As covid infection numbers set records almost every day in the state, the virus is once again pushing health care workers to the limit at Jefferson Regional hospital.
Erin Bolton, a registered nurse and director of quality and regulatory at Jefferson Regional, said late last week that the hospital had 18 covid patients, four of whom are in intensive care. That overall number wouldn't normally have been a difficult patient load for the hospital to handle, but because of personnel shortages, also caused by covid, an overflow area of rooms for covid patients could no longer be used.
"We're getting close to our maximum," Bolton said. "Because of staffing issues, we had to close that area, and we will have to figure out somewhere else to put those patients."
Statewide daily infections have climbed into the 8,000-plus range, but as Bolton pointed out, the number is likely much higher because many people who don't know they are sick or who aren't sick enough to seek medical attention are not being counted.
When the delta variant was the dominant form of the virus being seen, almost all of the people being admitted to hospitals, both in Pine Bluff and elsewhere, were unvaccinated. Bolton said that condition has changed dramatically.
"We now have more vaccinated people than unvaccinated in the hospital," Bolton said. "We know it's more contagious, and when they come in, we know they're vaccinated. But we don't know how long ago they were vaccinated or if they have received a booster. Just that they're reporting that they're vaccinated."
Bolton said the fact that vaccinated people are being hospitalized is a function of the large number of people now being infected with omicron and also of the limits of the vaccine.
"We know immunity wanes over time," she said. "We knew that was a possibility."
Bolton said the good news about omicron is that patients don't seem to be getting as sick with it as they did with delta.
"The four we have in ICU are not on ventilators," she said. "And a majority of the other covid patients are not requiring oxygen. That's different than what we were seeing with delta. Omicron does seem to be milder, but it also seems to be a little more resistant to the vaccine. Luckily, it seems people are getting over it quicker."
The highly contagious omicron variant is also creating havoc with the Jefferson Regional staff.
"We have quite a few employees out with covid," Bolton said. "They're trying to take care of people with covid, and the staff is coming down with covid. It's made the situation much more difficult. Staffing was already tight before this latest surge."
Asked what happens if a staff member tests positive, Bolton said the Centers for Disease Control will allow them to return to work eight days after the onset of symptoms if the employee has tested negative on day seven. She also said the CDC had other guidelines, which could be implemented in dire short-staff circumstances, such as allowing a healthcare worker with mild symptoms to continue working on the covid floor.
"That would be a worst-case scenario," Bolton said.
Bolton said Jefferson Regional was not unlike other medical care environments where some staff members continue to refuse to get vaccinated. Arkansas is one of the states where requiring workers to get vaccinated is on hold until the U.S. Supreme Court makes a ruling on the matter. In the meantime, however, the hospital is having to weigh the OSHA requirement to routinely test those individuals at a time when tests are not plentiful, Bolton said.
"We've got maybe a month's supply," she said. "Tests are in really short supply."
As for administering the vaccine, the hospital, at its Healthworks Medical Center clinic, and Doctor's Orders Pharmacy, at its locations in Pine Bluff, White Hall and Star City, continue to hold clinics and make appointments.
Lelan Stice, who operates the pharmacy group and who has been instrumental in administering vaccines in the region, said the public's desire for vaccines "seems to go in waves."
"It happens when there's a new variant that gets people's attention," Stice said. "When that happens, a lot of people show up to get them."
Stice said he is currently seeing 100 or more patients a day coming into the pharmacy in Pine Bluff to get a first or second vaccine or a booster and 20 to 30 at his other two locations.
"It ebbs and flows," he said. "People see a new variant and get concerned. Or they've had covid and are now over it and want to get vaccinated. Or they may know someone who got sick."
Stice said there continues to be a subset of the population that expresses doubts -- or worse -- about the vaccines.
"It's bizarre stuff, just baseless nonsense," he said. "For some people, it's like if you get the vaccine, you're taking on the mark of the beast. It seems like it's primarily white evangelicals who have the most problem with the vaccines now."
Both Stice and Bolton said they had access to a limited supply of monoclonal antibody treatment for high-risk patients, as well as access to a limited supply of a new oral antiviral treatment for covid patients that have underlying health conditions that could complicate their conditions.
Covid testing also continues to be done by Jefferson Regional and Doctor's Orders Pharmacy, Bolton and Stice said, with Stice saying that he has been working with larger businesses that may need to require all of their employees to be vaccinated, based on a decision by the U.S. Supreme Court, which heard arguments on the case late last week.
Healthcare professionals have been concerned with the possibility of patients coming down with seasonal flu at the same time they contract the coronavirus, a condition called "flurona." The worry is that such a "twindemic" could stress hospital staffing even further.
Bolton said Jefferson Regional had seen two people who had the double condition.
"They didn't have to be hospitalized to my knowledge," she said. "But they tested positive for both."