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Keeping seniors out of hospital best way to fight COVID-19

STORY BY LISA ZAHNER (Week of January 14, 2021)

The most important reason to get the COVID-19 vaccine into the arms of barrier island seniors as swiftly and efficiently as possible is that, of all the tools available in the fight against the virus, vaccination is the best way to prevent serious illness and death.

Local residents age 65 and older make up only 23 percent of total positive COVID-19 countywide cases, but those same patients account for 65 percent of hospitalizations and 84 percent of deaths.

Fewer than 5,000 Indian River County residents have been vaccinated so far, but every person who does not land in the emergency room or the ICU helps relieve pressure on the county’s two hospitals.

During the summer COVID-19 surge, the daily count of hospitalizations here fluctuated from the mid-teens to the mid-20s. On Dec. 30, that number topped out at 55 current hospitalizations – with 34 of those patients in the two COVID-19 units at Cleveland Clinic Indian River.

Even with those high numbers, Cleveland Clinic Indian River Hospital spokesman Scott Samples said “we continue to have capacity to admit COVID-19 patients.”

Steward Sebastian River Medical Center did not respond to questions about whether the North County hospital is admitting COVID-19 patients or continuing to transport them to Melbourne as was done over the summer.

Emergency room visits for COVID-19 illness declined from the peak of 75 per week over Christmas to 35 last week.

As of press time, 38 people were hospitalized countywide, but the reduction in that number was likely due in large part to the record 16 local deaths reported over the past week, plus six deaths the week after Christmas.

A report published by the Centers for Disease Control and Prevention in November stated that, nationally, the average hospitalization time for COVID-19 patients was eight days and that 68 percent of patients admitted to the hospital for COVID-19 had to be placed on a ventilator at some point during their stay.

It’s not uncommon for COVID-19 patients who require ventilator care and survive to be hospitalized for weeks before they are well enough to be discharged. That makes it tough for hospitals to reduce the “current hospitalizations” number reported daily by the Florida Agency for Health Care Administration once that number starts climbing.

Another compounding factor related to patients hospitalized with severe COVID-19 disease is that 9 percent needed to be re-admitted to the same hospital within two months, the CDC found in studying five months of patient data.

When the number of COVID-19 patients in hospitals increases, the number of available intensive-care unit beds decreases. When the virus was spreading more slowly this fall, 50 percent to 65 percent of ICU beds typically were open in Indian River County.

Over the past three weeks, the available ICU bed percentage in the county has gone as low as 20 percent or even 15 percent. At press time Monday, 18 beds or 40 percent of ICU beds were available countywide.

The high number of COVID-19 patients stretches hospital staff at a time of the year when hospitals typically see increased demand from Vero’s seasonal population surge.

Despite the record-high hospitalization numbers, neither Indian River Emergency Services Director Chief Tad Stone nor Indian River Shores Public Safety Department Captain Mark Shaw said their agencies have seen an uptick in ambulance calls related to COVID-19 patients.

“COVID call volume is not what it was six to seven months ago,” Stone said, adding that ambulances have not seen any significant wait times at emergency rooms, either.

Shaw said “we may have transported one or two over the last month ... I see the [hospitalization] rates are up, but so far we have not seen an increase call wise.”

Hopefully, this means patients are seeking medical attention earlier in the disease, when a loved one can drive them to the hospital for treatment, and are not waiting until it is a 911 emergency.

Paramedics have joined hospital staff in getting vaccinated, so they are protected from the virus when they do need to respond to a suspected COVID-19 medical call.