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COVID-19 Morning Report

Yuri Samoilov via Flickr creative commons

Florida Hospitals Anticipate Critical Staffing Shortage

Hospitals across Florida are feeling the strain on staff and other resources as COVID-19 patients continue to fill hospitals and intensive care units. Florida remains an epicenter of the nationwide surge in infections and hospitalizations, driven by the highly transmissible and more virulent delta variant.

The Naples Daily News reports, a Florida Hospital Association survey conducted Aug. 9, finds that by next week, 68% of hospitals expect to reach the point of having a critical staffing shortage.

The FHA survey is conducted twice a week, and that latest figure is up 8% from just four days earlier on Aug. 5.

The U.S. Department of Health and Human Services reports that as of Thursday, Florida reached 15,796 patients hospitalized with a primary diagnosis of COVID-19, and those numbers are climbing.

SWFL Hospitals Continue to Feel COVID Patient Surge

Lee Health has hit another record high of 498 hospitalized COVID-19 patients as of Friday morning, marking an increase over the previous day's 480 admitted COVID-19 patients. Forty-eight COVID patients throughout the systems hospitals are on ventilators and 81 are in intensive care.

Lee Health's Intensive care unit capacity is 91% full. Staffed bed capacity is also at 91%, which has gone down because the hospital system brought in additional staff. The News-Press reports, Lee Health hired 160 bedside nurses in June and July, but that the need for more nurses continues to outpace qualified job applicants. Currently, Lee Health has 1,400 job openings system-wide.

Lee Health's Golisano Children's Hospital had 13 COVID patients Thursday, down from 14 the previous day, but up from the just one or two hospitalized pediatric COVID-19 patients that staff typically treated at any given time during the pandemic a year ago.

The NCH Healthcare system in Collier County reported a slight drop in hospitalized COVID patients, Thursday, with 162 patients, compared to 166 the previous day. Forty are in the ICU.

Physicians Regional Healthcare System reported treating 89 COVID-19 patients Thursday, which is up from 79 on Tuesday.

Sarasota Memorial Hospital's coronavirus patient population dropped slightly on Thursday to 205 hospitalized patients, compared to the previous day's all-time high of 211 admitted patients. This marks the first time in more than a week that the number of hospitalized coronavirus patients hasn't set a new record high.

Sarasota Memorial reported treating 45 COVID-19 patients in the intensive care unit, Thursday, including a 17-year-old patient. The Herald Tribune reports about 10% of Sarasota Memorial Hospital's COVID patients in the ICU are younger than 30-years-old.

90% of the hospital's coronavirus patients are unvaccinated.

The Herald Tribune reports, Manatee Memorial Hospital in Bradenton reported treating 72 COVID-19 patients, Thursday, compared to 68 patients on Wednesday. Lakewood Ranch Medical Center reported having 61 coronavirus patients, Thursday, up from 51 the previous day.

Parents Fight DeSantis' Mandatory Mask Ban in Court

A group of Florida parents will square off with Governor Ron DeSantis’ administration in court this afternoon. The parents argue DeSantis’ executive order barring schools from mandating students wear masks, robs school districts of the ability to ensure student safety, which is a state constitutional requirement.

Attorney Charles Gallagher said DeSantis’ order also trample over the rights of school districts to govern themselves—a concept known as home rule:

“By fiat and saying it has to be done this way, and coming from the governor, that’s not what the constitution permits,” said Gallagher.

“And that exercise of power definitely exceeds the grant of the governor and runs afoul over the constitutional protections.”

The governor argues his executive order is meant to protect parents’ rights to choose what’s best for their children.

A second lawsuit challenging DeSantis’ executive order is pending in federal court in South Florida. The lawsuit alleges DeSantis’ mandatory mask ban jeopardizes the rights of disabled kids who can’t wear masks, but need to be protected.

DeSantis Touts Regeneron Clinics to Relieve Pressure on Emergency Rooms

Gov. Ron DeSantis was in Downtown Jacksonville Thursday touting Regeneron, an antibody treatment for those infected with the coronavirus.

The governor said emergency treatment “strike teams” will deploy across the state to increase access to the treatment, including in a clinic that will be set up in the Downtown Jacksonville Library conference room.

