The Future of Covid Looks Bleak if We Don’t Act Now

The coronavirus pandemic is the worst today than it has ever been in some states, such as Florida, where a lethal combination of a large unvaccinated population has collided with the resistance of politicians to mandate simple lifesaving interventions and extremely popular media personalities like Joe Rogan megadosing misinformation about vaccines to millions of listeners.

How bad things are today depends on where you live and how many of your neighbors are vaccinated. “For those who are unvaccinated, things are pretty grim,” said Tim Wiemken, an associate professor at the Saint Louis University School of Medicine.

The point of flattening the curve—remember that?—was to make sure hospitals were not overwhelmed, but this public health lesson has been quickly forgotten.

In Mississippi, which has the lowest number of people in the U.S. who are at least partially vaccinated, there are no intensive care unit beds in 20 of the state’s top hospitals. In Texas, two hospitals have closed their emergency rooms due to a Covid patient surge.

Kids are bearing a greater burden of the Delta variant’s spread, as child hospitalizations are the highest they’ve ever been. In Tennessee, children’s hospitals are nearly full and the median age of hospitalized kids in Louisiana has dropped from 16 to 12. And while some may point out that children do much better than adults with coronavirus, here is what a child in the ICU with Covid-19 looks like.

Florida accounts for 1 out of 5 new Covid-19 cases in the United States. Think about this: more people are getting Covid in Florida today after we have vaccines, than before. It also has more hospitalizations than last winter, and the number of people dying has increased 211% in two weeks. The state has placed an emergency request for 300 ventilators. Meanwhile, Florida governor Ron DeSantis has told school districts they will face “financial consequences” if they require students to wear masks. That’s a policy that has already seems to have produced the obvious, sad conclusion: two days into Palm Beach County’s school year, there are 51 new cases and 440 students have been asked to quarantine.

“Things are really bad,” said Kartik Cherabuddi, MD, an infectious diseases doctor at the University of Florida. “The hospital and the emergency rooms are bursting at the seams. People are in hallways. We are struggling with the number of nurses available.”

At University of Florida Health, the surge of Covid-19 patients means they cannot take emergency patients from smaller hospitals, which Dr. Cherabuddi said is “unheard of.” Elective non-urgent surgeries are being canceled due to the need for surgical intensive care units to care for Covid-19 patients.

The emotional toll on health professionals has never been greater, as they must navigate difficult conversations with the families of patients who are intubated, now often because they refused a vaccine that could have prevented their suffering and, in some cases, kept them alive. “You don’t want to add to the guilt to the family and patient, so you find a way to say it’s not your fault, it’s all this misinformation out there. You try to let them not feel it,” said Dr. Cherabuddi.

But even the experience of seeing a loved one hospitalized with a tube down their throat fighting for their life is not enough to convince some families to get vaccinated. “They are pleading for experimental therapies, but still refusing to take the vaccine,” says Dr. Cherabuddi. “When you have that person right in front of you and is sick, it is something that none of us can comprehend.”

Will Covid cases at least die down?

The worst of the current surge may peak in mid-October, when three times as many people will be dying every day from Covid-19, according to the COVID-19 Scenario Modeling Hub, a team of researchers that works with the CDC

While some models might predict the current surge to die down by January 1, that depends on no new variant emerging. “If we have a new mutation, an escape variant, then all bets are off,” said Ali Mokdad, PhD, a professor at the Institute for Health Metrics.

Each infection is a chance for the virus to mutate, become more infectious, and potentially lethal, especially for children and others who are unable to be vaccinated. “It is a ticking time bomb for variants. This is viral evolution 101. It is going to happen,” says Tim Wiemken, PhD, an associate professor in the division of infectious diseases, allergy and immunology at the Saint Louis University School of Medicine.

Who knew the end of coronavirus hell would depend not on whether scientists could make the vaccine but whether people would take it?

How bad the winter will be depends on how many of the unvaccinated are vaccinated. “We could have a tough winter, or the current surge, combined with more vaccination might lead to a milder winter,” said Stefano Bertozzi, MD, PhD, a professor of health policy and management at the UC Berkeley School of Public Health.

What is for sure is that, in areas of low vaccination, things will get worse before it gets better. “We have not plateaued yet,” said Sarah George, MD, an associate professor of infectious diseases at Saint Louis University.

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