United States hospital pressures

welcome to today's talk it's monday the 23rd of august i'm going to focus mostly on the united states i think in this video where the level of hospitalizations is increasing really quite alarmingly in some states and cases are still going up so let's think about some context to this first of all these contextualization slides are often quite useful now new zealand and australia now um people have been openly saying that the zero policy for covered 19 in new zealand is basically probably finished now it's going to be hard to see how it's going to be eradicated now in australia it's inconceivable now that they could go back to a zero coverage situation which is such a pity after doing so well for so long but they were somewhat slow on the vaccination uptake so i'm afraid in australia i think now for sure the genie is out of the bottle it won't go back in and new zealand potentially the same situation as well real pity so it really is a race to vaccinate in the antipodes now that is that is for sure um going up netherlands this lovely drop there in the netherlands in cases but leveling off now i think it would have to be said as indeed quite a few cases in europe south africa well still winter in south africa will be heading into spring fairly soon but uh case is still reasonably high ireland despite the high vaccination rate the cases in ireland are still going up now what is happening here is the vaccination program in ireland got off slower shall we say than than in than in the united kingdom for example slower than in the united states so there's a longer lag because we know it's taking quite a long time for the immunity to kick in we know the immunity does kick in but it takes a bit of longer time and i think that's why we're seeing this increasing cases in ireland still um united kingdom well definitely a an up tick there an increase there um it had looked promising for so long um but uh the united states i'm afraid it's up all the time an upward trajectory in the united states but it's unequal as we'll see in this talk southern states particularly more concerning than some northern states so that is the cases this is the vaccination status proportion of the population doubly vaccinated now you don't need me to tell you about the severe implications of this in south africa this is not a good situation for south africa we can see the pandemic rumbling on for a long time in south africa as a result of just that line on that graph new zealand australia picking up at comparable rates with vaccines but an awful long way to go and you know in both countries we're talking about delta variant this is so transmissible it really is it really is a bit of a worry and um hospital capacity i'm not so sure about new zealand but i'm going to do some research on that but in australia we know it's actually more limited than you would think for a sophisticated first world country like australia i'm afraid problems ahead in terms of hospitalization and stress on the health care system in australia i'm afraid i think that will pan out over the next month or two um united kingdom vaccines okay netherlands netherlands actually overtaken the united kingdom now a number of people doubly vaccinated um good good job there in netherlands uh ireland very good canada very good of course just the delay effect that we talked about in ireland whereas in the netherlands i think we are already seeing the benefit now um i want to focus your attention on this next slide because this is really the really really important one here hospitalizations canada netherlands manageable ireland still going up limited capacity in ireland very limited capacity as we've noticed from our talks with irish radio united kingdom hospitalization still much higher than we would like but the united states dear oh dear hospital hospitalizations going up really quite dramatically in the united states and that somewhat uh unequally it's worse in some areas than others so i'll just show you this uh this graphic here from the united states this is lifetime from the cdc um and here we see the figures current seven day average 79 310 up from 69 269 the prior seven days um up 14.5 percent still down on the the peak of course but up 14.5 we see the peak there but we see this still going up and this is really quite a big it's quite a bit well it is a big concern in the united states so let's look at some other united states data before we go on to that now as a result of the increase in cases in the united states vaccines are increasing and this this is very reassuring so uh trends in the number of covered 19 vaccines in the united states and again this is live data so we do see it going up somewhat in the country but the good news here is that states that particularly were behind let's take for example alabama um oh yeah and we see that's really going up quite nicely the number of daily vaccinations in alabama going up really quite considerably as people in alabama and other southern states are realizing the importance of vaccination we could show other examples maybe look at one more let's look at um let's try arkansas um yep and we see the same same kind of pattern there in arkansas uh an increase in people getting the vaccine as uh well i guess what's happening is people are seeing literally people around about them getting sick so the united states california texas florida are now over three million cases so pretty big escalation in these highly populated states texas florida california with their high populations good news um i wrote that rece actually that comes from the american news that i watched early morning so basically today monday it's probable or possible monday or tuesday or hopefully the well probably monday or tuesday or wednesday you never know quite with these things but the fda is likely to give full approval to the vaccine to the fisa vaccine literally any hour now so that is encouraging full approval for the fires of vaccine the first vaccine to move off emergency use approval which should give people quite a lot of reassurance i would hope but also makes it easier now it's an approved medication that more sectors in the united states are going to mandate vaccination inevitably that is going to be happening and indeed it's happening now uh mr and mrs jesse jackson hospitalized despite being vaccinated in january prior presidential candidate can't quite remember when reverend jesse jackson um being publicized quite a lot that these this couple despite being vaccinated fully vaccinated in uh finishing january been hospitalized um they are in a higher risk category of course they are older uh individuals and um i must say mr jackson probably has a slightly higher bmi than he would prefer um which of course is going to be um a risk factor but i don't i wanted to keep this in context because it's easy to look at famous individuals and draw too much inference