The latest COVID-19 surge at Concord Hospital is bringing in patients who are younger than previous surges, more likely to be middle-aged than living in nursing homes, but otherwise it is depressingly familiar, with unvaccinated people filling beds and no end in sight.
“The piece that’s more difficult are the staffing shortages, the morale. The general level of grind for our nurses, in particular, is really challenging,” said Dr. Matthew Gibb, chief clinical officer of the hospital. “The difficulties have gotten incrementally more difficult, week after week.”
Concord Hospital has more than 50 COVID patients and four out of five of them are unvaccinated.
“We have had some cases where people have regretted not taking it more seriously, and they got seriously ill,” Gibb said. “There still is a powerful level of what I would call denial in some folks who come in, unvaccinated.”
Concord Hospital has been running at or near capacity for its ICU and emergency room for at least a month, since the latest increase in COVID cases began sweeping through the state. On Tuesday, of the 11 COVID patients in the ICU, 10 of them were on ventilators because their lungs are so damaged they cannot get enough oxygen from the air.
Those numbers have been roughly stable for a week, Gibb said.
“I would say the majority of people we are seeing are in the 40 to 60 (years old) range. It’s less common to see the very elderly now, presumably because they are vaccinated,” he said. This is a contrast to earlier in the pandemic when the vast majority of serious or fatal illness occurred in people over the age of 60, and often much older.
Most COVID-19 patients have not been vaccinated even though vaccines have been freely available for much of the year.
“On the whole in the hospital, probably 60%-70% are unvaccinated” while the figure is much higher for serious cases, Gibb said. “The unvaccinated rate is quite significant for those that need to be on a ventilator – probably 90% or higher.”
Hospitals in many parts of the country are reporting an overflow of COVID-19 patients as cold weather sends people indoors to spread the virus, combined with early signs of the new, more contagious Omicron variant, which has been confirmed in New Hampshire. Overall hospitalization numbers and numbers of new cases in the state are at record levels and deaths have been climbing sharply. The CDC is warning that Omicron could cause even more of a surge as the winter goes on.
The leadership teams at Manchester’s two hospitals, Catholic Medical Center and Elliot Hospital, allowed news outlets inside their emergency rooms and ICUs in recent days, hoping scenes from the front lines would persuade people to get vaccinated.
The stories gave examples of patients who had not been vaccinated arriving at emergency rooms barely able to breathe, sometimes dying. They talked to staff members who cited “moral distress” for not being able to save patients who once believed COVID was overblown and nothing to worry about.
Many hospitals have delayed some elective surgeries and limited visitation in response to the latest outbreak. Concord Hospital is not allowing media inside its facilities.
Having enough trained medical staff continues to be an issue, Gibb said. That’s partly because nurses and other clinicians can make far more money working as traveling staff, going from place to place to help at COVID-19 hot spots, than in hospitals.
COVID outbreaks in families can also be an issue keeping enough medical staff to take care of patients. For example, if a child tests positive at school the parent will also have to quarantine and can’t come to work.
“In general, the pool of people available to come into nursing jobs is smaller than it was,” Gibb said.
He said Concord Hospital has not faced much of an issue with clinical staff refusing to get vaccinated. Fatigue is a different matter: “It is very hard on the staff.”
