BISBEE — As the number of delta variant cases of COVID–19 continue to climb, the county health department and local medical professionals continue to press the importance of getting vaccinated to prevent serious illness or death.
In Friday’s work session of the county Board of Supervisors, the Cochise Health and Social Services pandemic team and Copper Queen Community Hospital Chief Medical Officer Dr. Edward Miller pressed the importance of getting vaccinated to prevent the illness, which has claimed 321 lives since the pandemic began last year. Of those, 14 have been in the past two weeks.
Miller pointed out the influx in unvaccinated people with the delta variant is taking a toll on vaccinated people who have underlying diseases that cannot be treated locally. Two Copper Queen patients with critical care needs were unable to be transferred to a hospital in state or even out of state. They died because intensive care units had no beds available.
The Arizona Department of Health Services has a surge phone line dedicated to handling the transfer of COVID–19 patients in need of specialized hospitalization, said Alicia Thompson, CHSS director. The state allows only those who are unvaccinated to get on the list for transport.
Miller said, “At the peak of the January surge, most patients were COVID patients and the other third were non–COVID critical care. We have the opposite of that going on in the state now where only a third of intensive care unit beds are occupied by COVID and two thirds are non–COVID-19 related cases.”
He said CQCH can handle most of the patients, but those in need of a ventilator or other specialized critical care needs now face a problem.
“We have contacted the state and made our request to open the surge line for transfers for all patients, but they denied us,” Miller said. “Now, patients are being denied that level of care throughout the state. Ironically, they have not followed health guidelines to get people vaccinated.
“People who have not been vaccinated are getting preferential care in ICUs throughout the state. And those who have been vaccinated and are afflicted with something else and don’t have a COVID diagnosis have to wait. It can take four to five hours on the phone to find a hospital that can take the patients. And, that has been unsuccessful at times and has resulted in deaths. A hospital in Green Valley experienced two deaths due to the inability to transfer people.
“The equitable thing is that vaccinated and non–vaccinated people should be given at least equal access to this care and not ration things in favor of non-vaccinated. For me as a physician, this has been particularly bothersome because this surge is totally optional and needless. Mask studies show masks are 33% effective in reducing the spread of COVID-19 cases. The vaccine is 93% to 95% effective in reducing illness and death.”
He said the state claims there is a nursing shortage. Miller claims that is a completely false argument. The state gives COVID cases preferential treatment, so patients with congestive heart failure, advanced cancer cases or other critical care needs cannot be transferred to a hospital that could help them.
Miller also touched on vaccine hesitancy and said 87% of CQCH’s 350 staff members are fully vaccinated with half of those being for “irrational” decisions.
“I had a patient dying who said he did not have COVID. He didn’t believe it. He didn’t want to be transferred,” he told the supervisors.
Supervisor Ann English said the border counties sent a letter to the state asking for equity in hospital transports. The answer was “no.”
She said the Benson Hospital and the Northern Cochise Community Hospital in Willcox may not have the same problems.
Miller said those two hospitals are under the umbrella of Tucson Medical Center. If the state were to call either of them, the state may be told there’s no problem.
“They’re not seeing it as a community-wide problem,” English added. “We should call the other hospitals to see if they’re having problems with transfers.”
Thompson reported on the breakthrough cases in the county, those vaccinated who have the delta variant, which is 213 since February. In August, in 807 cases 80 were people who had been vaccinated. In September, there were 90 breakthrough cases out of 680.
Dr. Erik McLaughlin, CHSS medical director, provided an overview of the three variants in addition to delta now effecting people in the U.S. – mu, lambda and one yet to be named known as variant C.1.2.
Mu was found in Colombia and has spread to 43 countries. It is alarming as it can elude the antibodies formed from the vaccines, he said. The good news is cases in the U.S. are less than 0.2%.
“It doesn’t spread easily,” he said. “But, it can elude the antibodies.“But, it hasn’t faced the Pfizer, Moderna and the Janssen vaccines yet. I’m optimistic mu will not be another delta.”
Lambda originated in Peru in December, but has spread to 40 countries, he said. It also carries mutations that “make it more infectious and resistant to antibodies. The mRNA vaccines, Pfizer and Moderna, do maintain a similar rate of efficacy against the lambda variant as with the original virus and the monoclonal antibody treatment has the same rate of effectiveness.”
C.1.2 began in South Africa in May and though it is on the decline there it has spread to 10 more countries, he said.
“A proactive approach is the best way to keep ahead of the new virus,” he continued. “So far the mRNA Pfizer and Moderna vaccines are the most effective for preventing and reducing the severity of infections.”
Delta is still playing a crucial role in Arizona’s positive cases.
“Delta is very contagious and 1,000 more times virulent than the original virus,” McLaughlin said. “But, the vaccines are doing their jobs.”
McLaughlin suggested people should look to the science and listen to the experts on COVID–19. The technology of the mRNA vaccines has been around for 40 years and as the virus mutates, it will be relatively easy to create a new vaccine to fight the latest mutations.
Miller reported, “In our hospital, the non–vaccinated spend about 10 days in the hospital, while those who have been vaccinated may only require a three-day stay.”
Thompson said the county was 47.6% fully vaccinated with 53% who have had at least one shot.
As far as booster shots go, Thompson said those were recommended for people 65 and older as well as those 50 to 64 years who have underlying conditions. The Moderna and Janssen vaccines used by the county have not been approved for booster shots by the Food and Drug Administration. Using another vaccine for the third shot is not recommended.
Dr. Daniel Williamson, county epidemiologist acting as the liaison to the schools, said there have been 352 cases in schools since the start of the year with 109 of those cases being logged in the past two weeks. Three children have been hospitalized.
People are encouraged to get tested, get vaccinated and maintain mask usage and social distancing. The doctors also recommended people get the regular flu shot as the fall and winter influenza is different from COVID–19. Testing and vaccinations are provided free of charge.