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Young, unvaccinated Nebraskans among critically ill COVID patients, doctors say
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Young, unvaccinated Nebraskans among critically ill COVID patients, doctors say

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The number of people hospitalized with COVID in Nebraska rose again last week as the state continued to record one of the highest COVID case rates in the nation.

OMAHA -- Nebraska has seen this before: a fall spike in COVID-19 cases, hospitalizations and, ultimately, deaths.

Now the state is "smack in the middle" of the nation's COVID-19 hot spots, said Dr. Matthew Donahue, the state's acting epidemiologist.

But several things are different this year in the Cornhusker state: The delta-driven surge has dragged on longer than last year's shorter, albeit steeper, spike.

Nebraska hospitals last year had shut down elective procedures to clear space for COVID patients. This year, they're treating COVID patients and playing catch-up on care delayed by the pandemic. And unlike last year's pre-vaccine surge, many of the critically ill COVID patients are young — in their 20s, 30s, 40s and 50s.

All of those factors have combined to put pressure on the state's hospital systems, state health officials and Omaha-area critical care physicians said Wednesday.

The health officials urged people who haven't gotten vaccinated to get their shots and those who have been vaccinated to get booster doses. Every American 18 and older now is eligible for a booster six months after their last Pfizer or Moderna vaccine or two months after a Johnson & Johnson shot. 

"It was a lot easier a year ago ... when we decompressed our hospitals and everyone was in for the fight," said Dr. Brian Boer, section chief of critical care medicine for Nebraska Medicine. 

But in the year since, he said, many staff members have left, most retiring or quitting health care entirely due to burnout. Some have taken traveling medical jobs that allow them to earn more money. That means his hospital's ability to deal with COVID cases is not what it was.

Health care workers will continue to care for all comers. "But it's getting old when every person who rolls through the door, it's like, 'Yup, unvaccinated. Again,'" Boer said.

Of the 25 patients in the Nebraska Medical Center's intensive care unit Wednesday, he said, only a couple had been vaccinated, and they were profoundly immunosuppressed.

Because of the stress on the system, Boer said, Nebraska Medicine now takes few transfer patients. To help relieve pressure on other hospitals, the VA Nebraska-Western Iowa Health Care System is admitting nonmilitary patients from small hospitals in Nebraska. 

The number of cases and hospitalizations in the state has been ticking upward for the past couple of months, interrupted only by a brief dip in mid-October.

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The state now is at the highest number of hospitalized COVID-19 patients in 2021, with 555 hospitalized in the state on Wednesday. Hospitals in the Omaha area accounted for 272 of those patients.

Omaha-area hospitals also counted 57 patients on ventilators Monday, the highest number of the pandemic.

Since late October, said Donahue, the state epidemiologist, people who are not fully vaccinated have been 10 times more likely to be hospitalized with COVID-19 than those who are fully vaccinated. 

That margin, he said, shows that vaccines are working well in keeping people out of hospitals.

And that, Donahue said, goes for people of all ages. While younger people are less likely to become severely ill from COVID-19 in general, unvaccinated 30-year-olds now are filling hospitals at similar rates as fully vaccinated people over 80. The elderly tend to have more underlying health issues and less-robust immune systems.

Dr. Robert Plambeck, ECMO director for CHI Health, said younger patients often don't think they're going to get sick from COVID. "You can see the regret," he said. "Yeah, if they could go back, they would get vaccinated."

Seeing younger patients also has hit close to home, Plambeck said, noting he is seeing some patients near his age — 36 — who are dying and leaving kids and spouses behind.

"It's hard to see families suffering like that," he said. "It didn't have to be that way. They could have gotten vaccinated and not (be) dying in the ICU on a ventilator."

Dr. Adam Wells, ICU medical director at Methodist Hospital, said every patient in the hospital's ICU on Wednesday was a COVID patient. The hospital has had to open additional beds for such patients. 

Staff members are working around the clock to optimize care for those patients. But they also see the "despair and anguish" families go through as they watch their loved ones decline. And that is taking an "unimaginable toll" on staff, from nurses to cafeteria workers.

"It's really starting to drain on everyone because it's been a long haul," Wells said.

Donahue said he can't predict when the current surge will end, nor explain entirely why the state is seeing such a long surge. This summer's surge in the Southern United States ended much faster.

Dr. Gary Anthone, the state's chief medical officer, said people should not hold off on getting boosters in order to wait for more news about the omicron variant. All available information indicates that boosters provide a stronger antibody response, even against variants.

"It's not something to hold off for," Anthone said. "If you're eligible, go get boosted."

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