Virus Outbreak Milestones 200,000 Dead

In this July 31, 2020, photo, Romelia Navarro, right, is comforted by nurse Michele Younkin as she weeps while sitting at the bedside of her dying husband, Antonio, in St. Jude Medical Center's COVID-19 unit in Fullerton, Calif. 

JOPLIN, Mo. — Southwest Missouri health officials say the increase in COVID-19 hospitalizations they were seeing in recent weeks spiked over the weekend.

Cases throughout the Joplin area returned to levels comparable to the peak experienced last winter.

“We’re having admissions almost every single day to our COVID-19 units. We’ve got both of our COVID units open fully and full (capacity) at this time with patients," Jeanne Kennedy, chief nursing officer for Freeman Health System in Joplin, said Monday.

Missouri this week led the nation with the highest rate of new COVID-19 infections as vaccination rates remain low.

Donna Stokes, infection preventionist with Mercy Hospital Joplin, said they also began noticing an increase in COVID-19 patients who needed hospitalization and outpatients testing positive for the illness about two weeks ago. Mercy’s COVID-19 unit can house approximately 26 beds, which can overflow into other units as needed.

“We’re having to look at this several times a day just to be sure that we don’t exceed what we can manage,” Stokes said. “I don’t want to say that we’re there, but we’re certainly inching toward that. With the evaluation of our patients who are being discharged and requiring admissions, that’s going to be ongoing with these higher numbers of COVID-19 patients that we’re experiencing.”

On Friday, Mercy reported about 20 hospitalized patients and 20 outpatients who tested positive for the illness; that rose to 33 inpatients and 45 outpatients over the weekend.

“We definitely had an increase in both our (hospital) admissions and outpatient positive tests, so there’s been a significant rise in the last 72 hours,” Stokes said Monday. “At this point, we’re keeping up with being able to discharge patients at about the same rate as our admissions. The vast majority of patients are not vaccinated.”

On Monday, 80 people were admitted in Joplin hospital systems — Freeman, Mercy and Landmark — and that included residents from outside of Joplin city limits, according to the city’s COVID-19 dashboard. On Tuesday, the number dropped slightly to 76.

Health officials at both Mercy and Freeman said they’re starting to see hospitalization rates inch closer to peak levels that haven’t occurred locally since late last year or early this year.

“We were seeing numbers around this caliber in November, December, January when we were at the peak of that surge, so this is about equivalent to that time frame,” Stokes said.

On Dec. 1, shortly after the city of Joplin had reinstated its mask mandate, 95 were people hospitalized locally. That number had topped 100 in November, which was partly what prompted area hospitals to publicly call for the return of the mask mandate.

“Right now, we’re trending on par with where we were in January as far as rates are concerned,” Kennedy said. “I think we started to see the jump really after graduation season, when people were getting together, and then Memorial Day, it just kind of compounded there.”

Freeman’s second COVID-19 unit, which had closed in mid-March as virus numbers dropped, was reopened about two weeks ago due to the growing need, according to Kennedy. As of Monday at Freeman Hospital in Joplin, 48 COVID-19 patients were being treated, up from 31 patients Friday, according to officials.

On Monday, CoxHealth, in Springfield reported 83 patients in its COVID-19 census, up from 14 just four and five weeks ago, said Steve Edwards, CEO. Cox has other hospitals throughout Southwest Missouri, including Branson, Lamar and Monett.

"We can acquire immunity through infection or better immunity through vaccine," Edwards tweeted Monday. "With low vax rates, looks like many are going to do this the hard way. The Ozarks is my home, I realize we can be stubborn people. Please vaccinate."

Edwards also warned Southwest Missouri residents this week that the risk of hospitalization with the delta variant, which is what he said his area is experiencing, is twice that of the alpha variant, the dominant previous strain, citing a study in The Lancet, a British Medical Journal.

Freeman officials, however, said, their cases are the earlier variant, and the spike is the result of low vaccination rates and relaxed use of masks, social distancing and other protocols.

More local patients are exhibiting gastrointestinal-related symptoms such as nausea, vomiting or diarrhea, which could be attributed to the delta variant, said Kennedy.

“The delta variant is more contagious, and it has the same kind of symptoms you would have with the stomach flu, but also blood clots and hearing loss have been associated with that variant,” she said. “We’re mostly seeing people who have not been vaccinated or have only had one of the shots in the series being hospitalized.”

In the city of Joplin (part of Jasper and Newton counties), more than 40% of residents have been fully vaccinated, according to the state's COVID-19 dashboard on Tuesday. However, elsewhere in Jasper County, only 20.1% of the population have received their full vaccinations; nearby Newton County was 17.3%, and McDonald County, in the far southwest corner of Missouri, stood at 13.7% fully vaccinated on Tuesday, according to the Missouri Department of Health and Senior Services.

“Those who have been vaccinated, at least up to this point, we’re seeing mild to no COVID symptoms, so there’s a push for anyone who has that hesitancy for receiving vaccinations, now is the time to really contemplate their concerns versus the positive effects that we’re seeing from the vaccine for those who have gotten it,” Stokes said.

Another difference is the change in demographics among positive COVID-19 patients at local hospitals. Last year’s admitted patients were mainly 70 to 90 years old, but currently there are more patients in their 20s to 50s who are being hospitalized. Kennedy said they’ve seen a 75% decrease in the hospitalizations of those who are 70 to 80 years old.

“What they’re being hospitalized for has really stayed the same — they need fluids, oxygen support,” she said. “A lot of these things are very similar, and a lot of these patients look similar to what we saw before, but it’s just a different age bracket of individuals. I think we’ll be surprised to see how things unfold moving forward and what we don’t know every time we go through these surges is how many people, how long it’s going to last.”

With the July 4 holiday weekend approaching, Kennedy and Stokes encouraged people to continue wearing masks if not vaccinated, and practice social distancing and hand hygiene.

“But the most important thing we can do is get vaccinated,” Kennedy said. “We’ve seen the vaccines working against these strains of COVID-19, and we know that it helps us prevent spreading.”

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