Healthcare workers’ message: ‘Get vaccinated’
As of July 29, nearly 1,000 COVID-19 patients were being treated in Los Angeles County area hospitals, and 215 were reported in Orange County hospitals, according to the Los Angeles and Orange County Health departments. Hospitalizations are as a result of the continuing surge of the new COVID-19 Delta variant.
The majority of these patients were unvaccinated, but despite 53% of Californians now fully vaccinated, there continue to be “breakthrough” cases, with fully vaccinated people testing positive. And although they by-and-large suffer only mild symptoms and have mostly avoided hospitalization, the rise of the Delta variant has alarmed many people.
With Southern Californians carefully venturing back into the world after restrictions were relaxed in June, now the state is calling on everyone — even the fully vaccinated — to resume wearing masks indoors in public spaces. But how worried should people be and how many precautions are enough or too much?
Dr. Stuart Miller lives in Arcadia and practices internal medicine in Pasadena. He’s also on staff at Pasadena’s Huntington Memorial Hospital and already has seen an increase in COVID-19 patients in the wake of the Delta variant surge. “A few weeks ago we were down to almost zero [COVID-19] admissions, and this week we’re up to 12,” he said.
A few weeks ago we were down to almost zero COVID-19 admissions, and this week we’re up to 12.
— Dr. Stuart Miller
While that’s a far cry from the 200 patients at the hospital during the winter surge, “We’ve definitely seen a rise in the last couple of weeks,” he added, noting that they have been mostly unvaccinated people. And in his private practice, he’s already seen four positive cases in the past week.
On the plus side, he said those positive tests were the result of more people coming into his practice requesting testing because of the Delta variant surge. “A few weeks ago we weren’t getting any requests at all because people were not feeling any symptoms.”
At Cedars-Sinai Medical Center in Los Angeles, chaplain and Rabbi Jason Weiner reported similar findings. The deadly winter surge is still barely in his rearview mirror as the Delta variant is bringing in many new, unvaccinated COVID-19 patients.
“They’re increasing significantly,” he said, “especially in the emergency room and especially among unvaccinated people, so it tends to be younger people this time. It’s a real issue once again.”
However, for registered nurse Boaz Hepner, who works at Providence St. John’s Health Center, he’s yet to receive a COVID-19 patient during the Delta surge. Last winter the facility was overwhelmed with patients. “I hope it remains that way,” with no new COVID-19 patients, he said. “I don’t anticipate it ever getting as bad as it got in January but the numbers (in general) are certainly getting worse.”
Dr. Jonathon Weisz is a pediatrician who is part of the Optum group and works in Covina with a satellite office in Diamond Bar. To date, he’s seen some patients who have had symptoms that could be interpreted as possible COVID who are being funneled to him via his practice’s urgent care facility. “So we are doing the best we possibly can in the pediatric realm to train the urgent care [workers] on how to approach sick pediatric patients,” he said.
Although his practice has not yet been “bombarded with COVID patients,” there was a two-month period beginning in May when things seemed dramatically better, Weisz said. “So it’s sort of a psychological issue that we’re suddenly getting a pretty quick resurgence of COVID as the Delta version.”
And although he doesn’t characterize the surge as alarming, he said it’s a “disappointment. … “We (pediatricians) take it personally that the vaccine or lack of (getting the) vaccine is such a big part of this. It is an extreme challenge, especially as children [under 12] can’t be vaccinated.”
A major issue that all healthcare workers are now facing is the reluctance of many who still refuse to be vaccinated — among the general public and some healthcare workers. Miller said he believes 90% of his hospital’s staff is vaccinated, but just as the state is now mandating its workers be vaccinated, Miller said his medical group is “strongly thinking right now about mandatory vaccinations for all staff.”
The majority of Weisz’s patients have been vaccinated but he’s still treating a few parents who haven’t. “If you start to try to talk to some of them, they get very … not nice about it,” he said. “It can head in that direction quickly. Some may have political reasons, some may have (trust issues) about vaccines, which is really strange because some of these families are giving vaccines to their kids but they don’t want them as adults.”
Weisz said he takes vaccine reluctance personally, “because as pediatric doctors, we try to protect our youngest patients. If we could get a higher percentage (of adults) vaccinated, we would be very well protected and we wouldn’t be scrambling right now.”