from that because we looked at data from new york about from memory 10.5 million people in new york data based on it's actually on this site here we used it quite extensively a few days ago so um this was day updated what uh 18th of august new covered 19 cases and hospitalizations by vaccination status in new york i'll put the link there of course you can read the whole document if you would um care to do so it's it's there um but but what that was showing is um data on the 25th of july protection against infection after two vaccines just done just a tad under 80 percent so just a tad under 80 percent and the point about this figure is it had gone down from a couple of months before vaccine efficiency against protecting against infection is waning is waning even after adjusting for age adjusted effects against hospitalization july 25th same date the protection against hospitalization was basically 92 to what not to 95 percent so high levels of protection against hospitalization and that had been maintained over the past few months so bear in mind when we look at people like mr and mrs jackson who of course we wish as well as to hope to do really well um but this is the minority the vast majority of people um being hospitalized are not vaccinated because of the 92 to 95 percent protection now the cdc were saying 97 of people being admitted to hospital were unvaccinated we know the number is less than that we don't know the precise number but it's probably in that range 92 to 95 percent so that's that leaves what five to eight percent um of people are vaccinated who are going into hospital so the vast minority of hospitalizations have been vaccinated the vast majority of hospitalizations are unvaccinated that's the simple statistics now talking about this hospital pressure which is is a worry in the states um and it's a worry for two reasons firstly covered patients are going to find it difficult to get treated but we're going to look at some examples of other patients who aren't getting treated which is terrible and of course in the uk the nhs waiting lists are at all time high millions of people waiting for treatment it really is a terrible situation people not being able to get treatment i'm not just talking to a friend yesterday and you all have friends if you're in the uk you'll understand this you look i've talked to friend yesterday arthritic hit for many years been on the waiting list for an operation for quite a few months now but of course no appointment for his hip replacement insight meanwhile his mobility is reduced he's in pretty well constant pain and um and that the treatment is not available yet which is it really is really is a pity um both in terms of personal suffering and reducing his productivity but anyway getting back to the states hospital pressure alabama florida georgia mississippi texas arkansas louisiana high pressure on hospitals i've read a report about some stroke victim or victims in louisiana not getting treatment now this is just terrible you see if someone has a stroke what normally happens is there's a blood clot in one of the blood vessels supplying the brain so if we get these patients early we can give drugs or even do a an intravascular intervention to take that blood clot out or dissolve that blood clot and sometimes the stroke can essentially go away if they're not treated they can be left with permanent disability so it really is a pity that this is not being done it's got a significant impact on future morbidity in the country this is this is going to affect the this individual for another 10 20 years of their life or however long they're going to survive for after their stroke um realizing this mississippi authorities for example just using mississippi uh 500 find or indeed imprisonment for not self-isolating once someone knows they're infected so the the the importance of this is is now being realized also be it somewhat relatedly now it doesn't as we said we don't want to give too many personal examples but let's just give one joel valdez is in houston where the hospital is at the itu capacity is at or above capacity and he he says this having broken bones and bullets in me for over a week now it's a little frustrating now i don't know if he's got english blood but that's classic understatement isn't it i mean i have seen patients left overnight because they can't get surgery with broken bones and every time they move the bone ends can move and it's an agonizing situation whereas mr valdez apparently was shot innocent victim of shooting presumably the bullets have broken some of his bones and he's been waiting for 10 days for surgery probably not so much the surgeon's availability but with complex surgery such as that such as multiple injuries you need often need critical care or intensive care facilities for a few hours or a day or so after while the patient re-stabilizes sometimes only just for a few hours but without that the surgery is just too risky so i'm really terrible to be left in so much pain for that amount of time it really is quite quite upsetting to read about this but when you've seen people in this kind of pain and you know what it's like uh hospital authorities are saying due to strain resources surgical patients are being prioritized based on several factors which unfortunately may result in a delay of non emergency surgical procedures so we've got quite a lot of delaying and and again um well i've been in situations where there's been a delay for surgery you'll admit someone they're ready for the surgery i mean surgery is is frightening um you know you really don't see a patient who's not anxious about getting surgery um even though the anaesthetics and everything of course are typically excellent but people get anxious about it and then paid patients can be fasted ready to go to theater and then sometimes you have to come out and say well i'm sorry we can't do you today so they've had all that build up and all that fasting and then they've got to go through again the next day or the next week it's just terrible it really is tantamount to psychological torture is sometimes unavoidable horrible thing to do to someone when you you know when you look at someone's face when you tell them they're not going to get that surgery that day it's just terrible oregon for example activated 1500 members of the national guard to support 20 hospitals seemingly pretty well everywhere in the united states severe shortages of skilled staff now just got a quote here from mr donald trump and uh he says this i recommend take the vaccines i did it it's good take the vaccines so direct quote from former president donald trump so mr trump they're clearly saying that now he said this in a large political rally where a lot of people there didn't support what he said but you know he he had the you know the other guts really to stand up and say it i recommend take the vaccines i did it it's good take the vaccine