For more than a year, Annie Smith has seen the up-close damage COVID-19 has had on her patients and the emotional toll it’s had on her colleagues.
As a longtime intensive care unit nurse at Ochsner in Baton Rouge, she cared for people during the 2008 swine flu epidemic, in the aftermath of Hurricane Katrina and, like many health workers, she braced before breathing a sigh of relief when the country reported a handful of Ebola cases in 2014.
None of those have compared to the latest health crisis and the burden it’s had on health workers and their spirits.
"Everyone is just as exhausted and ready for a break,” said Smith, 40. “I think right now, there seems to be some sense of relief, but everyone’s exhausted.”
As more Louisianans have received their vaccinations, the number of people sickened by the virus has dropped significantly since the beginning of the year, and some Baton Rouge hospitals have even had days recently when they admitted no new COVID-19 patients.
Despite a lull in the number of patients needing intensive care for COVID-19, local hospitals are now seeing secondary impacts from the pandemic in the form of people developing complications sometimes months after recovering from the virus, as well as an increase in patients with existing conditions worsening because they may have delayed seeking care in the past year.
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Some hospitals are meanwhile still caring for people with severe and potentially life-threatening COVID-19 and some health leaders have been cautiously optimistic, fearing the low point in hospitalizations may only be temporary, especially as more people resume some semblance of pre-pandemic daily life.
“We are in a better place, but I do not believe we are all clear,” said Dr. Stephen Brierre, who heads critical care at Baton Rouge General Hospital.
Just more than a year after the pandemic intensified in Louisiana, there hasn’t been a day when the hospital's ICU haven’t had a patient, and the state hasn’t recorded a deathless day. The latest state Department of Health figures show more than 10,100 people are suspected of dying from the virus that’s also sickened at least 400,000 since last spring.
For health workers, the long slog of the pandemic has been emotionally draining. Some hospitals have reported an increase in PTSD among some workers, as well as higher levels of burnout.
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Hospitals have brought in counselors to help overstretched health workers cope with seeing the grim realities of the pandemic day in and day out, and staff have leaned heavily on each other for support.
"We're still living it every day and losing people," said Ochsner Baton Rouge ICU nurse Tammy Dickerson. “It is hard when you hear people saying 'I don't wanna do this or I don't wanna do that.’ But in our world, we've got the sickest of the sick, and we're still losing people."
Health experts raised alarms last year after noticing a significant drop in the number of patients coming into emergency rooms for heart attacks, strokes and other urgent health issues. The capital area's largest ambulance providers also saw upwards of one-quarter of patients refusing emergency care due to fears of contracting the virus in an ambulance or hospital, despite facilities going through lengths to assure a nervous public that they were both safe.
Though emergency service providers have no longer seen those issues in recent months, the impacts of putting off care are beginning to show themselves in hospitals.
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Baton Rouge General, for instance, saw a 50% rise in patients early this year who developed congestive heart failure, a permanent condition that can be managed but often diminishes a person’s life because their heart is unable to pump enough blood.
At Ochsner, doctors have observed a growing number of patients with underlying conditions that have worsened in the past year.
Dr. Russo, the health chain’s regional medical director in Baton Rouge, said in some cases, people may have fallen behind on taking medications or weren’t treating other conditions, such as high blood pressure and diabetes.
“It’s a pretty concerning thing and we’re not expecting the volumes to go down soon,” he said. “The fact that COVID admissions are down, that doesn’t mean anything.”
Baton Rouge General has also seen a rise in the number of drug overdoses in recent months, a trend that Brierre said may be a result of the pandemic leaving people in recovery isolated and unable to stay connected with sobriety and support groups.
His observation also comes on the tails of the deadliest year for fatal drug overdoses in East Baton Rouge Parish. With at least 232 drug overdose deaths last year, that figure shattered the previous record in 2019 nearly twofold, according to the parish coroner’s office.
Parish officials say they fear that trend may be continuing into this year after reporting earlier this year that Baton Rouge was on track to eclipse the 2020 drug-death toll.
Along with hospitals reporting a significant increase in patients needing care for other conditions that they may have neglected in the past 13 months, some facilities are seeing the aftershock the virus has on people’s bodies even after they’re no longer infectious.
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For some patients, the virus has left them weak and more prone to falls, pneumonia, heart damage, and a host of other issues, and doctors don't yet fully understand what the long-term impacts may be. Some people become malnourished because the illness has weakened them to the point they struggle to feed themselves.
“COVID leaves you with a very sick life to recover from,” said Catherine O’Neal, chief medical officer at Our Lady of the Lake Regional Medical Center.
The added stress of caring for those patients, too, is putting strains on health systems and the full impacts may continue to echo several months later as each surge has been accompanied by an aftershock of patients with health problems, O’Neal said.
Though the currently approved vaccines appear effective at shielding people from severe illness, more infectious variants have health experts concerned it could cause new cases to balloon. A greater fear, they say, is a version of the virus that can sicken people who’ve already been vaccinated.
As of now, O’Neal said the trend in Louisiana could go either way and either more people get vaccinated and drive infections down further or cases take off again for the fourth time. Convincing people to receive the vaccine will likely be the ultimate challenge, especially those who are on the fence about it.
“It’s really hard to read the tea leaves right now because we are on the cusp of doing a better job, but we are not there yet,” she said. “That last push will be the hardest. It will be convincing people who really aren’t ready to get the vaccine that they need to get it to end the pandemic.”
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