Omicron spawns rising COVID-19 cases in Polk County hospitals

When Polk County hospitals swelled with COVID-19 admissions during the delta surge in late summer, a heavy preponderance of patients had not been vaccinated against the virus.

The latest wave of the pandemic, propelled by the even more contagious omicron variant, is again driving up the numbers of patients who test positive for COVID — though not yet to the level seen during the peak of the delta swell.

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The Centers for Disease Control and Prevention’s COVID Data Tracker on Wednesday showed 515 hospital admissions in Polk County related to the virus for the week ending Sunday, a 74% increase from the previous week.

This time, however, the vaccination dichotomy is not as distinct as before.

In a weekly update, Lakeland Regional Health reported having 208 patients in its medical center who were positive for COVID-19 as of Monday at 5 p.m. Of those, 114 were listed as unvaccinated — 54.8% of the total.

By contrast, LRH officials consistently said that at least 85% of COVID patients were unvaccinated during the delta wave. But the shift doesn’t mean that vaccinations aren’t protecting people, said Dr. Hal Escowitz, Chief Quality and Medical Informatics Officer for Lakeland Regional Health.

“The fully vaccinated patients that are in the hospital generally represent a population that had multiple co-morbid conditions or significant underlying illnesses in general,” Escowitz said Wednesday. “And a fair number of those are some of the population we see that are here for other reasons. And I can tell you that in those here with critical illness in our ICU (intensive-care unit) population, the fully vaccinated population is very small.”

Indeed, of the 17 COVID-positive patients at LRHMC in intensive care as of Monday, 13 were unvaccinated. That amounts to 76.5% of the ICU patients. LRH reported that eight of the 10 patients needing mechanical ventilators had not received vaccinations.

Escowitz said LRH labels patients as vaccinated if they have received a two-dose regimen of the Pfizer or Moderna vaccine or one shot of Johnson & Johnson vaccine.

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National health officials, such as Dr. Anthony Fauci, Chief Medical Advisor to President Joe Biden, have emphasized that vaccinations won’t necessarily prevent infection. But they say inoculations substantially reduce the likelihood of severe symptoms or death.

Escowitz said his experience with patients at LRHMC corroborates that notion.

“There's no doubt, based on what we're seeing and what the experience is for my emergency department colleagues, that the unvaccinated patients are certainly the population that is sicker, that is requiring more care, that are here truly for traditional COVID-related ailments,” Escowitz said. “There's a much higher percentage of those.”

He added: “This variant, the vaccination seems to be less effective for (preventing) contracting the virus, but it is certainly holding true that it is highly effective against preventing severe illness.”

Escowitz said about 20% of COVID patients at the Lakeland hospital are being treated for some other condition and testing positive for the virus.

Vaccines make difference

The prevalence of unvaccinated patients remains stronger at Winter Haven Hospital, according to figures provided by BayCare Health System. The hospital had 102 patients positive with COVID as of Tuesday, and 69 of them — or 67.6% — were unvaccinated.

BayCare reported that Bartow Regional Medical Center had 20 patients with confirmed infections, and 11 had not received vaccinations. Winter Haven Women’s Hospital had three COVID-positive patients, all of them unvaccinated.

As evidence that the omicron variant appears to be less virulent than previous forms of the virus, only six of the Winter Haven Hospital patients were in intensive care and only three required ventilators. Two patients at the Bartow hospital were in the ICU, with only one on a ventilator.

Dr. John Davidyock, Chief Medical Officer at Winter Haven Hospital and Winter Haven Women’s Hospital, said the fully vaccinated patients requiring hospital treatment for COVID have underlying vulnerabilities.

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“I can tell you that even as of now, all of our patients in the ICU are currently unvaccinated,” Davidyock said. “So all of our patients that have come in that are vaccinated have multiple co-morbidities and are landing on our regular med-surge (medical-surgical) or telemetry floors, thankfully, which is also different, I think from the last wave, right? It was more so ICU where everybody was going first.”

COVID-19 infections have escalated in Polk County and throughout Florida in recent weeks. The Florida Department of Health reported 12,535 new cases for Polk in a weekly update issued Friday, a 66.6% increase from the previous week.

In Polk County, 64% of eligible residents (those ages 5 and older) have received at least one dose of a vaccine, compared to the statewide rate of 72%.

The CDC reports that 57.8% of Polk County residents are fully vaccinated. That figure does not consider booster doses, which the CDC recommends for everyone within five to six months of completing the initial regimen.

The CDC listed positivity rate for testing in Polk County at 38% as of Wednesday. The rate never eclipsed 30% during the delta surge. The CDC now rates community transmission as high for Polk and every other Florida county, with the local case rate 17 times higher than the threshold for the “high” category.

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Davidyock said vaccinated patients are much less likely to develop severe symptoms, and he said he has also noticed differences between patients who have received booster doses and those who haven’t.

“We do have a percentage that are also fully vaccinated without the booster,” he said. “And I can tell you, out of that comorbidity comparison, again, they have the same comorbidities of fully vaccinated and boosted, but they tend to be a little sicker if they did not get that booster. So they tend to end up, like, on our telemetry units. But again, they are still staying out of the ICU, though.”

While national reports suggest that more children are requiring hospitalization during the latest wave, Escowitz said LRHMC so far has not seen unusually high numbers of children with COVID.

Winter Haven Hospital does not have a pediatric unit.

Staffing shortages

While the latest COVID wave so far doesn’t seem to be producing severe cases at the same rate as the late-summer surge, the extreme infectiousness is creating hardships for medical centers.

Lakeland Regional Health is coping with high numbers of nurses and other employees out of work because of COVID infections, said Scott Dimmick, Senior Vice President and Chief Human Resources Officer.

“Given that the highly transmissible Omicron variant is prevalent in our community, like other organizations, Lakeland Regional Health has had a number of team members out related to COVID-19,” Dimmick said in an emailed statement. “At this point, we have been able to fill staffing gaps by offering extra shifts for interested team members and by contracting with staffing agencies. We have not had any widespread changes to patient care related to these shortages, but we are monitoring the availability of team members on a daily basis.”

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The virus is ravaging the staffs of local hospitals, said Ed Chambers, president of United Food and Commercial Workers Local 1625, which represents nurses and other health-care employees in Polk County.

“It’s just like COVID in the beginning; it’s overwhelming,” Chambers said. “They’re vaccinated and not getting as sick, but you’ve got to stay home for several days and you’re not feeling well enough to work. This is never-ending.”

The staffing shortages come amid a nationwide trend of nurses retiring, leaving the profession or shifting to jobs with outside nursing firms. Chambers said the COVID-related absences have forced hospitals to take drastic measures.

Nurses typically work three 12-hour shifts a week. Chambers said shortages have prompted the need for some nurses to work four or even five weekly shifts.

“They’ve had incentives for almost two years now, trying to get people to work extra shifts, trying to get people come out of retirement, go from part-time to full-time,” Chambers said. “Any way they can keep fresh nursing and staff on floors is what they’re trying, but it’s just very, very hard.”

Gary White can be reached at gary.white@theledger.com or 863-802-7518. Follow on Twitter @garywhite13.