From DR. DENNIS BECK
Chief Medical Officer, Interim Chief Administrative Officer, Deaconess Henderson HospitalAs the COVID-19 pandemic continues its worst surge to date in Henderson and throughout Kentucky, it is increasingly important to ensure that patients understand the effects of COVID-19 on themselves, as well as on the healthcare system.
Currently in Kentucky, as well as in border counties in Indiana, there are nearly no ICU beds available, and other hospital resources are stretched very thin. This is due to the large numbers of inpatients with COVID-19, many of whom are very sick; nearly all are unvaccinated.
What to Expect at the Hospital if You Have COVID-19
While at Deaconess—and at all other hospitals—doctors and staff will do their best to provide excellent care, we need patients to know what to expect if they become sick with COVID-19.
Those who are vaccinated typically experience more mild-to-moderate symptoms; only a small percentage of people who are vaccinated need to be hospitalized, and an even smaller percentage are in the ICUs, are ventilated or pass away.
However, those who are unvaccinated are frequently developing significant symptoms with COVID-19—adults of all ages, including young adults with children at home, as well as pregnant women. These patients are coming into the ED in high volumes.
The most distressing symptoms that bring people to the ED include combinations of:
When these patients arrive at our emergency departments, they may have a wait that is longer than they’ve been used to, as our EDs, as well as all others in our region, are experiencing volumes more than 50% higher than at any time during the pandemic.
When the patient is assessed, the emergency department staff will evaluate symptoms and determine if the patient should be admitted.
If the patient doesn’t meet criteria for admission, ED staff may refer the patient for outpatient monoclonal antibody treatment at a temporary clinic on campus, or evaluate if they can receive Regeneron injections in the ED (this drug is currently in short supply). The focus will be on both reducing the risk of hospitalization and on symptom management.
What To Expect if Admitted to the Hospital with COVID-19
If the patient does require admission, they are very sick, and probably have been for a several days.
Most patients hospitalized for COVID-19 require oxygen through a nasal cannula (a lightweight tube that delivers oxygen through two prongs placed in the nostrils) or oxygen mask, and will receive medications and IVs including antivirals, steroids, anticoagulants (to prevent blood clots—common with COVID-19), and sometimes monoclonal antibodies.
If symptoms worsen, patients may be transfer to the ICU for more close monitoring.
Not all patients who are admitted to the ICU require ventilation (breathing support from a machine that moves air in-and-out of the lungs). Doctors and other members of the care team will do everything they can to prevent the need for ventilation, but it is sometimes needed to save a patient’s life when their lungs are declining.
Overall, hospital stays for COVID-19 patients can vary from days to weeks. It really depends from patient-to-patient, and how their body responds to both the infection and treatment.
What To Expect When Released from the Hospital
Some patients are released to home, and given medications and instruction for self-care. Other patients may require oxygen when they go home, and may require remote monitoring (medical equipment at home with check-ins with nurses) for some time.
Some patients, especially those who have been in the ICU or on a ventilator, require extensive rehabilitation and are discharged to a rehabilitation hospital or other rehab facility. Being severely sick for a span of time has a terrible effect on the body. Muscles are weakened--including those that help the body stand and breathe--making simple tasks impossible. Some patients have had mild-to-severe strokes due to blood clots caused by COVID-19. Also, some patients have permanent lung damage requiring oxygenation for possibly the rest of their lives, or even a lung transplant.
While most people who are hospitalized for COVID-19 do survive, with varying degrees of short-or-long-term effects, about 15% of people who are admitted to the hospital die from COVID-19, despite expert treatment and care.
What People Need to Do
Right now, we need our community to do everything they can to reduce this COVID-19 surge. When hospitals are this full, is not safe for anyone.
If you’re eligible, please get vaccinated. Every large medical group in the United States has endorsed vaccination. You can find informative statements, representing nearly half a million doctors, on their professional websites (linked below).
We encourage all adults to complete advance directives, which are documents that specify the types of medical care a patient would and would not want in the event they are unable to communicate their wishes to their doctors.
Also, please continue wearing your mask and avoiding groups of people. This will help reduce the spread, hopefully lowering the demand on hospitals, helping to protect everyone in our community.
Vaccine Recommendations for Patients; Vaccine Safety Information
Infectious Diseases Society of America (about 11,500 members) https://www.idsociety.org/covid-19-real-time-learning-network/vaccines/vaccines-information--faq/
American Academy of Family Physicians (133,500 members) https://www.aafp.org/family-physician/patient-care/current-hot-topics/recent-outbreaks/covid-19/covid-19-vaccine.html
American College of Physicians (Internal Medicine) (161,000 members) https://www.acponline.org/acp-newsroom/acp-supports-acip-recommendation-of-full-fda-approval-for-pfizer-biontech-covid-19-vaccine
American College of Obstetrics and Gynecology (ACOG) (more than 60,000 members) https://www.acog.org/womens-health/experts-and-stories/the-latest/how-do-we-know-the-covid-19-vaccines-are-safe-and-effective-one-expert-explains
Joint Statement from ACOG & SMFM (Society for Maternal-Fetal Medicine, with 5,000 members) https://www.acog.org/news/news-releases/2021/07/acog-smfm-recommend-covid-19-vaccination-for-pregnant-individuals
American Academy of Pediatrics (approx. 67,000 members) https://www.aappublications.org/news/2021/05/12/cdc-aap-pfizer-covid-vaccine-teens-051221