Doctors at Marian Regional share concerns over COVID surge fueled by delta variant, youth spread

Aug. 4—Following two months of widespread access to COVID-19 vaccines in Santa Barbara County, health-care officials had hoped that they wouldn't have to face the devastation of another COVID-19 surge.

However, just under half of the county population remains unvaccinated as of August, and health-care workers are seeing cases and hospitalizations spiking once more as the highly transmissible delta variant spreads in what officials are calling a "pandemic of the unvaccinated."

To understand the impacts of the most recent surge, the risk of spread in young adults, and the changing landscape of variants and COVID-19 immunity, the Santa Maria Times spoke with the top physicians at Marian Regional Medical Center in Santa Maria.

Answering questions are Dr. J. Trees Ritter, medical director of infectious disease for Dignity Health Central Coast; Marian Regional Chief Medical Officer Scott Robertson; and Marian Regional Medical Director of Pathology and Clinical Laboratory Dr. Kevin Ferguson.

Question: Can you describe the impacts of the recent surge in COVID-19 cases on the hospital and on its health-care workers?

Robertson: When we saw the vaccines become more plentiful in the spring, we really pushed had to get everyone who wanted a vaccine available for a vaccine. We saw the impact of that in our communities, in our cases dropping just precipitously through April, May and the beginning of June. I think many of us on the health-care side said, 'this could be the end, if we keep up and continue this work.' But, what we found is there is a segment of the population that is very hesitant to get the vaccines, and it's big enough to continue to let the virus replicate in the community. For so many of us, to see us taking a step back, it's incredibly heartbreaking.

Ritter: It is almost like we're dealing with the PTSD of previous surges. These are competent, trained professionals who I have no doubt will step up and do their job exceptionally, but it's unfortunate that we're seeing this again. It remains mostly unvaccinated individuals. [Hospitalizations are] increasing but it is nowhere near the volume we were seeing in January. At our worst, we may have had 30 ventilated patients in our ICU that normally has 22 available beds. We're not there yet, but if you look at it relative to a month ago or six or eight weeks ago, we're now five times where we were before.

Question: Cases appear to be spiking among younger age groups more than in the past. Along with lower vaccination rates, what might be some of the reasons for this?

Ritter: Some of the other problems with this pandemic is that, from the beginning, it was described as a viral illness that young people were unlikely to die from or get very sick from. People had that ingrained in them, that it's not their problem. But unfortunately, we live in a global society, where we know that the unmitigated infection through any population has the potential to develop resistance and further variants that could potentially set all of us back to square one. Especially with the delta variant, which I fear will spread within that community like wildfire as soon as the kids go back to school. I think this belief that kids will be on campus no matter what is somewhat delusional. I think that the goal is on-campus, but there will be outbreaks, especially when you have such low vaccine rates within that population.

Question: Can you describe the process of variant tracking at Marian Regional?

Ferguson: That effort has been ongoing for several months. We're currently sequencing probably five [samples] per day, and we focus on anyone who's an inpatient ... and any vaccine breakthroughs, so any symptomatic patients who have been previously vaccinated. The idea there is we're not only looking for variants of concern, of which we have found several, but also potential variants of high consequence, which we have not seen yet. Most of what we're seeing now, again, is the delta variant, and that's our biggest concern.

Question: Will the virus continue to adapt and become more transmissible as we go along?

Ferguson: Yes, the virus will continue to evolve, and we know that we will be seeing new variants. Not every new variant is necessarily stronger, some are weaker, but realistically speaking, I think we will continue to see variants of concern.

Ritter: Right now our immunity is twofold — one immunity from vaccination and the other from natural infection. However, we've seen so much mutation between the original virus and the delta variant that the immunity provided by previous infection by a previous variant is no longer protective against the delta variant. You could get COVID last summer and then you could get COVID this summer with the delta variant, unless you get vaccinated.

Question: What have been some of the advancements over the past year for COVID-19 therapeutics?

Ritter: We're still not in a great place when it comes to overall therapeutics for COVID. What you would want — and this would be able to end the pandemic as well — is an inexpensive and safe, meaning no side effects, medication that could be given ideally in pill form or intranasal form that would interrupt the viral replication cycle and prevent people from progressing to disease. Unfortunately, that does not exist, and the only approved antiviral is remdesivir, and there is still debate about how effective it actually is.

Question: What are the current vaccination rates among health-care workers at Marian Regional?

Robertson: As we look to putting the process in place to complying with state and governor's order to have all health-care workers vaccinated or be subject to routine testing, we're assimilating data on our own employees to try to identify those who are unvaccinated, and currently, we estimate at least 90% of Marian Regional Medical Center employees have received the vaccine.

Editor's note: Answers have been edited for length and clarity.