The pandemic is taking a heavy toll on the medical community, as reported today by UAB Hospital CEO Anthony Patterson, whose facility as of Jan. 6 is caring for 294 COVID-19 patients.

That number includes 210 COVID-positive patients and 84 convalesced patients. For the most part, patients are placed in a unit devoted to COVID care. Patterson said that placing patients in the right venue is very important for protecting staff, other patients and faculty. UAB uses the term COVID convalesce for patients who are no longer infectious to others but remain very sick and are potentially unable to survive without intensive medical care and attention.

“Sharing the convalesce numbers does a better job to demonstrate and measure the impact of COVID-19 and those that are affected by the virus, and by the hospital resources that are ultimately required to take care of the patient population,” Patterson said.

The situation underscores the need for the public’s help in preventing the illness through social-distancing measures and actively protecting themselves from the virus by wearing a mask and taking other measures. UAB Epidemiologist Dr. Rachael Lee said 4,500 new cases of COVID-19 were reported in Alabama on Jan. 5.

“Unfortunately, our state is at the highest rate of hospitalizations with over 3,000 documented yesterday (Jan. 5),” said Lee, an assistant professor in the UAB Division of Infectious Diseases. “These cases are likely reflective of Christmas gatherings and those holiday gatherings that we have not yet even seen: hospitalizations related to New Year’s Eve.”

The numbers are concerning, Lee said, because UAB has a high number of hospitalizations and is seeing more people who require a ventilator and must receive medications.

Working with UAB’s Infectious Disease Consultation Service, Lee is seeing a wide range of patients, including those who are currently ill, young and have COVID-19; as well as being in the acute, still infectious stage. She said that many patients require high-flow oxygen through the nose in efforts to prevent them from being placed on a ventilator. There are a large number of patients on a ventilator, as well as in intensive care.

“I’ve seen a lot of patients who are no longer infectious but are still on the ventilator, they’re still fighting for their lives,” Lee said. “And this is the most heartbreaking thing for us, as we are doing everything that we can to get them home and to their loved ones, and it’s incredibly difficult.”

Every patient is unique: Some may have acute respiratory distress syndrome, with trouble breathing and a lot of inflammation that takes time to heal; some suffer scarring of the lungs. There have been some cases – not at UAB – that have required lung transplantation because of severe scarring.

“That’s what we’re trying to prevent, and the goal with the monoclonal antibodies is to prevent this hospitalization; if we can prevent that continuation of our really revved-up immune system, then that’s the goal,” Lee said.

UAB officials talk about Alabama COVID-19 hospitalizations and vaccinations from Alabama NewsCenter on Vimeo.

Patterson noted that early on in the pandemic, lack of PPE was a big issue and the hospital curtailed “almost everything” for a time. He said the hospital is paying close attention to “elective” procedures, such as elective plastic surgery or knee replacements – all are not the same because some are lifesaving procedures.

“Many of the cases that we are doing at UAB Hospital are connected to cancer, ultimately, or other disease processes where patients cannot wait forever,” Patterson said. “They might be able to wait for two, three, four days, and then we’re doing all the other adjustments within the hospital to get them a place to stay overnight.”

The hospital monitors every day how many cases are on the operating room schedule to help ensure top care of patients. UAB has tightly managed cases during the past two months to make sure patients are safely cared for after their procedure. The hospital is paying close attention to having available bed capacity for patients after operations. UAB has been able to continue to support surgical cases or other procedures where the patient comes into the hospital and goes home the same day.

To be able to continue to serve the community, UAB has converted some spaces not originally intended for overnight patient use. For instance, some recovery rooms are housing patients for one or two nights, then they go home. Some patients that would typically be watched overnight and go home the next morning are using hotels near the hospital.

Taking on the vaccination challenge

While UAB Hospital serves as a safety net for many hospitals statewide, the facility was tasked by the Alabama Department of Health to administer the Pfizer vaccine. UAB has vaccinated more than 25% of health care workers in the state. Students from UAB’s School of Nursing, medical school students and retired nurses are helping give vaccinations. The process is paperwork-intensive, requires separate space to be allocated, and those vaccinated must be monitored for 15 minutes afterward.

“The process that we have in place is administering close to 1,000 vaccinations a day,” Lee said. “For at least a few days, we hit 1,200 vaccinations, which is incredible.” Almost 11,000 people have been vaccinated, including more than 6,100 UAB employees.

Urging the public to stay well with safe behaviors

As Alabama and its medical facilities continue to grapple with how to care for the burgeoning load of COVID patients, Lee said it’s very important for people who are well to maintain safe behaviors.

“Is it really important going and eating in restaurants, on the inside with lots of other people, when we know that the hospital is struggling, and potentially rationing care for patients? Do I need to go to a pub and have a beer with multiple friends, and potentially that’s going to keep my kids from going to school? Those are the questions that we that are healthy need to think about now,” she said.

UAB encourages people to continue these safety practices:

• Wear a mask.
• Stay six feet apart from others.
• Wash your hands or use hand sanitizer.
• Stay home if you are sick.