The Pandemic

'We're in Pandemic Mode': Here's What's Happening With Covid-19 at SMH

"When you go through the ICU, it's an eye-opener."

By Megan McDonald July 29, 2021

This week, Dr. James Fiorica—Sarasota Memorial Healthcare System's chief medical officer—gave an update on the Covid-19 situation at Sarasota Memorial Hospital. In addition to providing information about the hospital's current Covid patient census and capacity, he offered insights into patient demographics (much younger than last year), changing recommendations from the CDC and prevention for both individuals and the community at large.

Here are the key takeaways.

Sarasota Memorial Healthcare System chief medical officer Dr. James Fiorica

Sarasota Memorial Healthcare System chief medical officer Dr. James Fiorica

On the Covid patient census now vs. last month:

"If you look at patient numbers now vs. a month ago, right now there are 95 Covid patients in the hospital. A month ago, that number was much lower. It's the same in the ICU; last month, we had no Covid patients there, and now we have three dedicated Covid-19 ICU pods open. We have capacity, ventilators and equipment, but we are certainly in pandemic mode right now.

"The vast majority of Covid patients in the ICU are unvaccinated. Of all the patients we’ve had, there may have been one patient who was vaccinated but had other co-morbidities that led to the ICU. All of our other ICU patients are  unvaccinated, which is sad. I wish we'd had the opportunity to get them vaccinated earlier."

On the delta variant:

"It's very aggressive. Once it finds you, you’re going to be infected. It's different than the alpha variant, there's no question.

"Sarasota County is very fortunate in that 60 percent of our population is vaccinated; that's why we're currently doing a little better than other counties and even some other states. I think it also proves how well vaccination does work—I don't want to underestimate that. We're protected, but only so much. Now the goal is how do we get more people vaccinated?"

On how the current fourth surge is different from previous ones:

"Every surge is different, but this time it's predominantly unvaccinated patietns who are sick, and they're younger. We're seeing 30- and 40-year-old patients now. I was talking to one of our infectious disease doctors and he said, 'I can't believe I have a 40-year-old patient who's so sick.' We're not used to seeing that; a year ago, we were talking about a much older population with a lot of medical issues. Now we're dealing with healthy young people. When you go through the ICU, it's an eye-opener."

On how we can best protect ourselves and each other:

"Right now, there are a couple of things we can do, and No. 1 is vaccination, vaccination, vaccination. It works. Now is the time to do it so we can put this [pandemic] to an end. Now is the time to say, 'I'm going to do it, not just for myself, but for my community.'

"No. 2 is masking, and this goes for unvaccinated and vaccinated people, both patients and in the community. The CDC is recommending this if you're in a high-risk area—and Florida is. We should take the precaution of wearing masks.

"And finally, social distancing and handwashing go hand-in-hand."

On whether there will be an increase in deaths as case numbers and hospitalizations rise:

"We don’t know. We’re hoping that because this is a younger population, their immune systems will be a little stronger and they will come through. With Covid-19, it's antivirals that control it; inflammation is the second part of the illness. We're trying to block that. With a younger population, we're hoping to better control it."

On whether the hospital will restrict elective surgeries and other procedures due to the surge:

"We’re not there yet. We've looked at our elective surgeries this week and next, as well as our inventory, ICU census, ventilators, equipment and staff. We have the ability to do them, so we haven't placed any restrictions on them at this time, but we monitor daily and weekly."

On what parents should be thinking about as children prepare to return to school:

"I don't want to underplay the value of masking. We're following CDC recommendations and reminding parents that they have the option to send kids to school with a mask on. It may not be popular, but it's certainly a safe way to do it.

"Everyone assumes children will be healthier and asymptomatic. The majority of children who are infected don’t know it, but they’re bringing the virus home and exposing themselves to other family members or friends. But children can get very sick with Covid as well. They can spread the disease, but they can also get quite ill."

On Sarasota Memorial's staff morale:

"We just told our staff to wear masks again. We've had masking in all clinical areas since the beginning, but we recently reinstated masks in meeting rooms because we don't fully know who's vaccinated and who's not. So we're asking everyone to put on masks even in non-clinical areas. The hospital feels this pain just like everyone else, but it's important. We don't want to spread this virus.

"I’ve always said the healthcare providers who are caring for Covid patients are heroes. They have to deal with all the emotion, and they feel the same thoughts about preventability as everyone does. But they’re going to treat the patient like a patient."


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