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'This Is Much Worse': Florida Hospitals Handling New Covid Surge


We know that COVID is roaring back in parts of the U.S. The seven-day average of new cases in the United States is up 53% over the previous week. Now, this is not spread evenly across the country. One in five of those new cases is in Florida - one in five. And the northeastern part of the state is driving the surge. Well, Chad Neilsen is there - director of infection prevention at UF Health, Jacksonville.

Chad Neilsen, welcome.

CHAD NEILSEN: Thank you for having me.

KELLY: And now we find you today at your hospital in Jacksonville. Would you just describe what it looks like, what it feels like, how crowded you are?

NEILSEN: Yes. So we've seen a near tripling in our number of COVID-19 admitted hospital patients over the last two weeks. In fact, last weekend alone, we saw a 40% increase. So...

KELLY: From roughly what to roughly what? How many people are we talking?

NEILSEN: Yeah, so we're talking 86 to over 120 just over the weekend. And now, today, we're sitting at 150 confirmed cases between our two hospitals. Our previous high in January of 2021 was 125. So by all measures we have internally, we are surging past our winter surge numbers, and we don't know when this is going to end.

KELLY: So you are - this is the worst it has been where you are. This is worse than it's been in previous surges, in terms of people checking into your hospital.

NEILSEN: Absolutely. Yes, that's correct. The testing has increased. Our percent positivity amongst our outpatients has increased. By all measures, this is much worse than what we've seen prior to now.

KELLY: What can you tell us about the patients? Are these young, old, all over the place? Are they vaccinated?

NEILSEN: The large majority of our patients, over 95% right now, are unvaccinated. The age profile has shifted. These are younger patients. We have more of a bell-shaped curve across the age continuum. So what I mean by that is, in previous surges, patients tended to be older, over the age of 60 and worse off healthwise. Well, now we're seeing a shift into younger patients. We have more pediatric patients, more patients in their 20s and 30s and, in fact, even our mortality rate. So how these patients are dying and their age at death has shifted from 69 to 59. So we're seeing admitted patients younger, and they're dying at a younger age as well.

KELLY: Those are just awful, awful numbers. Are you worried you might run out of room? Do you have capacity to deal with this many patients?

NEILSEN: So capacity is a funny question because really capacity is a function of, do you have space and do you have staffing? Our one campus on the north side of town actually is over capacity right now. We have more patients in beds than we have licensed space for, that we've gone through federal and local regulatory matters to handle that overflow. Downtown, we have bed space, but staffing is the real concern because staff have not recovered from the winter surge yet. We still have dozens of nurse vacancies in our hospital. And right now our nurses are also coming down with COVID, if they're not vaccinated. So we have bed capacity, but it's really the staffing that's going to be our rate limiter for providing good patient care.

KELLY: If I had told you a month ago, even a month ago, that this is where you would be, would you have believed me?

NEILSEN: Well, I certainly think we expected a slight bump in numbers as summer started. We expected that because, well, vaccine uptake in the state of Florida has stagnated. Did we expect it to escalate so rapidly? No. We did leave a lot of our processes, a lot of our PPEs and supply logistics in place, prepared for a summer bump. But we couldn't have predicted it would have been at such a rapid rate. And we largely believe it's due to the delta variant of the COVID-19 virus. It's more contagious, and it's burning through an unvaccinated population right now at speeds we couldn't expect.

KELLY: I don't know if you're ever in the room for any of these, but can you tell me what some of the conversations are like with people who are coming in, who are unvaccinated, who are now very sick?

NEILSEN: Yes, many of them are regretful. We've actually gone through and asked some of these patients with other local media channels if they'd be willing to talk, and continuously they want to be heard saying they regret not getting the vaccine. And I know that's coming from me as an infection prevention director, but it's out there in the media for a variety of different news sources that our patients are largely saying, I regret not getting vaccinated. And we can't hammer home that point enough. This doesn't need to be occurring. And when our deaths and our patients who are admitted are all unvaccinated, I don't know what else anyone needs to turn them to get vaccinated, if they aren't already.

KELLY: How are you holding up?

NEILSEN: Well, about as best as I could. Obviously, we are extremely busy. Staffing is short. My own infection prevention staff are and have been doing yeoman's work over the last 19 months. But our health care workers at the bedside are hurting. They're frustrated, especially those who are vaccinated, because they know this is largely a preventable issue at this point that they're unfortunately dealing with. And they're tired. They're getting burned out because we thought largely that the vaccines would have a higher uptake in our region and in the state of Florida to prohibit this from happening. And so now that our nurses are seeing patients come in unvaccinated one after another, there's a real sense of, here we go again. And they're getting frustrated, and they're getting burned out.

KELLY: I want to play you a comment from your governor. This is Republican Governor Ron DeSantis talking not about vaccinations, but about masks. He was talking with reporters yesterday, and here are his thoughts about reimposing public health measures.


RON DESANTIS: Yeah, I have a 3-year-old son. And you got people like Fauci saying he should be muzzled, that you should be throwing masks on these 3-year-old kids. It's totally unacceptable and certainly unacceptable to have any level of government imposing that on parents and on kids.

KELLY: Chad Neilsen, how does it affect your job as a public health official when the governor, the leader of the state, is taking a hard line against some of the very things that public health officials say could help control the spread?

NEILSEN: Well, obviously, it's frustrating. And I would guess that Dr. Fauci never used the word muzzled when it comes to masking up children. But I have a 4-year-old myself. And because I'm an epidemiologist and because I've been dealing with this for 19 months, I have no qualms masking up my daughter and, frankly, masking up myself again, even though I'm vaccinated, to model good behavior. I think we're coming at a real head here in our state because schools are starting soon, and these kids who are under 12 and unvaccinated are going right back into schools unprotected, with the delta variant surging. And I have real concerns that if something's not done at a higher level in our state regarding masking in schools, then these 3 and 4-year-olds are going to get COVID unnecessarily. And frankly, I think all of our politicians, from the governor to the state level to federal, need to be putting all of their energy into espousing folks to get vaccinated and be safe and follow CDC guidelines. Wear a mask if you're unvaccinated. And that's where I think that energy should be spent, instead of denigrating public health officials who are really just trying to help save lives.

KELLY: Chad Neilsen, director of infection prevention at UF Health in Jacksonville, thank you.

NEILSEN: Very welcome. And thanks for having me on. Transcript provided by NPR, Copyright NPR.

Mary Louise Kelly is a co-host of All Things Considered, NPR's award-winning afternoon newsmagazine.
Ayen Bior
Ayen Deng Bior is a producer at NPR's flagship evening news program, All Things Considered. She helps shape the sound of the daily shows by contributing story ideas, writing scripts and cutting tape. Her work at NPR has taken her to Warsaw, Poland, where she heard from refugees displaced by the war in Ukraine. She has spoken to people in Saint-Louis, Senegal, who are grappling with rising seas. Before NPR, Bior wore many hats at the Voice of America's English to Africa service where she worked in radio, television and digital. Bior began her career reporting on the revolution in Sudan, the developing state of affairs in South Sudan and the experiences of women behind the headlines in both countries. In her spare time, Bior loves to kayak, read and bird watch.
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