Sedalia is sometimes a step behind the rest of the nation; that's also been the case with the COVID-19 virus. The virus hit the area hard last year, but months later than neighboring states. This year the omicron variant is also hitting the area later than others.
Dr. Philip Fracica, Chief Medical Officer at Bothwell Regional Health Center, says Sedalia is still dealing mostly with the delta variant and is still behind the rest of the country this season.
“I would kind of characterize it as an extension of the delta wave,” Fracica said. “Delta was still going strong when we had the Thanksgiving and Christmas holidays. Last week the incidents of omicron in the Kansas City metro area was about 30% of the cases, it may be closer to 50% now, but we typically lag several weeks behind so the recent activity that we've seen is likely not mostly omicron, we're still seeing significant number of cases with delta.”
This renewed infusion of energy to the delta wave will likely merge and transition into more of the omicron variant, a more transmissible disease with milder symptoms.
So how is Bothwell managing with the extended waves of COVID?
“Less beds, and I'd say struggling to keep her head above water,” Francica said. “What is the major problem is there's just too many patients coming in. Last winter we were at a point where we had every ICU bed filled with a COVID patient on a respirator and we were at our limit of our capacity of taking care of critically ill patients. We are not in that situation, we’re in an interesting but different situation right now.”
Currently, Fracica said, the hospital has only four of five ICU patients with COVID and only two on ventilators. The problem is not necessarily beds, but the staffing to cover each bed. Medical staff aging out and retiring after a year of draining work, and shortages of staff due to high pay offered to temporary workers willing to travel the country.
“That has actually given some people lots of additional income that they weren't expecting to get,” Fracica said. “It sort of paradoxically has made matters worse because now they earned as much in a year as they were expecting to earn over the next two or three years so they can retire early.”
Low staffing issues take a toll on the people who do show up.
“Every day you're scrambling to call in people on overtime or extra shifts,” Fracica said. “It just makes everything that you're doing more difficult and more stressful. Respiratory therapists and nurses and laboratory technicians, just about anything that is a skilled occupation within the hospital, we're having challenges with.”
Other hospitals in the area are full and Bothwell gets daily requests from hospitals to accept transfer patients. Unfortunately, there is a balance as too many full beds mean local patients may suffer.
“We get calls requesting transfers of patients in central and western Kansas, Nebraska, and Iowa,” Francica said. “Places that never have called us and they tell us that we're the 20th or 30th place that they've called.”
Last year Bothwell staff was well-rested and prepared as COVID came late to Sedalia. This year things have changed.
“This year’s a different situation,” Fracica said. “Now we’re kind of battered and exhausted from dealing with this for over a year now. Like everybody else, we'd hoped this was going to be over and it just seems to be going on and on.”
Fracica sees the effectiveness of monoclonal antibodies and other treatments early in cases of COVID most helpful and recommends seeing your physician as soon as possible.
“You can give it to patients immediately and get them up to very high levels of antibodies and immunity by using these engineered cloned antibodies that are specifically directed against the spike protein and that can pretty much nip it in the bud,” Fracica said. “The two primary workforce monoclonal antibodies that have been available, neither one of them are particularly effective against omicron. So the government distribution process for those monoclonal antibodies has basically been suspended. We're scrambling for our last few doses.”
Valuable doses that still prove effective against delta. And supply chain issues affect Bothwell in other ways.
“Last week we had more of the monoclonal antibody but didn't have the saline to be able to mix it up and then dilute it,” Fracica said. “That's just kind of symptomatic of an ongoing supply chain limitation.”
Fracica urges vaccinations and booster shots to keep a high level of antibodies.
“If you top off and you have a high level of antibody protection that will be a significant factor in preventing serious illness,” Fracica added. “The vast majority of people that we're seeing that are hospitalized and certainly critically ill are the ones who haven't been vaccinated.”