“I do think this is probably the best thing we can do to reduce the number of people that require hospitalization,” DeSantis said. “So I want everybody to know that this is an important way to be able to protect yourself in the event that you are infected.”

A temporary Regeneron clinic opened at 12 p.m. Thursday in a field at 300 Bay Street near the Hyatt Regency Jacksonville Riverfront in a Florida Department of Emergency Management Mobile Incident Management Unit. It will be open from 9 a.m. to 5 p.m. Monday through Friday, and can treat eight people every hour-and-a-half.

"These monoclonal antibody therapy sites will expand access to proven effective COVID-19 treatment,” said Florida Division of Emergency Management (FDEM) Chief Medical Officer Dr. Kenneth Scheppke. “The treatment reduces severe illness, hospitalization and death risk by 70%, and reduces the odds of household contacts developing COVID-19 by 82%.”

Unlike a vaccine, once Regeneron wears off, you’re no longer protected if you have another exposure to someone who is sick.

“What we’re trying to do, ultimately, is relieve the [emergency department] space,” said FDEM Director Kevin Guthrie. “We do believe this will be a situation where the state, the Surgeon General, will be able to help all of the hospitals around the state of Florida bring the number of emergency department admissions down and open up that space.”

Dr. Sunil Joshi, head of the Duval Medical Society Foundation, said the vaccine is a good long-term solution, but it’s not going to help you if you’re unvaccinated and you’re exposed to the virus now.

“You get vaccinated, you wait two weeks to get your second dose, then you have to wait two more weeks for it to be fully effective. So you're looking at six weeks before the vaccine really protects you,” Joshi said. “What about these people right now who are getting very sick now, when our hospitals are at capacity? If there are people who are at high risk of hospitalization because of other risk factors, if we give them Regeneron, can we prevent that person from becoming hospitalized?”

Former President Donald Trump was treated with Regeneron when he was sick with COVID-19 last year, before the drug was widely available.

The Food and Drug Administration has granted the drug Emergency Use Authorization “for people who are not fully vaccinated or who are not expected to mount an adequate immune response to complete SARS-CoV-2 vaccination (for example, individuals with immunocompromising conditions including those taking immunosuppressive medications.)”

The state has contracted with private firm CDR Maguire to distribute the antibody treatment.

For now, the FDEM is prioritizing people who have referrals for Regeneron, either from an emergency room physician or their own family doctor. It is expected that within about a week, the temporary clinic will relocate to the Downtown branch of the Jacksonville Public Library. At that point Guthrie is hopeful referrals will no longer be necessary and walk-ups will be able to get immediate care.

A Regeneron treatment involves four simultaneous injections in the lower belly, after a 20-minute waiting period for the drug to warm up to room temperature. The injection lasts about 15 minutes. Then, the patient must be watched for an hour in case they exhibit any side effects.

The governor said the treatment is not a replacement for vaccinations.

“Maybe people thought that if you tell them there’s a treatment, they wouldn’t necessarily get vaccinated. I don’t think it’s an either/or,” DeSantis said.

Florida May Be at Peak for COVID Cases, But Experts Anticipate a Long Road Ahead

An expert tracking pandemic trends says Florida could be at its peak when it comes to new coronavirus cases, but that a rough couple of months are still ahead.

Ali Mokdad is with the Institute for Health Metrics and Evaluation at the University of Washington, which was instrumental at predicting trends during past COVID-19 surges.

He attributes this surge in large part to the highly contagious delta variant, which has spread rapidly among mostly-young, unvaccinated Floridians continuing to move around society without using preventative measures like mask-wearing and physical distancing.

The IHME estimates far more people are currently infected with the virus than are getting tested, as many as three-to-four times the amount being reported each day.

Mokdad said with more people developing some form of immunity to the virus, the state is likely reaching its threshold.

"Basically, like a fire, you're running out of wood; the virus is running out of people to infect and the cases will start coming down,” he explained, adding that the recent uptick in vaccinations will also help curb the surge.

However, Mokdad projects COVID-19 hospitalizations and deaths will continue to rise for several more weeks as those metrics lag behind new cases. He expects deaths will decline throughout the fall, but that Florida could lose about 6,000 more lives by December, which would increase the state’s death toll to more than 46,000.

