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Appalachia Health News tells the story of our health challenges and how we overcome them throughout the region. 

Omicron Could Peak Soon In W.Va., But Staffing, Therapies In Short Supply

Clay Marsh.jpg
WV Governor's Office
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West Virginia's Coronavirus Czar Clay Marsh speaks at a virtual press briefing with Gov. Jim Justice on Oct. 23, 2020.

West Virginia’s coronavirus czar Dr. Clay Marsh said COVID-19 cases should peak next month.

“We anticipate over the next week to two weeks, we will see omicron be the majority, if not basically all the cases of COVID-19 in West Virginia,” Marsh said. “We then anticipate another five to 10 days afterwards we will see the number of cases peak.”

After a peak in cases, hospitalizations and deaths will continue to rise for a few more weeks.

COVID-19 cases in West Virginia dipped over the holidays but have soared since. Average daily cases have tripled since Christmas. Last week, the state broke a record in most new cases in a single day at 4,757 on Friday.

The virus is spreading fast across the nation. Northeastern states and metropolitan areas were hit first by the highly infectious omicron variant.

Marsh said right now only half of COVID-19 cases in the state are from omicron.

“We are just behind the rest of the country, the urban parts, by about two to three weeks, but we're starting to feel that as well,” Marsh said.

Hospitalizations are also rising. There are 829 West Virginians in the hospital with COVID-19. That’s 252 more patients than there were on Christmas Day.

West Virginia reached a record number of COVID-19 hospitalizations last fall at more than 1,000.

“We did see one model that has, by the end of January, West Virginia hospitals hitting a new peak for the pandemic, well over 1000 patients,” said West Virginia Hospital Association President Jim Kaufman.

International research shows that omicron causes less severe illness than delta did. But with more people expected to get sick with it overall, the number of people in hospitals is still on the increase.

“We're just seeing such a incredible number of people being infected, including people that are not vaccinated or not boosted that you're seeing breakthrough of the impact of the new variant of COVID-19 is either directly leading people to be hospitalized, or it is exacerbating pre-existing problems and driving people to be hospitalized,” Marsh said.

Hospitals

Before the new year, Kaufman and hospital administrators sounded the alarm that omicron would strain healthcare providers.

“I feel like a broken record, because I've been saying the same thing for weeks and it's coming true,” Kaufman said.

Most hospitals are operating at a “crisis level” of care. At that point, everyone who needs care will receive it, but not at the standard providers would strive for during normal times.

“Much of this is being driven by issues related to staffing and the number of bed-side caregivers who are out due to COVID,” said WVU Spokesperson Angela Knopf.

Any treatment that is not urgent is likely to be delayed, Kaufman said. Elective procedures can be postponed. Patients can wait for hours at emergency departments if an injury is not life threatening. When emergency rooms are backed up, emergency responders might have to hold patients in ambulances longer than normal, keeping them from hitting the streets again to serve more people.

While smaller hospitals often transfer sicker patients to larger systems, that is becoming more difficult. Kaufman said. To relieve some of the strain, , specialist doctors at larger systems are offering telemedicine to patients at smaller hospitals.

“What I really do appreciate about West Virginia hospitals is they're all working together,” Kaufman said.

Kaufman said providers are troubleshooting on a case-by-case basis. Doctors are deciding what procedures can be postponed, rather than a blanket ban on elective procedures the state saw in the early days of the pandemic.

Still, Marsh said delaying care can cause serious health impacts for West Virginians who suffer from a number of illnesses.

“A lot of people are getting backed up on the care for their heart disease or cancer,” Marsh said. “There's downstream, more chronic implications of what's going on now for health in our country and our state.”

Staffing

Every month that the pandemic goes on, more healthcare workers are leaving their jobs. Last August in West Virginia, there was enough staff to care for about 5300 hospital patients. That number dropped by 550 beds just last month.

“We focus on nurses because they're the backbone of the healthcare delivery system, but it's every healthcare professional,” Kaufman said. “We're seeing shortages of respiratory therapists, technicians, environmental services, cafeteria staff, nutritional services, and it’s impacting the entire operation.”

Kaufman attributes this loss to emotional and physical burnout.

“Numerous hospitals are working with stress managers, and they bring in therapy dogs, and they're really looking across the board of how we take care of our caregivers, so they can care for their community,” Kaufman said.

The West Virginia National Guard is offering up 350 of its members to help out at hospitals.

“It's a resource to help relieve pressure to allow medical staff in the hospitals to be able to focus more on direct patient care,” said retired Maj. Gen. Jim Hoyer, who leads the state’s COVID-19 response.

The service men and women will not be administering care. Instead, they will screen patients and guide them as they enter and exit the hospital.

“The highly trained doctors, nurses, physician's assistants, nurse practitioners, respiratory therapists that are in the Guard are already working in hospitals,” Hoyer said of the military-meets-civilian personnel. “If we pull all them back into uniform and put them back out, we're taking them from other places.”

Hospitals must ask the state for these resources. Both Charleston Area Medical Center and Grafton City Hospital are guaranteed some help.

The governor also allocated millions of dollars to further fund nursing programs in the state, though the impact will take years to realize for a crisis that is happening right now.

Treatment

When Gov. Jim Justice came down with COVID-19, he received a potentially life-saving dose of a monoclonal antibody treatment. But these and other therapies are in short supply.

Marsh said West Virginia expects to receive about 250 doses a week of a monoclonal antibody and 150 doses a week of the Pfizer antiviral pill, though those allotments could change every week.

Hoyer said the federal government is phasing out shipments of another monoclonal antibody treatment because it might not be as effective against the omicron variant.

“We're like ‘Whoa, stop. We're not there yet.’ We're usually three weeks behind. So we still need antibodies that address the delta threat,” Hoyer said.

He and Marsh also said that the Pfizer pill cannot be taken with certain other medications.

“You get a lot of publicity out there now about ‘Hey, we're going to save the day with this Pfizer pill,” Hoyer said. “The Pfizer pill cannot be used in conjunction with a lot of different other medications. One in particular, are statin drugs, and statin drugs are used for cholesterol and heart related issues. And what do we in West Virginia have a lot of? We have a lot of West Virginians on statin drugs, the doctors couldn't even prescribe the antiviral to.”

Appalachia Health News is a project of West Virginia Public Broadcasting with support from Charleston Area Medical Center and Marshall Health.


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