Cleveland hospital leaders talk potential winter COVID surge, kids vaccines

Northeast Ohio hospitals are preparing for a future surge in COVID-19 cases, now that the wave brought on by the delta variant appears to be subsiding, said Dr. Robert Wyllie, chief of medical operations at the Cleveland Clinic.

At the peak of the most recent surge, the state averaged about 7,200 COVID-19 cases per day. It's now averaging about 3,500, Wyllie said. 

"Hospitalizations have dropped from over 3,700 to now, this morning, we're down to 2,500, so a drop of over 34 percent," he said. "Although we still have 426 patients in Cuyahoga County and the surrounding counties, so we still have a challenge to go through."

Wyllie joined doctors from Cleveland Clinic and University Hospitals Thursday for a joint press briefing about COVID-19 trends and the vaccine. 

It's hard to predict if there will be a future surge this winter, but Wyllie said he wouldn't be surprised if there was. 

"Just over 50 percent of Ohioans are vaccinated at this point, so there are still plenty of people to potentially become infected," Wyllie said. 

Nearly all hospitalizations are unvaccinated people, said Dr. Claudia Hoyen, director of pediatric infection control at UH Rainbow Babies and Children’s Hospital.

Dr. Hoyen recommends everyone get the vaccine, including eligible children.

Children are at risk of getting COVID-19 and having side effects from the virus, Hoyen said. 

"Unlike the other surges in the past, this time, pediatric hospitals were very impacted," she said. "We got to a point where our beds were very tight."

Doctors have seen increased rates of Multisystem Inflammatory Syndrome in children or MIS-C, an inflammatory response to the virus where the child's immune system doesn't turn off after infection, Hoyen said.

Other COVID-19 side effects in kids include myocarditis, or inflammation of the heart muscle, and long COVID, which could include a lingering cough or brain fog.

"(It's) just another reason for parents and those caring for kids to get kids vaccinated," Hoyen said. 

Currently, kids 12 and up can get the COVID-19 vaccine. The U.S. Food and Drug Administration is expected to give emergency use authorization soon for kids ages 5-11 to get the vaccine.

Children should get the vaccine as soon as they are eligible, Hoyen said. 

New antiviral oral pill available to treat severe COVID-19 cases

"There's a lot of room for excitement today," said Dr. Daniel Simon, Chief Scientific Officer at University Hospitals.

"We now have, within our hands, the Tamiflu equivalent for COVID-19, he said.

The antiviral oral pill molnupiravir from Merck reduced severe infection by 50 percent, Simon said. 

During clinical trials, there were zero deaths in the group that received molnupiravir and eight deaths in the group that received a placebo, he said. 

The drug is "yet another tool in our toolbox against COVID-19," Simon said. 

It still needs to be approved for emergency use authorization by the FDA, but once it is, some 1.5 million doses will be distributed to the states by the federal government. States will then distribute the pills to hospitals and doctors, who will administer the medicine to COVID-19 patients. The company expects to produce over 10 million doses by the end of the year, he said.

Staffing shortages are causing issues for hospitals nationwide

Northeast Ohio hospitals are dealing with staffing shortages, much like hospitals across the country, Dr. Simon said.

Many health care workers have left due to burnout, after more than 18 months of filled hospitals due to the COVID-19 pandemic, he said.

“Health care workers are tired, they’re frustrated," Dr. Simon said.

On top of burnout, some workers face child care issues, where they either can’t find childcare during their shifts, or it makes more sense financially for them to stay home.

About 18 percent of the nursing workforce nationwide and more than 15 percent are thinking about leaving the health care industry, he said. 

In spite of the shortages both UH and the clinic said they have been able to continue to provide services. 

"We have continued to be able to provide the care that we need to provide by caring for our teams," said Dr. Hassan Khouli, chair of Critical Care Medicine at the Cleveland Clinic.

The hospital system has provided meditation and counseling for staff who are stressed by the pandemic and staffing shortages, he said.

There are currently no vaccine mandates for employees of either UH or Cleveland.  Hospital officials said they are waiting for guidance from the U.S. Department of Health and Human Resources and will follow federal guidelines. 

A little more than 80 percent of staff are vaccinated at both hospitals. MetroHealth does have a vaccine mandate in place for employees.