We hope this finds you well, safe, and healthy as you enter the new year. While winter is upon us, the hours of light are already getting just a tad bit longer each day. Think spring and imagine summer. We can just make out the light at the end of the tunnel, but the path ahead is still long. As clear from the news in Maine, around the country and the world, the pandemic will continue to wrestle with our daily lives and activities. The return to the pre-pandemic feels a long way off.
The update from LifeFlight:
We were able to control the spread of transmission in our small outbreak with a total of six cases among the aviation and clinical staff. Everyone is well, has returned to work, and we have conducted sequential testing of all our team at our southern bases for the last several weeks with no new cases. Hopefully Christmas and New Year’s will not present more internal risk.
We are steadily vaccinating our team members while also working on a separate project with our public health colleagues to accelerate the delivery systems as the state is issued additional vaccine.
Our perspective on the vaccines is that they are safe and effective. We have not experienced untoward reactions and crews feel safer. The vaccine is one more piece of armor as we care for critically ill patients.
We were interviewed on Maine Public last week (read an edited summary here). Here is what we shared and are experiencing:
We have transported 1,768 patients since this all started in March. As we have noted there is huge uncertainty at the time of emergency transport, so our standard operating procedures and protocols treat every patient as if they were positive to keep both us and our patients safe.
Overall, 43% (760 patients) were being tested for symptoms at time of LifeFlight care or exposure with 28% (495 patients) known or presumed positive.
Month to month this number of suspected or proven COVID+ patients changes and while we were at 31% in September, it jumped to 75% in December with multiple positive cases each day.
We expect the new variant in Maine over the next week and we are doubling down on maintaining our safety actions.
On the challenging front, as we also shared with Maine Public, we are seriously fatigued (as are we all). The pressures the pandemic continues to visit upon all healthcare providers will take years to understand. It will take a long time to recover from this experience and fully realize the bright promise with which we all started our medical careers. Luckily, Maine is not yet facing our EMS system and hospitals being overwhelmed.
As we enter this new year and winter takes hold, we all need to double down to keep ourselves and each other safe. From all accounts the next 12 weeks are going to be very trying. The new variant with much higher transmission rates will be far more challenging to hold back than our experience over the last nine months. It will take concerted effort to keep COVID in check.
This is all the law of large numbers. If we look at all the cases in Maine since inception, the good news is that most people do not get seriously ill and recover pretty quickly—about 4.2% of patients who contract COVID are hospitalized and 1.4% succumb to the disease. However, these rates are multiples of the influenza toll every year—the not good news.
The percentages do not sound like much but over the weeks they add up. We are still experiencing the effects of Thanksgiving. Yesterday we had 599 new cases which on average will lead to 24 more hospitalizations two to three weeks from now and around 8 new deaths five to six weeks from now. The seven day moving case numbers are around 510 cases a day. But it will be another two to three weeks before we see the effects of the Christmas and New Year holidays. On present course, we are likely to see 168 new hospitalizations and 56 additional deaths each week. The new variant could increase the numbers. This is how the healthcare system becomes overwhelmed. At the moment, we cannot change the course of the next few weeks but our individual actions every day can change the course of the next months and year. You can help. Each of us is a member of the healthcare team by virtue of our human existence and behavior.
As we have noted in each update there are important things we must do every day to reduce risk and limit transmission until we have widespread vaccination. These steps are even more important with the new variant. The vaccines are a game changer but will take us a while even if we can ramp up delivery to 30,000 new vaccinations a week plus delivering the second dose. This is a monumental task. We will need to deliver 8,500 combined first and second doses each day through next fall. This is a huge hill to climb but we are going to climb it.
In the meantime, please do what we do every day and challenge everyone you know to do the same:
- Reduce exposure by limiting our interactions with people outside our immediate “bubble” and practice social distancing when among other people.
- Protect ourselves through washing hands and wearing a mask. (Masks should be at least two layers that you cannot see through when held up to the light or, even better, have a pocket for a filter)
- Protect our loved ones and those around us (and all of us in healthcare) by keeping to your bubbles, wearing masks, washing hands, and keeping track of your symptoms.
- Protect our living environment with good ventilation, increased humidity on these cold dry winter days, and regular washing of surfaces.
- Build resilience in ourselves and communities in troubled times. We all need to reach out and make sure those around us are not losing ground. Find a way to support the organizations in your towns which are protecting the most vulnerable in the community.
If we can really work together for the next 12-14 weeks, we will leave the dark days of winter behind and come spring we will see a real difference. By the fall we will be looking toward the holidays to treasure family and friends.
Stay strong. Stay healthy. Stay with us. Let’s protect each other. There is light ahead.
On behalf of the LifeFlight team,
Thomas Judge, Paramedic
Norm Dinerman, MD, FACEP