The summer wasn’t meant to be like this. By April, Greene County, in southwestern Missouri, seemed to be past the worst of the pandemic. Intensive-care units that once overflowed had emptied. Vaccinations were rising. Health-care workers who had been fighting the coronavirus for months felt relieved—perhaps even hopeful. Then, in late May, cases started ticking up again. By July, the surge was so pronounced that “it took the wind out of everyone,” Erik Frederick, the chief administrative officer of Mercy Hospital Springfield, told me. “How did we end up back here again?”
The hospital is now busier than at any previous point during the pandemic. In just five weeks, it took in as many COVID-19 patients as it did over five months last year. Ten minutes away, another big hospital, Cox Medical Center South, has been inundated just as quickly. “We only get beds available when someone dies, which happens several times a day,” Terrence Coulter, the critical-care medical director at CoxHealth, told me.
Last week, Katie Towns, the acting director of the Springfield–Greene County Health Department, was concerned that the county’s daily cases were topping 250. On Wednesday, the daily count hit 405. This dramatic surge is the work of the super-contagious Delta variant, which now accounts for 95 percent of Greene County’s new cases, according to Towns. It is spreading easily because people have ditched their masks, crowded into indoor spaces, resumed travel, and resisted vaccinations. Just 40 percent of people in Greene County are fully vaccinated. In some nearby counties, less than 20 percent of people are.
Many experts have argued that, even with Delta, the United States is unlikely to revisit the horrors of last winter. Even now, the country’s hospitalizations are one-seventh as high as they were in mid-January. But national optimism glosses over local reality. For many communities, this year will be worse than last. Springfield’s health-care workers and public-health specialists are experiencing the same ordeals they thought they had left behind. “But it feels worse this time because we’ve seen it before,” Amelia Montgomery, a nurse at CoxHealth, told me. “Walking back into the COVID ICU was demoralizing.”
Those ICUs are also filling with younger patients, in their 20s, 30s, and 40s, including many with no underlying health problems. In part, that’s because elderly people have been more likely to get vaccinated, leaving Delta with a younger pool of vulnerable hosts. While experts are still uncertain if Delta is deadlier than the original coronavirus, every physician and nurse in Missouri whom I spoke with told me that the 30- and 40-something COVID-19 patients they’re now seeing are much sicker than those they saw last year. “That age group did get COVID before, but they didn’t usually end up in the ICU like they are now,” Jonathan Brown, a respiratory therapist at Mercy, told me. Nurses are watching families navigate end-of-life decisions for young people who have no advance directives or other legal documents in place.
https://www.theatlantic.com/health/arch ... ge/619456/
