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It’s going on one year after the first Ohioans got vaccinated against Covid-19, and patients with the virus are flooding the Cleveland Clinic at volumes rivaling the pandemic’s most dire surges. Now more than ever, Englund said, conversations about the vaccines with those who haven’t already gotten them can feel futile.
“Six months ago, there were folks who were somewhere in the middle of that decision tree,” Englund said. “I could talk some people into it. I could really convince them of the importance of getting vaccinated.
“What I’m finding now is that people are really kind of at one end of the spectrum or the other. So people have either already been vaccinated, or they are entrenched in their decision that they’re not going to.”
Across all of its Ohio locations, the Cleveland Clinic as of Tuesday, Dec. 14 had 786 Covid-19 patients, 218 of which are in intensive care units (ICU). About 80 percent of those patients were unvaccinated. The remaining 20 percent of patients were vaccinated but were primarily older or had underlying health conditions.
MetroHealth reported that it, too, is reeling from the surge, hospitalizing an all-time high 136 Covid-19 patients, according to a press release. Across the entire MetroHealth system, 275 people have been diagnosed with Covid-19.
No matter that the vaccine does widely prevent severe hospitalizations and death. At this point, Englund said, many unvaccinated patients simply refuse to discuss it.
“I’m unfortunately convinced that there is a certain amount of the population that I will never be able to convince,” she said. “I’m not sure what it’s going to take…I’m running out of answers for that.”
As of Thursday, Dec. 16, 161,778 Clevelanders had been vaccinated against Covid-19. That’s about 43 percent of the city’s population and about 16 percent lower than the number in Cuyahoga County overall. Vaccinations surged at the city, county, and state levels in the early months of 2021, after the vaccine was made available to adults over age 16. Nearly two-thirds, or 64 percent, of those vaccinated in Cuyahoga County did so by May 2021.
Now, as the more virulent Delta variant proliferates across the country, Englund said she sees more and more otherwise young and healthy people hospitalized and intubated, which can cause irreparable lung damage. But the alternative, in most cases, she said, is death.
“We certainly have learned from the very early days of the pandemic…but certainly there is no magic bullet at this point in time, nothing that we can give that’s going to guarantee that somebody is going to survive once they hit the intensive care unit,” she said.
There appears to be no break on the horizon. Englund estimates that about half of the patients she sees for infectious disease consultations have Covid-19, and with the holidays and indoor gatherings looming, Englund said she expects the surge to continue into the new year. National data suggests this year’s winter surge is nowhere near as bad as last years, but that’s not how Englund views the situation at the Cleveland Clinic.
“If patients are coming into the emergency room with medical problems other than Covid, they’re going to continue to come, right?” Englund said. “Nobody can stave off a heart attack or another type of pneumonia. They have to be admitted. We can’t just turn them away, but the beds are filling up to near capacity, and they’re going to continue to worsen as this pandemic continues to worsen over the next month.”
The Clinic has backup plans in place if Covid-19 patients exceed its current capacity, such as retrofitting other parts of the hospital for Covid-19 care. Sending patients to other hospitals, however, isn’t an option, Englund said, because other facilities are also struggling with similar capacity issues.
While the Cleveland Clinic is not experiencing any staffing shortages at the moment, Englund said she can’t rule out a shortfall in the future. Across the nation throughout the pandemic, burnout and resignations among medical staff have been commonplace.
“My heart goes out to the physicians, the respiratory therapists, and the nurses in the intensive care units because they’re having to deal with death on a daily basis for patients with Covid,” she said. “That’s brutal, to have to see that much death from something that is, for the most part, completely preventable.”
Michael Indriolo is a reporting fellow at The Land