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By Jamie Martines of Spotlight PA
HARRISBURG — Coronavirus cases and hospitalizations are rising, and hospital officials say Pennsylvania could be on course for another difficult winter as unvaccinated patients fill up hospital beds across the state.
“We’re bracing for a worse Christmas than last year because people aren’t staying home this year,” said Gerald Maloney, chief medical officer for hospital services at the Geisinger Health System, a provider that serves central and eastern Pennsylvania.
Without masks and physical distancing rules, which were in regular use last year before the availability of vaccines — and which helped curb other respiratory illnesses — the coronavirus is likely to spread easily in spaces that gather people close together and lack good ventilation.
On top of those concerns, Maloney said, Geisinger is also seeing a rise in flu cases compared to last year. “Last year we talked about the possibility of what we were calling a ‘twindemic,’ where there may be another Covid pandemic and a flu epidemic combined, so that’s a real possibility this year,” he said.
As holidays get underway, here’s what you need to know about Pennsylvania’s Covid-19 status:
Cases and hospitalizations are still increasing
Covid-19 cases in Pennsylvania have increased throughout the fall as the weather has cooled and people have started spending more time indoors. At the same time, the highly contagious delta variant — which emerged earlier this year — has driven a rise in infections.
Delta is still the main source of Covid-19 cases in Pennsylvania, according to Centers for Disease Control and Prevention data from early December, though some cases of the omicron variant have been detected since it was first reported in Philadelphia earlier this month.
Coronavirus vaccines are helping to mitigate the rise in infections, said John Goldman, an infectious disease specialist with UPMC. While providers are seeing some breakthrough cases, vaccines are helping to keep most vaccinated people out of the hospital.
Statewide data released by the health department Tuesday show that in the month leading up to Dec. 6, about 23% of Covid-19 hospitalizations were among fully vaccinated people.
Unlike last year, when vaccines were not available, the state’s oldest and most vulnerable residents are not the ones filling up hospital beds.
Instead, younger, unvaccinated people ages 45 to 60 make up the bulk of Covid-19 patients.
In many cases, the only underlying health issue these younger patients have is being overweight, said Goldman. At UPMC, about 95% of patients in intensive care units are unvaccinated.
At Geisinger facilities, about 88% of hospitalized Covid-19 patients are unvaccinated, Maloney said.
The steady upticks in cases and accompanying hospitalizations have strained hospitals across the state for weeks. The surge affects all patients, not just people with Covid-19, hospital officials say.
“People with heart attacks, strokes, people who get severely ill for non-Covid reasons, traumas,” Maloney said. “People are back out on the roads, and they’re back out climbing up ladders and things like that. There’s collateral damage to all those people created by the fact that the health care system is clogged with Covid patients.”
Geisinger facilities have cut back on surgical procedures and reduced transfer requests from the smaller, rural hospitals that typically rely on the larger health system for help handling severely ill patients.
“We can’t do a heart surgery on a patient if we don’t have an ICU bed to put them in after a surgery,” he said.
Gov. Tom Wolf requested staffing support from the Federal Emergency Management Agency, or FEMA, for the state’s health care facilities.
Citing statewide staffing shortages, Wolf asked FEMA to supply both clinical and non-clinical staffing support to hospitals and nursing homes, as well as ambulance services.
He also asked FEMA to supply 1 million rapid at-home Covid-19 tests.
A spokesperson for the governor’s office said more details about how residents can access the at-home tests will be available once FEMA confirms the request.
How to stay safe for the holidays
Medical leaders at health systems across the state send the same message: If you’re planning to gather for the holidays, get vaccinated.
“The first thing you should do is get vaccinated,” said Goldman. “If you’re vaccinated, you should be boosted.”
Anyone who has completed an initial vaccination series is considered fully vaccinated, he said. But getting a third shot provides higher levels of protection, he added.
Everyone 16 and older is eligible for a booster shot. Guidelines for choosing a booster shot are available at the Centers for Disease Control and Prevention website.
You do not have to return to the same location where you received your first or second shots for your booster. Search for locations offering Covid-19 vaccines near you on the CDC’s website at vaccines.gov. If you are traveling, the site also can be used to find vaccines nationwide.
The CDC now recommends choosing the Pfizer or Moderna vaccines over the Johnson & Johnson vaccine, a change outlined in guidance.
The advisory comes months after Pennsylvania and other states paused distribution of the J&J vaccine due to reports of rare, but serious, blood clots. Those incidents remain rare, but more cases have occurred since the spring. Given that the Pfizer and Moderna vaccines are now widely available, the CDC panel that reviews vaccine safety and efficacy decided that they are the better option.
The J&J vaccine will still be available to anyone who wants it, or who is unable to receive the Pfizer or Moderna shots due to medical conditions.
Next, consider taking a rapid test before heading to the airport or a holiday party, especially if you are meeting with people who are not vaccinated. The best time to take a test is the morning of the gathering, Goldman said.
“Given the amount of disease activity in our area, I would be wary of having unvaccinated people come to the family dinner,” Goldman said. “If you have elderly parents or elderly grandparents, you have to think long and hard.”
Finally, if you’re not feeling well — even if it just seems like a mild cold or allergies — the safest thing to do is stay home, even if you’re vaccinated, Goldman said.
Philadelphia Public Health Commissioner Cheryl Bettigole on Wednesday asked residents to consider skipping group gatherings.”As health commissioner and someone who cares deeply about the people who will get sick and miss out on work, on school, will get sicker, will end up in our hospitals, and those who will die, I have to say it: Please do not get together with other households for Christmas, or if you do, keep those gatherings small,” Bettigole said during a news briefing.
“We’re now entering what could be the most dangerous time since last winter,” she said.
Official mandates and mitigation efforts vary
Wolf said in multiple interviews Tuesday that he is not considering any new statewide COVID-19 mitigation measures.
“The vaccine is our strategy,” he told KDKA Radio. “But local municipalities I think ought to be free to do what they want.”
Wolf noted that hospitals are inundated throughout Pennsylvania and especially in the northeastern part of the state, and municipalities are responding based on local conditions.
In Philadelphia, proof of complete vaccination or a negative COVID-19 test will be required for anyone dining out starting Jan. 3, the city health department announced. After a two-week grace period, beginning Jan. 17 restaurants will only accept proof of vaccination for admission.
The mandate applies to all indoor restaurant spaces, including bars, sports venues, movie theaters, and casinos that allow food or drinks on the floor.
The Allegheny County Health Department is not considering a similar mandate, a county spokesperson said Monday. Spokespeople for Bucks, Chester, Erie, and Montgomery counties – which all operate county health departments – confirmed that they also are not planning additional mitigation measures on top of those that are currently in place.
A state health department order requiring masks in all schools and child care centers originally scheduled to stay in place through mid-January was struck down by the Pennsylvania Supreme Court on Dec. 9.
The high court upheld a Commonwealth Court ruling that previously decided that the health secretary did not have the authority to issue the order.
The ruling quickly went into effect. Starting this past Monday, school officials have been allowed to decide whether they will continue to require masks in school buildings.
Beam had served in the role since last January, when she took over for pediatrician Rachel Levine, who left the post after she was appointed to a role in the Biden administration.
Beam will be replaced at the end of December by Keara Klinepeter, who currently serves as the executive deputy secretary at the state health department.
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