JACKSONVILLE, Fla. — Debi de la Paz, a nurse at UF Health Jacksonville, worked in the intensive care unit during some of the darkest days of the Covid-19 pandemic last summer.
“It was bad,” she said of the first wave, “but now it seems to be even worse.”
UF Health Jacksonville is once again filling up with patients battling Covid-19. They are younger — many are in their 20s and 30s, some even in their teens — and they appear to be much sicker than those who flooded hospitals in the early months of the pandemic, de la Paz said.
Sabrina Oetterer, a nurse who started working at UF Health in March, said the change has been “insane.” These days, Oetterer said, it seems as though virtually every new patient coming into the hospital has Covid.
Florida, the third most populous state, has become the new national center for the virus, accounting for about a fifth of all new cases in the country. In hospitals across the state, doctors, nurses and staff members are confronting a fast-moving and escalating crisis with no end in sight.
Florida shattered Covid records over the weekend. On Saturday, the state recorded 21,683 new daily cases — the most since the start of the pandemic. On Sunday, the state broke a record for current hospitalizations with 10,207, the Florida Hospital Association confirmed. The previous record — 10,179 hospitalizations — was set July 23, 2020, more than a half-year before vaccinations started to become widespread.
Dr. Dean Watson, a vice president at Tallahassee Memorial Healthcare, said his hospital has seen a significant increase in confirmed cases and hospitalizations over the last three weeks alone, putting new pressure on caregivers and straining resources.
“We have more Covid patients in our hospital with this surge than we did with the original surge,” Watson said. “We have been living Covid for over a year and a half. The stress and the strain for all the providers and nursing staff is really getting to everyone.”
In the last week, Florida averaged 1,525 new adult hospitalizations a day and 35 new daily pediatric hospitalizations, both of which are the highest per capita rates in the U.S., said Jason Salemi, an associate professor of epidemiology at the University of South Florida.
The weekly trends paint an especially bleak picture. Salemi pointed out that in the most recent weekly report from the state Health Department, for example, the state logged more cases in children younger than 12 than it had in its entire population just six weeks ago.
The alarming spike has come as the new and more transmissible delta variant spreads across Florida and while many residents and tourists have effectively returned to pre-pandemic social rituals.
“You have a lot of vulnerable people in Florida, and then you couple that with a general relaxation of mitigation strategies like mask-wearing and social distancing — and so, unfortunately, this ends up being the result,” Salemi said.
The influx of patients in their 20s and 30s has been particularly unsettling for caregivers.
Dr. Samer Fahmy, the chief medical officer at Boca Raton Regional Hospital, said: “We have had patients in their 20s gasping for air and getting intubated. We've had, unfortunately, young mothers who get very sick and lose their babies in the midst of a pregnancy.
“We need this to end, and the best way we know how to do that is through vaccination and some of the mitigation measures,” Fahmy added.
Watson is deeply distressed by the new surge, but he was not entirely shocked because about half of the state’s population has not been fully vaccinated. He believes the new round of suffering “most definitely” could have been prevented if more people had gotten their shots.
“We’re taking care of patients who, if they had made the right choice and gotten the vaccine, would not be in the hospital,” he said. “You’re battling through sadness, but you’re also battling through a little anger, too.”
Oetterer, one of the nurses in Jacksonville, said nearly all the patients she has seen in recent days were not vaccinated.
“Every day I come to work and I’m tired and I’m ready for people to be vaccinated,” Oetterer said. “I’m ready to go back to taking care of one or two people who are sick and not everybody and anybody.”
Alix Zacharski, a nurse manager for the medical intensive care unit at Jackson Memorial Hospital in Miami, recalled how painful it was to lose a 54-year-old patient Friday who expressed regret over not having gotten vaccinated in time.
“She said: ‘I shouldn’t have waited. I thought I could wait longer,’” Zacharski said the patient told her.
Zacharski said it was especially heartbreaking to see the patient’s husband and children say goodbye. By then, the patient was no longer responsive.
Next to her was a 27-year-old patient who also died Friday after four weeks of hospitalization. The same day, Zacharski expanded one of Jackson Hospital’s Covid-19 ICU units from eight beds to 24.
When people express regret over not having gotten vaccinated, Zacharski tells them “let’s concentrate on breathing better” to focus their energy on something else.
Florida hospitals are also dealing with the ripple effects of the new surge. Watson said Tallahassee Memorial is pulling back on some elective operations and certain procedures that require overnight stays so it can devote more time to treating people with Covid.
Florida Gov. Ron DeSantis, a Republican who is said to be considering a presidential run in 2024, has resisted mask mandates and vaccine requirements.
DeSantis, along with the state Legislature, has curbed local officials’ authority to impose restrictions designed to stop the spread of the virus.
The state’s medical providers recognize that persuading unvaccinated residents to set up appointments for doses of the Pfizer or Moderna vaccines is an immense challenge.
Paul Carl Vélez, the president and chief executive of Borinquen Medical Centers, which runs community health centers in Miami-Dade County, said staff members at Borinquen centers have encountered people across age groups and income levels who do not want to get vaccinated.
“It’s people from all walks of life. They don’t say they’re anti-vaccine, but they don’t want to get the vaccine,” Vélez said. “We’re at a crossroads, so what do we do?”
Lawrence Johnson, one of more than 220 Covid patients at UF Health Jacksonville on Monday, said that he does not drink or smoke and that he tries to keep healthy. But Johnson, 67, who has been hospitalized for 22 days, conceded that he did not get vaccinated because he listened to “foolishness.”
“Every day I get on the phone: ‘Please do not play. Get the vaccination.’ If I wasn’t stupid, I wouldn’t be in this predicament. Don’t listen to foolishness. Go get vaccinated.”
Vaughn Hillyard reported from Jacksonville, Daniel Arkin from Los Angeles and Carmen Sesin from Miami.