Delta variant of COVID-19 more contagious, but not lots of hospitalizations at CHA Everett

As the Delta variant of COVID-19 has grabbed a lot of headlines, and statewide case numbers have started to increase, the news from CHA Everett is still very positive.

The hospital is very busy, and COVID is simply another part of the overall program, but to date, it isn’t a big part of what the hospital is seeing from patients.

In an update from Dr. Melisa Lai-Becker, chief of the Emergency Department at CHA Everett, she said they have returned to pre-pandemic volumes of patients, but they’re not really coming in by and large with COVID-19 anymore.

“There were times where we had more than four dozen patients hospitalized across both campuses,” she said. “There were times across both campuses we had more than 60 patients that had COVID-19. Today, we only have four patients in the hospital that have COVID-19. That’s great news. It’s pretty good especially since we’re near the end of the second summer with COVID.”

She said they have seen a little bump in cases over the past few weeks, and experienced a cluster of cases that were from the outbreak on Cape Cod, but by and large people are coming with other illnesses and ailments.

“What has happened as of June and at the end of July is we have increased volumes and are back where we were in terms of volume pre-pandemic,” she said. “In addition, the acuity of patients has stayed pretty high. All the earlier things with right sizing and tele-health and re-distribution of space and other options for less acute issues has, I believe, happened. That said, this summer we are experiencing very high volumes and in the Emergency Department people have things going on. Now in the last week of July we are seeing a little bump of actual COVID-19 and all the other viruses.

“We did have a small cluster of COVID in late July and all of them had been out at the Cape,” she continued. “That’s probably the Delta variant and as it turns out the Delta variant is more contagious because it does have to do with the fact that there are a higher number of viral particles in people.”

She said it has become very interesting in the Emergency Department when people come with COVID symptoms. Nowadays, they have the ability to give a panel test that detects COVID-19, as well as other coronaviruses and the common cold and other such illnesses. When they give that test, they may think the person has COVID, but they don’t. There seems to be no dead-solid-perfect prediction as there once seemed to be.

“It’s funny the number of times we’ve used this panel, and it pretty much always detects a virus, but it’s not COVID-19, but just another virus,” she said “…We will see people who have an influenza illness and it could be COVID-19 or something else and now more likely than not it’s something else… I’m happy to report the very, very few times (breakthrough infections are) happening, it’s clearly not a big deal for the person. They have a little sore throat and feel a little icky. That’s it and that’s great news. Anecdotally, I have had patients with one of those combo tests that I did and they had COVID-19 and have been vaccinated and don’t seem to have the same symptoms as when they had COVID-19. Then there are those vaccinated that have symptoms and everything about it screams COVID-19 except the oxygen level is steady…They’ll tell you they’ve had the same symptoms as COVID. You give them the panel test and it comes back and it’s the other coronavirus. It’s not COVID.”

At CHA, Lai-Becker said they have an admirable rate of more than 90 percent of employees that are vaccinated. Now, vaccination and COVID-19 care are simply part of the regimen of care when someone comes to the hospital. Gone are the days of body suits and other precautions that once were standard in 2020. Now, as has been the case for a while, COVID is part of many other considerations.

“That’s how it is now and actually how it’s been for the past several months now,” she said. “It has become very much a part of COVID-19 being implemented into the workflow of the hospital. It used to be we treated everyone that needed to be admitted and we sheltered and cohorted patients because we had COVID-19 wards. Now we admit people and check their COVID-19 status and ask what their vaccine status is and if we can help unvaccinated people get a vaccine. All Emergency Departments are prepared pretty much to give the vaccine on the spot.”

One of the more interesting things now is the Delta variant of COVID-19, which is more contagious than the Alpha variant and much more contagious than the original Wuhan variant. However, one of the things that’s happened is the virus has clearly become less deadly.

Lai-Becker said part of that is the fact that successful viruses cannot be too deadly to their hosts. She said they’ve found that there are about 1,000 more virus particles in an infected person with Delta. With more particles comes an easier chance to spread the disease.

“As viruses go and any infectious vector goes, they’re like parasites,” she said. “They have to live in the Goldilocks zone. They can’t kill off the host too quickly. If the host is dead, they can’t go spread it around. They also can’t be so easily spread and so less severe that no one cares. Then it’s just like the common cold…That’s the problem because COVID-19 has found the sweet spot. It doesn’t settle so deep in your lungs.”

She said for someone with the Delta variant, if they cough, it may just take one deep breath to ingest the virus when one is around an infected person. Previously, that was estimated to be about 10 deep breaths, so the contagion is much more severe. The flip side, she said, is that it seems less deadly, and people and medical professionals know more about what to do with COVID.

“I think it certainly is less deadly and I think we have also figured more out about COVID,” she said. “The best way for a virus to be successful and to grow and replicate and spread from host to host is not to kill off the host too quickly. It could also be a combination where we are a host that understands what better to do. If you get sick, you don’t go out. You don’t go to work and you don’t spread it around. Part of it also is people recognize that you need to go to the hospital earlier before it gets too bad. That’s maybe a PR triumph because the first round…we didn’t fully realize what was going on. That led to a lot of late presenters who thought they had a cold…There were a lot of essential workers and non-essential workers who maybe worked themselves to death because they showed up one more day on the construction site and pushed themselves too far…Just that one more day at work, and that maybe is what tipped them over the edge.”

However, people have become much better about washing their hands, and many don’t fight the call to wear a mask either. The hospitals now don’t intubate COVID patients immediately, but practice a gentle but firm approach to care. It likely is all of that mixed together that has made Delta, to this point, less deadly than the previous variants of the disease.

“Perhaps all of those things together have combined to, in fact, make things less deadly,” she said.

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