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As beds fill, St. Louis area hospitals again postpone procedures

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BJC begins vaccinating frontline caregivers

Dr. Ryan Fields, professor of surgical oncology at Washington University School of Medicine, prepares a vial of the Pfizer COVID-19 vaccine on Thursday, Dec. 17, 2020, at the school's campus near Barnes-Jewish Hospital in St. Louis. (Christian Gooden, cgooden@post-dispatch.com)

ST. LOUIS — Area hospitals are postponing some elective procedures as COVID-19 patient numbers climb in the region and resources stretch thin, the acting head of the St. Louis Metropolitan Pandemic Task Force, Dr. Clay Dunagan, said during a briefing Tuesday.

Also on Tuesday, Gov. Mike Parson’s administration announced that Missourians with compromised immune systems are cleared to get COVID-19 vaccine booster shots, a move to protect the most vulnerable.

Dunagan said hospitals don’t have enough staff members to continue normal levels of elective procedures while caring for virus patients and providing emergency medicine.

Patients with suspected and confirmed COVID-19 are occupying 21% of the region’s intensive care unit beds, which Dunagan described as “getting to a fairly critical level.”

In the spring of 2020, the task force hospitals postponed procedures that could be delayed for eight weeks or more without risk. Some also delayed some procedures during the winter surge. The task force is composed of the area’s four major health systems: BJC HealthCare, Mercy, SSM Health and St. Luke’s Hospital.

Dunagan, BJC HealthCare’s chief clinical officer and an infectious disease expert at Washington University, also expressed concern about availability of equipment used to care for patients with severe COVID-19, called extracorporeal membrane oxygenation, or ECMO, machines. The health systems have had to send at least one patient out of the region to receive ECMO treatment.

ECMO machines are used for patients whose lungs are so damaged they cannot provide enough oxygen to their blood. The machines oxygenate a patient’s blood until their lungs heal.

“Ordinarily, the St. Louis region is an area to which other hospitals send their patients who need this therapy,” Dunagan said. “This is really pushing us to the limit, and is something that’s going to impair our ability to take care of other patients.”

Booster doses

The task force reported 543 confirmed COVID-19 patients in the region’s hospitals — 84% of them unvaccinated.

Dunagan said most of the vaccinated individuals who are sick with the virus are elderly or have an illness that compromises their immune system, which may have weakened their body’s reaction to the vaccine.

But some St. Louis area residents soon might be getting their third dose of COVID-19 vaccine. In a move mirroring guidance being mulled by President Joe Biden’s administration, the Missouri Department of Health and Senior Services outlined the state’s new policy. It applies to people who are “moderately to severely immunocompromised” because of a medical condition or a combination of medication or treatments they are undergoing.

“Individuals who do not meet the criteria for ‘moderately to severely immunocompromised’ do not need a third dose at this time,” the department said in a statement.

The latest update affects those who received the Pfizer and BioNTech or Moderna vaccines, not the one-shot Johnson & Johnson vaccine.

Mental Health spokeswoman Debra Walker confirmed Tuesday that booster shots already are in the works for residents of its facilities, in which there are now eight active cases among residents and 73 among employees.

Six employees and 13 residents of the department have died since the beginning of the pandemic.

U.S. health authorities are expected to soon recommend an extra vaccine dose for all Americans eight months after the second shot, the Associated Press reported, according to two people who spoke on condition of anonymity to discuss internal deliberations.

In Missouri, 43% of the population is fully vaccinated, according to state data. That is compared with 51% nationwide, according to the U.S. Centers for Disease Control and Prevention.

Missouri’s seven-day average of new confirmed cases was 2,739 on Tuesday, up from 581 two months earlier, according to a Post-Dispatch analysis.

The state on Tuesday reported 124 more deaths because of the virus. Of those, 86 occurred in prior weeks: one in June, 52 in July, and 33 earlier this month.

According to the CDC, Missouri is the fourth-highest state in the nation for virus deaths per capita over the past week. Louisiana leads the nation, followed by Arkansas and Nevada.

Dunagan said there are some signs that St. Louis-area case numbers might be slowing, but added, “it’s a little bit too early to bank on that.”

The slight flattening in the case rates could be a temporary downturn in numbers, or a lag in data reporting.

“It is a time where we really need to remain diligent in our use of masks and vaccines,” Dunagan said. “Those are really the only things we can do to mitigate the risk of spread, and try to protect the health system.”

Originally published on Aug. 17.

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