delta variant
Dr. Dale Bratzler, OU Health's chief quality officer, speaks at a press conference on Tuesday, Aug. 17, 2021. (Screenshot)

In a press conference this morning, representatives of four of the state’s largest health care systems underlined the severity of the current COVID-19 outbreak and pleaded with Oklahomans to get vaccinated against the virus.

“All our resources are stretched beyond our limits. Our staff is burned out and wondering how we’ll survive yet another surge,” Dr. Bahar Malakouti, a neurohospitalist and stroke medical director at Mercy Hospital Oklahoma City, said at a joint appearance with personnel from OU Health, SSM Health St. Anthony and Integris Health this morning.

“This problem is currently unmanageable,” she said.

The press conference came as COVID-19 cases and hospitalizations in the state have spiked as the highly contagious delta variant of the virus has spread, bringing with it higher hospitalization rates than the initial variant that was spreading last year.

The daily average of new cases is 2,213, according to Dr. Dale Bratzler, OU Health’s chief quality officer, approximately the level they were at in November of last year, and the number of cases is likely to grow as the school year starts. Approximately 8,900 Oklahomans have died of COVID-19 in the course of the pandemic.

Gov. Kevin Stitt last week approved emergency rules for hospitals, allowing them to expand capacity in various ways, such as by putting patient beds in conference rooms and other spaces. The governor has, however, so far declined to issue a wider state of emergency, which would enable the enactment of mask mandates and other measures.

The providers at Tuesday morning’s press conference described a health system stretched to bursting and attempted to correct common misconceptions about the virus and vaccines, while “pleading” and “begging” the public to get vaccinated.

‘The height of the pandemic is likely still yet to come’

Dr. Kersey Winfree, Chief Medical Officer at SSM Health St. Anthony, said the public needs to “reconceptualize” its understanding of the arc of the pandemic.

“If you’re like me,” he said, “you might have passively said something like ‘during the pandemic’ or ‘during the height of COVID’ as if these things were in the past. Well, I wish we were talking in the past tense. Make no mistake, the pandemic rages on, and as case numbers multiply exponentially, the height of the pandemic is likely still yet to come. This is a dire situation.”

At another press conference on Tuesday, members of the Healthier Oklahoma Coalition, which includes a number of health care providers statewide, reviewed the current COVID-19 numbers, which show a spike in cases and COVID hospital admissions in recent weeks.

According to Dr. David Kendrick, CEO of MyHealth Access Network and department chair of medical Informatics at OU School of Community Medicine, approximately 22 percent of COVID tests are currently coming back positive — a reflection of both rising case numbers and insufficient testing. Hospitalization numbers, meanwhile recently “eclipsed” the previous high, set in January, Kendrick said. 

The delta variant is also affecting younger people than last year’s variant, and the majority of those hospitalized with the virus are younger than 65.

‘ICUs are filling up’

The physicians this morning described a cascading series of consequences resulting from these numbers, as health care providers scramble to care for both COVID and non-COVID patients.

“It’s now common for hospitals, particularly in smaller communities, to struggle to find a place to put a patient who’s really sick,” Bratzler said. “And I’m hearing multiple reports of hospitals having to transfer Oklahomans out of state to find a bed. Our emergency rooms are backed up. If you go into our emergency room, you will find we have quite a number of patients who are holding, waiting for a bed, whether it’s COVID or some other illness, because the hospitals’ ICUs are filling up.”

Full ERs lead to ambulance delays, as paramedic crews wait for staff to take patients before leaving for the next call. And patients in the hospital for non-COVID reasons — such as a car accident or a stroke — often experience delays that would not have happened in normal times, Malakouti explained.

Delays in care can sometime be disastrous, prolonging pain or even causing long-term disability or death.

Malakouti said that Mercy Hospital, in normal times, is able to accept approximately 90 percent of transfer requests it receives from other hospitals. Currently, the number of requests has doubled, and the hospital can accept only about 36 percent of transfers.

Nursing shortage continues to hamper care

Malakouti said that the crowding at Mercy is caused by a lack of actual, physical beds to put people in, rather than a lack of staffing. But elsewhere staffing shortages have become a critical issue, and nurses are particularly hard to find.

Regan Wickwire, a nurse in St. Anthony’s COVID ICU unit described the toll the pandemic has taken on hospital workers. The news that the hospital would need to re-open its dedicated COVID unit hit hard.

“I can’t tell you how debilitating that news has been,” she said. “While not surprising, it was confirmation of (our) fears that Oklahomans have not been taking the simple steps of wearing masks and getting a free, safe vaccine. And family and neighbors are paying for those decisions with their lives.”

Oklahoma has long had a nursing shortage, which has been compounded by COVID burnout.

While the governor’s state of emergency was in effect, renewal rules and fees were loosened to help retain health-care workers, but those allowances expired with the state of emergency.

Dr. Jean Hausheer, of the Healthier Oklahoma Coalition, said the nursing shortage is a matter of concern for the organization.

“The issue is trying to entice them to stay here,” Hausheer said. “We know that neighboring states from Oklahoma. Texas, for example, are constantly trying to pull our nurses toward them for more money. It’s a concern, definitely. We are working on it.”

‘I wish most vaccines were mRNA vaccines’

Throughout both press conferences, the speakers repeatedly asked people to get vaccinated.

Dr. Julie Watson, Chief Medical Officer for Integris Health, emphasized that 93 percent of those hospitalized with COVID are not vaccinated, and though there are some infections among the vaccinated, it is “600 times less likely that they will need the hospital to get better.”

All the vaccines, she said, “are safe,” even for pregnant women.

“These vaccines have undergone and will continue to undergo the most intensive safety monitoring in United States history,” she said. “Yes, COVID-19 vaccines were developed rapidly, but they were based on 30 years of preparation. (…) No trial phases were skipped. The speed came from having years of preparation.”

“To be honest, I wish most vaccines were mRNA vaccines,” she said. “It’s some of the cleanest technology I’ve seen as a physician and a scientist.”

The patients she sees suffering from COVID in the hospital, she said, “beleive in us when they are sick, but seemingly haven’t trusted us when we’ve shared with them how to stay well. It is heartbreaking and exhausting.”

While others made similar arguments regarding the science of vaccines or the health risks to the unvaccinated, Bratzler closed the morning’s press conference by trying a different tactic.

He remembered standing in line for a polio vaccine as a child, accompanied by his father, a WWII veteran, “as patriotic as you can get.” For his father, he said, getting his son vaccinated was “a civic responsibility,” and polio vaccines ultimately all but eliminated the disease.

Similarly with COVID, he said, “Getting the vaccine is your civic responsibility to protect the people around you. Because if you’re not spreading the virus, other people don’t get infected. (…) This is a virus, It’s not a political issue. It’s just a virus.”

“There’s so many people,” he added, “who get sick with COVID, end up in the hospital and say either ‘I wish I’d taken the vaccine’ or ‘Can you give it to me now?’ But it’s too late.”