Anchorage ER doctor says omicron presents a whole new set of challenges

A COVID testing site.
Bethel, Alaska. (Katie Basile/KYUK)

Alaska health officials say the omicron variant of the coronavirus is hitting hard and hitting fast, as hospitals start to see an increase in COVID-positive patients, an uptick in hospitalizations and growing concerns about health care workers calling in sick.

And while those infected with omicron tend to have milder symptoms, the sheer number of cases — more now than at any previous time in the pandemic — means hospitals are bracing for an influx of sick patients needing specialized care.

Among those on the front lines of the pandemic is Alaska Regional Hospital emergency room physician Dr. Dave Scordino, who is also the hospital’s Emergency Department director and, of course, a veteran of the delta variant surge last fall. Scordino says omicron presents a whole new set of challenges.

Listen here:

The following transcript has been lightly edited for clarity.

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Dave Scordino: Mostly because some of the things that we were using before, such as some of the monoclonal antibodies, you know, we’re seeing less efficacy compared to delta. And so combine that with just the number of cases that we’re seeing that also, admittedly, is slightly different than delta, because we’re just seeing a really large volume.

Casey Grove: With omicron — or with just with coronavirus cases that you see now — is there less pressure to have somebody be hospitalized knowing that the symptoms might not get worse? Or is there any way of even knowing that?

DS: You know, the same risk factors for progression to severe illness are the same: certainly age, obesity, hypertension, diabetes, renal disease, right, those haven’t changed. But we’ve also seen individuals with risk factors still end up doing OK. And so I haven’t seen a pressure change to admit vs. not admit, because that’s driven by their presentation at the time and what their oxygen needs are or their lab values — if they’ve gone into renal failure, whatever their additional conditions could be. What we’re seeing is just a lot of people. And so far, we haven’t had quite as many people — as a percentage of those cases — that have ended up requiring hospitalizations, you know, a week or two after they were diagnosed. Admittedly, I have concerns because we are still early on in this wave, comparatively, what we seem to be on the national trends. I think that we will be seeing some increase hospitalizations over the coming weeks. But that, of course, is to be seen.

CG: Even if that’s yet to be seen, just with this increase in cases, and having been through this before with the delta variant surge, is this discouraging, to see case counts going up again?

DS: I think everyone — health care workers and community members — are all discouraged by a recurrent wave. It is sad to see how disruptive this virus can continue to be even two years into this. And I think that is obviously disheartening. And what’s more disheartening is obviously the degree of preventative capability there is out there with vaccinations, knowing how effective masks can be in reducing transmission. And still seeing this degree of transmission is certainly, I think, disheartening to many to know that we could be doing better.

CG: I guess one of the main concerns right now it sounds like is the number of health care workers having to call in sick either because they were exposed or because they tested positive themselves? Are you seeing that too? Is that a difficulty just keeping staffing levels up?

DS: A lot of hospitals, ours included, have had increased sick calls comparatively to where we were, say, a month or two ago. So that’s certainly creating some challenges with staffing that are obviously difficult to anticipate, which makes it difficult to plan for. So it’s definitely creating some real challenges. I mean, gosh, as a better example, let me put it this way: When I try and discharge a patient to get their medications, I send their prescription to a pharmacy, but the pharmacies might be closed, right? Because their hours are now kind of erratic because of their staffing shortages, because their pharmacy techs have either quit or have called off sick. And the same with their pharmacists. And so we are seeing shortages in some supplies that come across because of those labor shortages. So it’s not just the direct patient care, that we’re obviously experiencing some challenges of staffing, but even those ancillary and community services are all experiencing labor shortages associated with COVID at this point.

CG: Has news of omicron coming and now that it is here, and you’re seeing case counts go up, have you had to change your personal life at all and cancel things and stuff like that?

DS: The honest answer is no, but that’s because I have two kids under the age of five. So I have kids that can’t be vaccinated yet. So in many respects, we had begun to have some hope of opening up ourselves a little bit over the summer, in terms of our behaviors and social networks. And then obviously we started seeing delta and we had our own wave come into the summer and into the fall. And things never really slowed down enough for us to kind of have that reconsideration. We actually applied for daycare over the summer, thinking that things were getting good enough and maybe things wouldn’t be that bad and we could talk about it before our kids were vaccinated. And the fall surge happened. And now this is happening. And so they’re still not going. So we had a change of heart. But, unfortunately, our behaviors never got a chance to change.

CG: Yeah, it’s kind of like you weren’t in a position to ever let your guard down.

DS: Yeah, I mean, we briefly had that feeling, maybe, over the summer, we got to go and see some family that my young kids hadn’t got to see before. One of them was born during the pandemic. And so they haven’t met many of my my family members out of state. And so we were able to do that. And then things started picking up here and nationally. And so that was the brief glimpse of that kind of return that we had. And then we lost it.

CG: That’s interesting. And thanks for sharing that. There definitely was kind of a window there.

DS: Yeah, there was a brief window where I really did think that we were headed in a better direction. And then it stopped. We really do appreciate the community’s support and masking when they go out into the community and getting vaccinated if they haven’t done so and getting their booster if they are due for it because that is really what’s going to stem this tide of patients coming to the hospitals and getting what will end up as being more admissions and, unfortunately, likely more deaths. I’m heartened by the fact that we are seeing that, you know, the length of stays for hospitalization seem to be a little bit less. Obviously the percentage of patients being hospitalized seems to be a little bit less. And certainly for the patients that have been vaccinated, we’re certainly seeing milder disease in them for sure, even though they are getting breakthrough cases at a higher rate than we saw with delta. And so there’s some glimmers of hope with this, but at the same time, really would love to see that engagement we had before come back.

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Casey Grove is the host of Alaska News Nightly and a general assignment reporter at Alaska Public Media with an emphasis on crime and courts. Reach him at cgrove@alaskapublic.org.

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