Louisiana’s ongoing surge of COVID continued to escalate over the weekend, with an additional 6,225 cases reported since Friday, marking one of the largest increases in case counts since the pandemic began. Though vaccinations are also increasing, it’s not enough to stem the flood of patients into hospitals, according to weary health care workers now well into their fourth surge in the past 18 months.
“It’s so fast we can’t really grasp it,” said Dr. Catherine O’Neal, chief medical officer at Our Lady of the Lake in Baton Rouge and associate professor at LSU Health New Orleans School of Medicine. “I don’t know where we’ll be in three days, but I’m afraid we’ll reach crisis standards of care if we don’t make some changes quickly.”
Hospitals request crisis standards from the state when there are not enough resources — including staff — to care for patients. The last seven days saw a total of 15,282 cases, a weekly average higher than any other time except the first few weeks of January.
Hospitals in other states are pushing forward with requirements
OLOL stopped taking transfers two weeks ago, but there are still too many patients to keep up with the normal business of surgery. The 800-bed hospital, Louisiana’s largest standalone facility, started limiting elective surgeries on Monday, harkening back to the early days of the pandemic. Those who do need care unexpectedly may face waits. The emergency department had 19 people waiting for a bed on Monday.
“We’re the biggest hospital,” said O’Neal. “If there’s no room at our inn, there’s no room at anyone else’s inn.”
On Monday, LCMC Health also paused elective surgeries indefinitely in order to redeploy staff to critical care units, according to a representative. The pause includes surgeries at University Medical Center, Touro Infirmary, New Orleans East Hospital, Children's Hospital New Orleans, East Jefferson General Hospital and West Jefferson Medical Center.
Ochsner Health, Louisiana's largest health system, has not instituted a widespread halt on surgeries at its 40 hospitals, but individual facilities may reduce or postpone non-emergency surgeries requiring overnight stays based on resources and staffing, according to a representative.
St. Tammany Health System also said elective surgeries that require an inpatient stay during the next week would be rescheduled because of a "significant demand on bed capacity at its Covington hospital."
Statewide, hospitalizations have increased by 213 since Friday, bringing the total across the state to 1,221, according to a noon update from the Louisiana Department of Health.
Patients on ventilators increased by 31, bringing the total to 113. The fast-paced rise in cases and patients sick enough to be hospitalized reached levels that remind providers of winter’s deadly surge, before vaccines had a chance to blunt infection rates for some of the most vulnerable, seniors in particular.
“We’re seeing our admissions at rates we saw in that winter time frame,” said Dr. Julio Figueroa, chief of infectious diseases at LSU Health New Orleans School of Medicine. “The major difference between now and winter is that we’re seeing a lot more younger people, and younger people in the ICUs with severe disease.”
“Those younger people are also dying,” said Figueroa. “The vast majority of those individuals are unvaccinated.”
As COVID-19 cases surge in Louisiana among unvaccinated people, the inevitable is occurring: some vaccinated people are also getting sick.
At the same time, new vaccinations more than doubled over the last week, an indication that the worrisome spread fueled by the delta variant is convincing more people to get the shot.
Over the last seven days, there were approximately 9,622 new vaccinations daily, a huge spike from the first two and a half weeks of July, when the daily average was 4,366.
But new vaccinations are not enough to make up for the majority of Louisiana residents who are not immunized. Only about 36% of the population is fully vaccinated, much lower than the national rate of 49%. Models from the COVID-19 Scenario Modeling Hub, made by scientists who advise the Centers for Disease Control and Prevention, predict the nationwide surge will last through mid-October.
In low-vaccinated areas like most of Louisiana, things may be worse.
“When September starts and schools are back … that’s when, if we still have delta going around, or God-knows-what next variant of concern that either evades the vaccine or is more contagious or more lethal, that’s when it’s really going to be a terrible surge,” said Figueroa.
Each vaccination helps, although it takes between two and six weeks for vaccines to reach full efficacy, depending on the shot given.
“If you look at the vaccine studies, by 14 days you had an antibody response and that antibody response will help keep you alive and out of the hospital,” said O’Neal.
Health experts emphasized that vaccination could tamp down the pandemic and get Louisiana out of the surge faster.
“That is our most important weapon to finally get ahead of this pandemic,” said Dr. Lucio Miele, who has been part of the genome sequencing effort in his lab at LSU Health New Orleans. “It looks like people are beginning to come around. And that could be the game-changer.”
The delta variant makes up 83.7% of cases in Louisiana and neighboring states, according to the CDC's latest update.
The vaccines are still effective against the delta variant. Though there have been more breakthrough cases in vaccinated people — inoculated people can still contract and spread the virus, though it is less likely — the vaccines are effective at preventing severe illness and hospitalization. About 93% of COVID-19 cases reported to the state are among unvaccinated people, Louisiana state health officer Dr. Joe Kanter said at a press conference Friday.
The Louisiana Department of Health recently changed its guidance on who should be tested. Now, both unvaccinated and vaccinated people should be tested immediately after notification of exposure and again after 5 to 7 days. Previously, LDH recommended following guidance from the Centers for Disease Control and Prevention, which does not recommend testing for vaccinated people if they have no symptoms.
Last week, Gov. John Bel Edwards and New Orleans Mayor Latoya Cantrell both issued indoor mask advisories for all residents, regardless of vaccination status. Unlike a mandate, advisories do not trigger enforcement action from local or state government.
Staff writers Jeff Adelson, Marie Fazio and Sara Pagones contributed to this report.
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