Health Care Workers Are Again Coping With Too Many COVID-19 Deaths NPR's Noel King checks in with Dr. Jamil Madi, a critical care specialist at a hospital in Harlingen, Texas, about current levels of COVID-19 cases, hospitalizations and vaccinations.

Health Care Workers Are Again Coping With Too Many COVID-19 Deaths

Health Care Workers Are Again Coping With Too Many COVID-19 Deaths

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NPR's Noel King checks in with Dr. Jamil Madi, a critical care specialist at a hospital in Harlingen, Texas, about current levels of COVID-19 cases, hospitalizations and vaccinations.

NOEL KING, HOST:

As of this morning, more than 161 million Americans are fully vaccinated against the coronavirus. That's a lot of people, but it's still less than half of those who are eligible in this country. The delta variant is causing a surge, and again, health care professionals are seeing it first. Throughout the pandemic, we've talked a few times to Dr. Jamil Madi. He's the chief of critical care medicine at Valley Baptist Medical Center in Harlingen, Texas. And he's with us again. Good morning, Dr. Madi.

JAMIL MADI: Good morning. Thank you for having me.

KING: We're very happy to have you. When we talked a year ago, you said the hospital was at capacity. You had makeshift units all over the place. What's it like now? How are you doing?

MADI: Well, we are definitely in a different place today than we were a year ago. The - there is a slight uptick of the hospitalizations in the last few weeks that we've had, but of course, nothing compared to what we had last year. But we had our lowest numbers around a couple of months ago, back in May - April and May. And then we started seeing a rise in the number in the last several weeks and, obviously, most likely due to the delta variant. So we've almost doubled our census in all the hospitals that I work in, in the Valley, in the Rio Grande Valley.

KING: How concerned are you about the delta variant?

MADI: I'm somewhat concerned. The - it seems that this virus, according to the initial studies, is more contagious than the mother virus, but there's no data that says that it's more virulent or more deadly. Yet we are seeing patients that are coming into the hospital, some of them very sick, and ending up in the units.

KING: OK. Are you seeing people hospitalized for COVID-19 who have gotten the vaccine?

MADI: We do - very rarely, but we do. And there are issues around - you know, for every 20 patients that are being admitted to the hospitals, there's one patient that gets admitted that has been vaccinated.

KING: One person in 20 who's coming to the hospital now has been fully vaccinated. I know our listeners will be very curious about this. Are the symptoms of those people who've been vaccinated less severe than folks who haven't been?

MADI: Good question. So far, because we have so few numbers, the patients that did come in seem to have a less severe disease than the ones that are not.

KING: OK.

MADI: But there are too many variables among that.

KING: And does 1 in 20 being fully vaccinated, does that surprise you? I mean, it was always said that the vaccine was not 100% effective, but I wonder if 1 in 20 seems high to you or how you're processing this number.

MADI: Well, you understand that the delta variant, according to the CDC and to the recent studies, that the efficacy of the vaccines is - has gone down from around 95% to probably around 88%, which is still high.

KING: Yeah.

MADI: So you still have another 12% of the population that is - that will not be affected by the vaccine and will not have that immunity. So I'm not surprised by that number. That number seems to be adequate.

KING: OK.

MADI: What I'm surprised by is the number of patients that are coming in that are not vaccinated that are very sick.

KING: OK. And I wonder - when you and other doctors there ask people, why didn't you get the vaccine, what do they tell you?

MADI: Well, you know, the issue is - the excuses are they didn't get a chance to get to it, or they don't believe in the vaccine, or they're vaccine shy, or they've heard this or heard that about the vaccine, and the vaccine has side effects, and they don't want to try the vaccine. So we've got different discussions about the vaccine, and everyone has their own excuse about why not - why they did not take their vaccines.

KING: And when you're presented - or when you encounter an individual who shares misinformation with you and says, this is the reason I'm not going to be vaccinated, how do you handle that? What is the conversation sound like from there?

MADI: It's not an easy conversation...

KING: OK.

MADI: ...Because at that time, you know, the patients are sick, and we want to deal with what they're going through right now.

KING: Yeah.

MADI: So we don't want to go into a discussion that might not lead anywhere. We have to deal with what's going on and dealing with their underlying, active disease. The discussions should actually be made in the clinics, in the public arena, rather than the patients being already in the hospital. You don't want them to feel - some of them feel somewhat guilty about, you know, not having the vaccine...

KING: Sure.

MADI: ...And ending up the way they did.

KING: That is entirely understandable. Let me ask you about guidance at the national level. The CDC's guidance since May has been that fully vaccinated people don't have to wear face masks or socially distance in most settings. Now, we've had public health officials on our air say that is something they may reconsider, given how transmissible the delta variant is. What do you think about the masking guidance as it stands?

MADI: I think we should continue with it. I think the issue - the problem that we had with the guidance is that it flip-flopped a little bit, and when you flip-flop some guidance, people get confused. And then they decide, OK, well, which is true? What is - what do we need to do? It's too confusing for us. So if you stick to one prospect of doing things, then people will go ahead and follow that. I think masking is important, especially at this time, especially that the vaccine is not as efficacious as it is with the mother virus.

KING: OK. Dr. Jamil Madi is chief of critical care medicine at Valley Baptist Medical Center in Harlingen, Texas. Thank you so much, Dr. Madi, for taking the time.

MADI: Thank you for having me.

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