Colorado hospitals overwhelmed by young, ‘dramatically ill’ unvaccinated COVID patients

Nationwide hospitalizations and deaths from COVID-19 have been on the rise again. The numbers are rising in the Midwest and New England, and remain dangerously high in parts of the West. Some states like Colorado have seen spikes that threaten to overwhelm hospitals. Amna Nawaz discusses with Dr. Ivor Douglas, chief of pulmonary and critical care medicine at Denver Health.

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  • Judy Woodruff:

    Nationwide, hospitalizations and deaths from COVID-19 had been dropping around much of the country in recent weeks. But now cases are on the rise again in the Midwest and New England. And they remain too high in parts of the West.

    Some states like Colorado have seen spikes that threaten to overwhelm hospitals.

    Amna Nawaz has our conversation.

  • Amna Nawaz:

    Judy, the Colorado Department of Public Health estimates one in 48 people in the state are infected with COVID. There are fewer ICU beds available now than at the peak of hospitalizations last December. And, yesterday, the state implemented crisis standards of care to give more options to burned-out staff.

    For a front-line perspective, I'm joined by Dr. Ivor Douglas. He's chief of pulmonary and critical care medicine at Denver Health and a professor at the University of Colorado School of Medicine.

    Dr. Douglas, welcome to the "NewsHour." Thank you for making the time.

    Take us, if you can, inside your hospital right now. What does it look like? What do you see?

  • Dr. Ivor Douglas, Denver Health:

    It's an exceptionally busy time.

    And as much as we have been here before, unfortunately, we're dealing now with a very busy surge of COVID-19 and a very substantial demand for hospital services for a range of other things.

    Unlike the previous surges that we have dealt with, where we had a little bit of reserve, without the impact of social distancing, masks and a relatively low immunization rates, we are really at the point where our resources are maximally strained.

    Despite that, what I am seeing is remarkable commitment to care. Our teams are doing their — really the utmost. And I think that, while we hear a lot about burnout, what we may not hear about is resilience, and the recognition that there are folks that have been at this for months and months and months, and every day turn up and do outstanding care.

    So it's a tightrope balance, but the truth is, we're in trouble.

  • Amna Nawaz:

    We're so grateful to them and to so many others in other states as well.

    But tell me a little bit more about this surge that you're seeing. Is there an average COVID patient profile? Mostly unvaccinated, older, younger?

  • Dr. Ivor Douglas:

    Mostly unvaccinated, younger by about 15 years than the first surges, very worrying, because we're seeing patients who are presenting and getting very sick very quickly.

    This seems to be a little different than earlier, with patients who would languish a little while at home or languish in the hospital, then get sick. We're now seeing younger people who really have no business getting this sick being dramatically ill very quickly.

  • Amna Nawaz:

    So, what does the crisis standards of care mean for all those patients with other critical needs?

  • Dr. Ivor Douglas:

    Yes.

    And I think that, for our patients, they may — it may be utterly opaque. The point of this is that crisis standards of care apply, not just to the specific individual cares of COVID patients, but our ability to leverage additional resources, dialysis machines, additional staff and expertise, to bring to the bedside care of all patients.

    The key issue about Colorado's crisis standards of care is that, while there has indeed been an activation, it's done in a layered fashion. And the most important initial phase of this is the crisis standards around staffing.

    What this does is open a channel for us at the federal level to leverage additional FEMA support, for example, additional expertise to do front-line care, supplement services, and, most importantly, allow us to distribute patients in a more rational, balanced fashion within the state and not require a very strict adherence to ratios of certain patients to certain providers.

    At the end of the day, we have to preserve our work force. While we're committed to the care of every patient, we have lost large numbers of highly expert and professional people. It's true we're tired, but, at the same time, we have got to be there for tomorrow's patients as well.

    And if we burn through everybody, there is no future and there is no cavalry coming. So we have got to do this in an affordable, careful way.

  • Amna Nawaz:

    Dr. Douglas, help me understand.

    Statewide, Colorado has a relatively high vaccination rate. So why are you seeing this surge right now?

  • Dr. Ivor Douglas:

    The answer is, we don't really know.

    But the likely answer has a lot to do with Delta virus, and the fact that 70 percent vaccination rate is just not enough for herd immunity, part one. Part two, there are pockets of Colorado that are doing phenomenally well, where there's great pride in what our state has achieved, where immunization rates are far above 70 percent, particularly amongst the elderly.

    But there are pockets where vaccination rates are much lower, where adherence to social distancing and mask requirements are zero or next to zero, and where cohorting, particularly now very worryingly going into the Thanksgiving and holiday period, represent a tremendous risk to us, not just from COVID, but, very worryingly, with an influenza season on our front door, the real risk and concern that we will have a confluence of undervaccinated folks for COVID, unvaccinated people for influenza, and we're already at the top of our resource availability.

  • Amna Nawaz:

    Dr. Douglas, briefly, now we know there are new federal vaccine rules, the vaccine now available to millions of more people, including younger Americans.

    What kind of impact do you think that will have on what Colorado is evening?

  • Dr. Ivor Douglas:

    Oh, we are tremendously excited about this.

    While the likelihood that young people will get very severe disease from COVID is lower, the benefit is that, with young people, under-12s particularly, getting vaccinated is, it protects the entire community and particularly around the holidays.

    Because the likelihood of asymptomatic carriage is higher amongst kids, the likelihood that they will not transmit to older relatives who may have waning immunity from earlier vaccination or, unfortunately, if you're unvaccinated, goes down.

    This is probably the most important public health balance to the work we're doing at the level of personal care in the hospitals right now.

  • Amna Nawaz:

    Dr. Ivor Douglas joining us tonight from Denver Health.

    Thank you for your time, Doctor. And thank you to you and your staff for everything you do.

  • Dr. Ivor Douglas:

    Thank you and your team. Thank you for allowing me to join you. Have a good evening.

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