so we have a political leader recommending taking the vaccines let's hope people who agree with that political uh ideology take the vaccines in the uk we find it bizarre that questions about mask wearing and vaccination are party political we just find that bizarre so whatever party you're in now we've got mr trump take the vaccines that's what the man is saying and again just as you know an experience from one of the doctors here really um this doctor is a radiation oncologist so he does uh x-ray therapy for people with another radiation therapist for people with cancer florida tampa um i'm just going to read you out a few of the things he said here because it really is just quite um quite quite quite hard hitting really the this is a report from the article in the washington post the unvaccinated are killing people in ways they probably never imagined so it's not just themselves it's the knock-on effect in the health service as we've just seen with mr joel valdez who's hopefully being operated now but like lay around for days with bullets in them the risk of infection apart from anything else anyway this oncologist my hospital one of the largest in central florida was full of covered patients more than 90 of whom were unvaccinated so again confirmation this doctor is saying 90 of patients unvaccinated we had no beds available we had paused elective surgeries the previous week our emergency department had a 12-hour wait that day simply unsafe but i had no choice for the first time in my career i had to say no to a patient who i was an urgent referral for oncological cancer treatment and then the doctor says please do your part and get vaccinated i for one don't want to have to turn away more people who need care now this particular patient was treated at another facility but we've got a radiation oncologist here who uh according to this report has basically never turned a patient away in his life and has had to do so heartbreaking for the doctor and for the patient right i'm gonna just finish off with a few um a few faqs now i think it's probably good to do so bob asks um so following your logic john if someone is vaccinated uh it is fine for them not to wear a mask if they get infected that will boost their immunity right um it may boost their immunity we're still looking at data on that bob but they should wear a mask emphatically they should wear a mask to protect those around them the main reason for wearing a mask is not to protect me although it does the main reason to wear a mask is to protect those around me from me so um while it is true we believe that it's true that if someone has had two doses of vaccine then gets the infection that's going to boost their immunity doubly vaccinated people as per cdc guidelines and as now what is polite not mandated in the uk but what is the polite thing to do is to wear a mask to protect those around us children of course under 16 in the uk are unvaccinated so it's to protect those some people don't respond to the vaccine they're immunocompromised some people are particularly at risk from getting more severe infections for things like high blood pressure increasing age cardiovascular disease respiratory disease and the comorbid obesity hypertension the morbidities we know about so the answer to that one's bob is no we should still wear a mask um joella those who like me as this those who like me are severely immunocompromised and having been tested have found that the double dose vaccine has generated negligible antibodies sorry to hear that joellen we still need some further protection to keep from severe sickness death as exposing ourselves to the disease is a high risk strategy so joella really illustrates that the answer to bob's question why is so important so the the reason it's so important bob is to protect joella excellent point jolan john writes in uh thanks for very interesting stimulating talk john i have one question arising why do we then need annual boosters after flu shots if this is related to how this is related to how the two viruses mutate okay so the thing that the thing about um influenza is there's many different viruses that can threaten it so like last year my flu shot was quadrupled so out of the dozen or so uh influenza viruses that could cause next winter's pandemic um clever people pick the four that are most likely and give us antigens to those four um so there's more flu viruses around there's a bigger variety of influenza viruses than there is of um there is of uh coronaviruses so if one virus falls there's another one waiting behind it as it were to to take its place and as well as that the influenza virus is even less stable than the coronavirus so we know the coronavirus mutates but the influenza virus mutates more readily more often there's this genetic drifting and from time to time there's what we call a genetic shift where there's a big change in the genetic material of the virus so it's due to the number of the viruses john and the um and their quickness to mutate would be the answer to that question uh final question from ruth uh interesting theory about natural infection plus two vaccines which we're talking about uh on saturday now this may know there's no such thing as a silly question there's no never always ask questions um but why does this not apply to flu or the common cold again um we might we've answered that in terms of influenza but the common cold um the common core there are four corona viruses can cause the common cold um or common cold type symptoms but there's i don't know tens or hundreds probably have different rhinoviruses nose viruses that that um that that can cause cold so you could get a cold you can have terrible cold symptoms i'm sure we've walked in here at one time you can have terrible cold symptoms be really quite knocked off and terrible runny nose and horrible cold symptoms for five days maybe sometimes and then get over that and then just a few weeks later you can have another one sometimes just as bad because it's a completely different what's not completely different it's another rhino virus but it's a rhino virus to which you don't have immunity so again it's the number of viruses which are able to cause common cold type symptoms ex infecting the upper respiratory mucous membranes and again these rna viruses can mutate very quickly so good questions from bob joeller john and ruth thank you for those and uh thank you for watching this update oh i'm going to do one uh shortly i've almost prepped it on the new antibody tests that are coming out in the uk so we might we'll see how we get on but that's that's the next thing thanks for watching

Channel: Dr. John Campbell

Views: 128,919

Keywords: physiology, nursing, NCLEX, health, disease, biology, medicine, nurse education, medical education, pathophysiology, campbell, human biology, human body

Id: DUMkXjqkd_U

Length: 22min 34sec (1354 seconds)

Published: Mon Aug 23 2021