COVID hospitalizations likely to keep rising in NC, Duke infectious disease doctor says

·3 min read

The number of people hospitalized with COVID-19 in North Carolina has more than doubled this month, and it will likely continue to go up over the next two weeks, according to an infectious disease expert at Duke University.

Rising hospitalization is one of the statistics that have shaken public health officials and brought renewed efforts to curb the spread of the coronavirus. They include mandatory vaccinations for state health care workers and at many hospitals, and a recommendation from the Centers for Disease Control and Prevention that people again wear masks indoors, even if they’ve been vaccinated, in areas where the virus is flaring up.

But those steps will take a while to blunt the rise in hospitalizations, says Dr. Cameron Wolfe, an associate professor at the Duke University School of Medicine. It can take 10 to 14 days for an infected person to end up in a hospital, which makes today’s hospitalization numbers an indication of who was getting infected in mid-July.

“It is baked into the system that that number is going to go up for at least a couple of weeks,” Cameron said during a press conference Thursday. “All of those people who have been exposed yesterday, for example, are not likely to get sick for quite a few days, and not likely to get sick enough to need the hospital for further time.”

The number of people hospitalized with COVID-19 across the state has risen from less than 400 in early July to 1,091 on Thursday, according to the N.C. Department of Health and Human Services. That’s the highest number since early May.

State health officials say more than 90% of those patients have not been vaccinated against COVID-19. Hospitals also report that large majorities have the delta variant of the virus, which is more contagious than earlier versions.

Wolfe said people with the delta variant seem to get sick a couple of days sooner after being infected than earlier COVID-19 patients and are more likely to experience shortness of breath.

Does delta variant prey on the young?

Hospitals also report that COVID-19 patients are younger now than during the pandemic’s peak last winter. In January, those age 60 and older accounted for about 70% of people hospitalized with COVID-19 in North Carolina. Now hospitals say patients are more likely to be in their 30s, 40s or 50s.

That may simply reflect which groups are more likely to be vaccinated. About 84% of people 65 and older are fully vaccinated in North Carolina, compared to about 57% of adults 18 and older overall, according to DHHS.

But doctors are starting to consider that the delta variant is behaving differently — in ways that could make younger people more vulnerable, Wolfe said. He said he’s seen relatively young COVID-19 patients without underlying health problems who need hospitalization.

“So I think there’s something that’s changing there in terms of severity, independent of the fact that the young tend to be the unvaccinated,” he said.

Wolfe said hospitals are better prepared for a surge in COVID-19 patients than they were last year. They have good supplies of respirators, gowns and other personal protective equipment, as well as oxygen and medications that coronavirus patients need.

And he said Duke has changed its staffing system to increase flexibility and try to prevent doctors, nurses, therapists and others from getting burned out.

But seeing a resurgence in COVID-19 can take an emotional toll on hospital workers, Wolfe said. In some ways, the availability of vaccines makes it worse.

“It is absolutely a fatiguing element to see patients in front of you when you know that there was something that that person could have done to avoid that situation. That is hard to face,” he said.

“To see large numbers of unvaccinated people in the hospital, really struggling and often at that point in their decision-making quite regretful for the situations that they’ve come through and now find themselves in, that takes a toll.”

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