However, he added things aren’t all doom and gloom. “I know one of the arguments is about the safety of school children” who are too young to be vaccinated. “But what’s unique and curious about COVID-19, he said, “is that children in school are in close contact with each other and constantly get upper respiratory infections (colds), and pass them on to adults when they come home.”
However, in the case of COVID-19, it’s the reverse.
“The children aren’t the ones who are typically picking it up and giving it to everybody,” he said. “It’s the adults that are most prone and most contagious.”
Babies, he added, would seem to be those most at risk; they have the most delicate immune systems. But even babies he’s seen with COVID-19 have had mild cases, as have the toddlers and children he’s treated. “Overall, they tend to have mild symptoms with a few exceptions.”
For this reason, he said, “While we’re waiting for a safe vaccine dose for the younger ones, at least the reassurance is the parents can be vaccinated. But that’s our problem with the Delta variant. The (adults) that aren’t getting vaccinated and we are unfortunately putting the children at risk.”
Weiner spoke of a “sense of frustration. It’s hard to kind of go backward now,” after the spread slowed a couple of months ago. “We’re trying not to be judgmental and negative toward people who didn’t get vaccinated and are now getting sick, and trying to treat everyone with respect and dignity, but at the same time, we’re really strongly encouraging people to get vaccinated — those who might have initially said, ‘I don’t need to be first to get the vaccine,’ or ‘I’m younger so I’m safer,’ or ‘The pandemic is waning, so what’s the point?’ ”
Hepner, too, has felt disappointment, frustration and anger at those who have not been vaccinated. But he’s also been pro-active, taking it upon himself to educate people about the importance of getting vaccinated.
The vaccines totally work. Yes, vaccinated people can still catch it, but just because there’s a few thousand breakthroughs going on out of hundreds of millions people, it doesn’t mean people need to freak out.
— Boaz Hepner, RN
In his own hospital he’s become somewhat of a vigilante, persuading 17 of his patients’ family members to get vaccinated and eight staff members to do so.
Part of the reason for people’s reluctance — both in the profession and outside of it — he said, is a lack of training and education in the healthcare field. So he urged his hospital to let him train his unit and explain why the vaccine was necessary. That included bringing in epidemiologists and specialists and addressing people’s fears and concerns. He’s hoping to be able to expand the program within his own hospital and beyond.
“COVID-19 is the most important thing we’re going to probably deal with in our lifetime,” he said, “and nobody has ever taken the time to say, ‘Let’s educate staff. And they can educate their patients.’ ”
Miller concurred. “Get informed. If you have hesitations, get more educated on those hesitations. We have people who are working on these vaccines. Some of my colleagues are researchers at City of Hope working on these vaccines so they can give you the details of it and the safety of it.”
One of the argument that Miller hears a lot is that people have bad reactions to the vaccine. “So I say: Let’s talk about that. It doesn’t mean that they got COVID. And the reactions lasted only a short period of time. People also get bad reactions to flu shots.”
As a past president of the Pasadena Jewish Temple, Miller also has helped steer his synagogue on COVID-19 protocols, given talks through Jewish organizations on COVID-19 and is a consultant for the Pasadena Public Health Department on COVID-19. “We’re lucky,” he said. “God forbid we didn’t have (the vaccine). We’d just be fighting it on our own. So there is a positive here. We can fight this. Everybody should be optimistic if we do the right thing and get vaccinated.”
And if they need further convincing, Miller spoke of his experience during the winter surge when he worked in a tent that his hospital set up for COVID-19 patients. “I saw a 15-year-old all the way up to 90-year-olds” with the virus, he said. “It’s not fun. Even the ones I’m able to send home after a few hours of being stabilized in the hospital — it’s not fun. And then there are the ones we lost, where the families couldn’t even say goodbye. Get vaccinated.”
“The vaccines totally work,” Hepner added. “Yes, vaccinated people can still catch it, but just because there’s a few thousand breakthroughs going on out of hundreds of millions people, it doesn’t mean people need to freak out.”
And with the High Holy Days just weeks away, Weiner said it’s an opportunity to remind people to get vaccinated.
“One of the themes of Rosh Hashanah is that we never know what the future brings,” he said. “And so we pray and we rely on God and we do our best to prepare. And that’s something we’ve learned from the pandemic. There’s always a vulnerability to the sense of fragility of life. But at the same time, we can take actions to do our best to mitigate those concerns in that vulnerability.”