“Go get your vaccine as soon as possible,” Mokdad advised Floridians. “And wear a mask. You wear a mask to save your life but also to protect the younger generation, because young kids under 12 are not eligible to get the vaccine.”

Mokdad said he is concerned about new variants appearing around the world that could be more resistant to vaccines. If they were to gain traction in Florida, this surge could drag on much longer than expected.

OBGYNs Advising Pregnant Patients to Get COVID-19 Vaccine

Florida physicians are echoing guidance from the U.S. Centers for Disease Control and Prevention that pregnant women should get vaccinated against COVID-19.

Dr. Pamela Carbeiner is an OB-GYN who practices in Volusia County. She said she wasn’t pushing as hard for her pregnant patients to get vaccinated because COVID-19 wasn’t making her patients as sick, but the Delta variant changed that.

“This year we had to hospitalize a number of patients, do emergency caesarian sections for someone who need to be on a ventilator at 34 weeks and we couldn’t vent until the baby was out,” said Dr. Carbeiner.

Last week, she emailed all her patients and urged them to get vaccinated. The U.S. Department of Health and Human Services doesn’t track the number of pregnant patients who are hospitalized, but statewide, more than 3,000 COVID-19 patients are in the intensive care unit, accounting for nearly half of all ICU patients.

USF To Study Moderna Vaccine Effects on Kids Under 12

University of South Florida researchers are looking for volunteers to participate in a clinical trial about the use of a coronavirus vaccine on children.

USF's Health Morsani College of Medicine announced, Wednesday, that the clinical trial will look at safety and immune responses to the Moderna COVID-19 vaccine from kids between 6 months and 11-years-old.

Right now, children under 12 are not authorized to receive coronavirus shots.

Seventy-five percent of participants will receive two injections of the vaccine four weeks apart. The other participants will receive a placebo.

More than 12,000 children will take part in the study nationwide and their health will then be monitored for a year.

Tallahassee Memorial Confirms COVID-19 Death of Child

Tallahassee Memorial Healthcare officials confirmed Thursday one of their pediatric coronavirus patients has died.

Officials said the patient who died was younger than five-years-old and died within the last month. Patient privacy concerns prevented officials from providing further details. During an online media availability, pediatric critical care specialist, Dr. Thomas Truman, said as the Delta variant spreads, he’s seeing more intense impacts for children.

“Like the rest of the state of Florida we’ve seen a significant and worrisome increase in pediatric COVID patients presenting to the hospital and indeed admitted. Just in the last 2 months, we’ve seen more cases than we have in the prior five months combined. They tend to be sicker and require more help and more medial therapy,” said Dr. Truman.

He said he’s also concerned about a multi-system inflammatory syndrome that sometimes impacts kids after they recover from the coronavirus. He said with more young people testing positive, he expects to see more of those cases. He’s urging everyone who can, to get vaccinated and says universal masking is an important part of making kids safer.

South Florida Medical Schools Say Influx of Applicants Is Result of the “Fauci Effect”

South Florida medical schools are seeing an influx of applications as a result of the pandemic. This is all part of what some are calling “The Fauci Effect.” Florida Atlantic University and Florida International University are among many schools seeing these increases.

Dr. Sarah Wood is senior associate dean for FAU’s College of Medicine. FAU’s medical school received over 6,000 applications for 66 spots.

“A lot of students or people who are just starting their careers, may have had time off. They may have lost other jobs and it may have been a time where going back to school made more sense than being in the job market.”

Wood says at times of uncertainty people seek job security.

“I think the idea of watching the crisis unfold and people in need and the frontline healthcare workers featured in the media has really inspired a new generation of future doctors. People are calling it the Fauci Effect.”

Cristina Arabatzis is director of admissions and recruitment for FIU’s College of Medicine.

“I know that many are naming it the Fauci Effect.”

She says they saw a 53 percent increase in applicants from before the pandemic.

“Any time that the economy is down or unemployment levels are high, there tends to be an increase in applications to graduate and professional programs.”

Wood at FAU says the trend should continue as long as the admissions process remains virtual.

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