PBS Newshour: Rising COVID hospitalizations in San Antonio burden fatigued health care workers

Dr. Jason Bowling, Infectious Diseases, was interviewed for the PBS Newshour.


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Judy Woodruff: The highly contagious Omicron variant has brought new daily COVID case numbers to record highs this month, and the magnitude of infections has left many hospitals once again under tremendous pressure and even on the brink.vIn Texas, where just 58 percent of the state is fully vaccinated, hospitalizations have risen dramatically. Amna Nawaz has our report.

Amna Nawaz: Judy, this month, the city of San Antonio is reporting the highest average of cases since the pandemic began. On Monday, health officials reported more than 7,000 new cases. The positivity rate has climbed to 38 percent. And over the last two weeks, hospitalizations have increased 80 percent. Dr. Jason Bowling is an infectious disease specialist at University Health and an assistant professor of infectious disease at UT Health San Antonio. He joins us now. Dr. Bowling, welcome to the “NewsHour.” And thank you for making the time. You guys in San Antonio are now dealing with your fourth COVID surge. Hospitalizations there have tripled since the start of January. What is it like for you to go into work every day?

Dr. Jason Bowling, UT Health San Antonio: Well, it’s incredibly busy, as you can imagine, with the numbers increasing so quickly.
We’re really seeing a lot of hospitalizations and a lot of business in our outpatient settings, in the clinics. With this most transmissible variant, the number of cases has gone really high. And even though it’s relatively less severe than the Delta variant, given the high number of cases, that still leads to a lot of people ending up in the hospital setting.

Amna Nawaz: Tell me about your patients. Are they mostly breakthrough infections, vaccinated people who are also getting sick, as we know happens with Omicron, or mostly unvaccinated?

Dr. Jason Bowling: So, the majority of the patients that we see in the hospital are unvaccinated. We do see some breakthrough infections in the hospital setting. And those are often that people that have issues with their immune system or on medicines that can impact their immune system.
But most of the people that are really ill and end up in the ICU are unvaccinated, and the majority of the patients hospitalized. More of our vaccinated patients may be seen in the clinic, in the urgent care clinic, or with their primary care doctor.

Amna Nawaz: For the patients who are unvaccinated who you’re treating, do you talk to them about getting the vaccine?

Dr. Jason Bowling: I do. I think most of the providers do. I talk with them about the vaccine. I think, at this point, trying to find a place where you’re just providing information — obviously, there’s been a lot of information out for quite some time now about the vaccine. We’re further along with our experience with that. And so I’m happy to share my experience with people that have been vaccinated. The other thing that we see with people that are sick enough to be in the hospital is, actually, many of them are more amenable or more willing to listen to talk about the vaccines. There are still some people that don’t want to talk about it. And they will usually tell you that right away. We’re careful to respect those boundaries. But we definitely want to provide helpful information, let them know what’s recommended, also that it’s important, even when you’re infected, to still get vaccinated, because you can’t get reinfected. Natural immunity is not enough to keep you from getting sick again.

Amna Nawaz: Can I ask you about some of the updated CDC guidelines for health care workers? Because we have been hearing a lot of headlines about that. Obviously, you have had staffing issues, like every hospital around the country. The CDC says, if any health care worker has a potential exposure, they recommend testing before returning to work. But with the rates that you are seeing and managing in your hospital, is that even possible?

Dr. Jason Bowling: Yes, that’s a great question. So, we really have had to look for a way that we could balance the CDC recommendations with what’s practical. One of the challenges with having cases so high here and a test positivity rate so high is that we see people that will have multiple high-risk exposures within a week. So, early on, when we were trying to implement the testing before returning, we were finding people would need to be tested two or three times in a week. And that was a real challenge with the fact that we were trying to test all these symptomatic people that really need to be tested, so we can establish a diagnosis. So, we have kind of had to find a balance to find a practical approach. We certainly want it to be safe when people come back to the work environment, so they’re not infecting their co-workers, but also find a balance that we’re using the tests as prudently as possible to keep it safe.

Amna Nawaz: Tell me about your staff and what you’re seeing among them right now because we have been hearing stories, especially now as we’re well into year two of this, of health care workers around the country just saying they are burned out, and they feel like the shorter isolation periods and having to go back to work, sometimes even if they have tested positive, just because they need to fill those staffing shortages, it really, really adds to the burnout.
There was actually one nurse I read in a report in The Washington Post in California. She said: “The more I give, the more you want. I have nothing left to give.” I wonder if you’re seeing or hearing that sentiment among your staff.

Dr. Jason Bowling: Well, we are certainly seeing that this has been a long road. It’s been a long pandemic. People have given a lot of time.
And now what we’re seeing with this most transmissible variant is that lots of health care workers in a unit may be out at the same time, and so that we’re asking the ones that are left to cover more hours. And so it has been hard. I have realized now that, when you ask people, how are you doing, you’re asking it with an intensity that you didn’t ask before, because you’re concerned about how people are doing and their well-being. But I have also been really impressed with the volunteerism, people stepping up to help cover for their colleagues that are out, people asking if they can come back in five days, so that they can come back and help, because they know people have been covering for them. So, certainly a whole mix of emotions. Definitely, we’re seeing fatigue. This has been a long time. But I have also been impressed with how people have stood up and risen to this challenge, despite it going on for much longer than anybody anticipated at the beginning.

Amna Nawaz: Dr. Bowling, you have been here before, in a sense, right, the staffing shortages, supply shortages, another surge in your area.
I wonder if you thought two years ago that you would be where you are today.

Dr. Jason Bowling: So, I don’t think that anybody can honestly state that they would think that this would go on for this long.
I mean, people had predictions. So, no, I didn’t anticipate that. Certainly, it does feel like we have been here. And I think one of the words I think is known, Webster’s dictionary, of Blursday holds a lot of meaning, because it does seem to be the same day over and over again.
But I do see glimpses of progress, right? We have vaccines now. We have better strategies. We’re trying different things. I think we have made progress. There’s been some impressive scientific advances throughout this. We just need to continue to embrace those, so we can get further past this, so that the days coming forward don’t look exact same as the days that we have had in the past.

Amna Nawaz: That is Dr. Jason Bowling from UT Health San Antonio joining us tonight. Dr. Bowling, thank you so much to you and your team for everything you’re doing. We appreciate it.

Dr. Jason Bowling: Thank you very much.

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