NC hospitals say nearly all COVID-19 patients on ventilators are unvaccinated

"I think we are going to keep setting new records for COVID cases here in North Carolina for some time to come," said Dr. Mark McClellan, a former FDA commissioner who now heads the Margolis Center for Health Policy at Duke University. "Nationally, we are averaging over 500,000 recorded cases per week. I think those numbers are going to go up considerably to 800,000 or 900,000 perhaps over the next week or two."

As cases soar, local emergency departments are strained, and the number of people hospitalized for COVID -19 rose to 3,293 on Thursday, an increase of almost 200 from the day before.

Dr. Chris DeRienzo, system chief medical officer for WakeMed, said all of the health system's emergency departments have set records for capacity in five of the last 10 days.

DeRienzo called the number of emergency room patients "truly crushing" and said around 40% of patients who show up at the ER either have COVID-19 symptoms or are there to be tested for COVID-19.

The ER is not the place to come for a coronavirus test unless you are seriously ill and need emergency care, all doctors agreed.

Asymptomatic people or those with mild symptoms will add to the strain of emergency departments and will likely endure very long waits, they said.

Getting vaccinated and boosted is the key to staying out of hospitals or becoming seriously ill from coronavirus, all three physicians urged. At WakeMed and UNC hospitals, 100% of COVID-19 patients on ventilators are unvaccinated, they said.

At all WakeMed hospitals, only 1 in 10 ICU patients are fully vaccinated, and at Duke, all the patients on ECMO, a form of life support used for only the sickest patients, are unvaccinated.

As of 4:40 p.m. on Thursday, a spokesman for UNC Health said all COVID-19 patients on ventilators in the ICU were unvaccinated.

North Carolina has seen a slight increase in its vaccination rate. As of Wednesday, 70% of all adults in North Carolina are fully vaccinated and 63% of all residents age five and up have their shots.

Data released Wednesday showed 3,099 people hospitalized with the virus in North Carolina and 634 COVID-19 patients in the ICU — a 36% increase compared to last week.

Only 12 ICU beds, or 8% of all beds, are open in the Triangle, according to state Department of Health and Human Services. Across the state, about 15% of all ICU beds are open and staffed.

Only eight ICU beds are left open at all Duke hospitals across North Carolina, and Duke University Hospital's ICU has reached capacity, according to Dr. Lisa Pickett, chief medical officer at Duke Health.

"Right now just over 10% of the patients in our hospital are there with COVID," she said. "Throughout the system, that’s about well over double where we were about 10 days ago."

About 16 people are waiting on an ICU bed on any given day, she said, and the hospitals are considering moving patients to tents outside.

"We are now looking at plans where we may have to divert some of our COVID patients into those tents," she said. "We have not yet done that."

Part of the strain comes from the number of hospital staff out of work due to COVID-19, Pickett said.

Around 700 Duke Health employees, or around 3% of the work force, were out of work on Tuesday due to COVID-19. That's a stark increase from Dec. 30, when 400 employees were out.

"Even if we could open all of the beds that we would like to, it’s because we simply don’t have enough healthy staff to do that," she said.

Pickett said Duke Health has already started to pause elective procedures and worries about delaying care to people in need.

While North Carolina's case counts skyrocket, the number of people hospitalized with COVID-19 remains relatively low when compared to both the surge in hospitalizations last winter and fall. As of now, the average number of hospitalizations is 36% lower than at the peak on Jan. 16, 2021, but that number could increase in the next few weeks.

"We are concerned both for patient care and for staffing," Kinsley said.

90% of patients hospitalized in Duke Health's ICU units are unvaccinated, Pickett said. Every patient in the Duke Health system on the highest level of life support is unvaccinated, she said.

UNC Health reported more than 650 employees, or around 1% of all employees, were absent on Tuesday due to a COVID-19 exposure or a positive COVID-19 test.

Even with hundreds of staff members out, only nine hospitals reported to the state that they were experiencing a "critical staffing shortage." The state Department of Health and Human Services does not disclose which nine hospitals are experiencing a staff shortage.

As area hospitals grapple with staffing shortages and surges in cases, health experts said it could still be several weeks before North Carolina peaches its peak from the omicron variant.

"We still have weeks ahead of us but not many weeks with this level of surge," said McClellan.

"What we will see happen sometime, I predict in the next couple weeks, is those rates of case growth will slow down, the test positivity rate will go down, and that will be the sign we are coming up on the peak," he added.

McClellan said perhaps late January or early February is when he expects numbers to begin to improve.

"I expect at least some parts of the country to begin peaking pretty soon, and nationwide, for us to be on a downward trajectory by early February," he said. "It is still going to be a challenging few weeks."

WRAL News investigative data journalist Ali Ingersoll said another way to predict the surge is by looking at the data from places around the world. For instance, in South Africa, there was a sharp increase in cases with the omicron variant and a sharp decline.

"They have actually decreased week-by-week by 50 percent. Their deaths are now up 73 percent from last week," said Ingersoll.

Health experts said the fast virus spread will mean more widespread immunity — whether through infection or immunity.

"I think a lot of people are viewing this as perhaps the last big wave of COVID ... once we are past this wave, we will be in a much better position to start thinking about how we will actually live with COVID being around but not so disruptive to our lives like we are seeing in this current surge," said McClellan.