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MOUNTAIN HOME, Arc. — When the boat factory in this leafy Ozark Mountains city offered a free coronavirus vaccine this spring, Susan Johnson, 62, who was the receptionist there, rejected the offer, believing she was protected as long as she never left her home. mask.
Linda Marion, a 68-year-old widow with chronic lung disease, worries that the vaccine might actually trigger and kill Covid-19. Barbara Billigmeier, 74, retired from California and an avid golfer, believed she didn’t need it because she said, “I’ll never get sick.”
Last week, all three were patients at 2 West, an overflow service largely devoted to Covid-19 treatment at Baxter Regional Medical Center, the largest hospital in north-central Arkansas. Ms Billigmeier said the scariest part of the job was “not being able to breathe”. For 10 days, Ms. Johnson relied on supplemental oxygen fed into her lungs through nasal tubes.
Ms Marion said she felt very ill at one point and wanted to give up because she was afraid. “It was just horrible,” he said. “I felt like I couldn’t handle it.”
Yet despite their ordeal, none of them changed their minds about getting vaccinated. “This is very new,” said Miss Billigmeier. “It’s like an experiment.”
While much of the nation is making strides toward normalcy, the coronavirus is resurfacing hospitals in places like Mountain Home, where fewer than 13,000 people live, not far from the Missouri border. According to health officials, the main reason is new, much more infectious variant Delta now accounts for more than half of new infections in the United States.
The variant highlighted a new divide in the Americas between communities with high vaccination rates, where it causes almost no fluctuation and where, like Mountain Home, it threatens to turn life upside down again. Part of the country is breathing a sigh of relief; part is holding its breath.
While infections rose in more than half of the nation’s states last week, those with low vaccination rates were much more likely to see larger jumps. Among the 25 counties with the sharpest increase in cases, all but one had less than 40 percent of their residents vaccinated and 16 less than 30 percent, according to an analysis of the New York Times.
In Baxter County, where the hospital is located, less than a third of residents are fully vaccinated – below both state and national averages. Even fewer people are protected in the surrounding districts served by the hospital.
Chest specialist Dr. “It was definitely flooded,” Rebecca Martin said while wandering 2 West one morning last week.
In the first half of June, the hospital averaged only one or two Covid-19 patients a day. On Thursday, 22 of the unit’s 32 beds were filled with coronavirus patients. Five more were in intensive care. In a single week, the number of Covid patients increased by a third.
In general, Arkansas ranks near the bottom of the states in the vaccinated population. Only 44 percent of residents had at least one shot.
“Boy, we tried everything we could think of,” Robert Ator, a retired National Guard colonel who oversees the state’s vaccine efforts, said in an interview. “I don’t think there’s anything in the world we can do to get them vaccinated,” he said of one in three residents.
The state pays a price for this. Hospitalizations have quadrupled since mid-May. More than a third of patients are in intensive care. Health officials said deaths, a lagging indicator, are also expected to rise.
State health director Dr. José R. Romero said he still believes enough Arkansas are vaccinated or immune from contracting Covid-19, and that the “darkest days” of December and January are over. “What I’m worried about right now is there will be a surge or fluctuation,” he said, “then winter will add another surge, so we will have one surge on one surge.”
Dean of the College of Public Health at the University of Arkansas, Dr. Mark Williams said the Delta variant raises pandemic estimates. It’s spreading “very quickly” to the state’s unvaccinated population, threatening to strain hospitals’ ability to cope. “I can definitely say we’ve reached the alarming stage,” he said.
At Baxter Regional, many doctors and nurses are getting ready for a new wave as they get tired of the fight with the pandemic they think has eased.
Obsessed with caring for his patients, pulmonologist Dr. “I started having flashbacks like PTSD,” Martin said. “This will sound selfish, but unfortunately it’s true: The fact that people won’t be vaccinated means I won’t be able to go home and see my kids for dinner.”
The Biden administration has pledged to help prevent outbreaks by providing COVID-19 tests and treatments, promoting vaccines through advertising campaigns, and sending community health workers door-to-door to try to persuade the hesitant.
But not all these tactics are welcome. Dr. Romero said Arkansas would gladly accept more monoclonal antibody treatments, a Covid-19 treatment often used in outpatient settings. But vaccine coordinator Mr Ator said that, given residents’ suspicions of federal intentions, knocking on the door “probably would do more harm than good”.
Both said Arkansas people are saturated with vaccine promotions and incentives, including stands offering free lottery tickets, hunting and fishing licenses, and shooting opportunities at state parks and high school graduation ceremonies.
The last mass vaccination event was May 4, when minor league baseball team Arkansas Travelers played their first game since the pandemic hit. Thousands gathered to watch at the stadium in Little Rock. Fourteen shots accepted.
Even healthcare workers resisted. Dr. Only 40 percent statewide are vaccinated, Romero said.
In April, the state legislature added another roadblock, essentially requiring any state or local entity, including public hospitals, to require a coronavirus vaccine as a condition of education or employment until two years after the Food and Drug Administration issues a full license for a vaccine. made it illegal. . This almost certainly means that such a requirement cannot be issued until late 2023.
Fear of the Delta variant alone seems to be pushing some off the fence.
When the pandemic hit, Baxter Regional became a vaccine distribution center and vaccinated 5,500 people. But only half of their 1,800 staff have accepted vaccinations, according to Jonny Harvey, the occupational health coordinator. In early June, demand was so low that the hospital was dispensing an average of one medicine per day.
Now, Mr. Harvey said he has ordered enough vaccine to get 30 shots a day as people are increasingly concerned about the Delta variant. “I hate when we wave,” he said. “But I love that we inoculate people.”
Vaccines have also suddenly become more popular at the state’s only academic medical center in Little Rock operated by the University of Arkansas Medical Sciences. In the last two weeks, the vaccination rate of hospital staff has increased from 75 percent to 86 percent.
But these encouraging signs are outweighed by the growing number of Covid-19 patients. On Saturday, Little Rock hospital held 51 patients, the most since February 2 at any point. One coronavirus death occurred in April. There were six in June.
Tracing the trajectory of the coronavirus, Dr. Williams said the rise in infections and hospitalizations mirrored what he saw in October. And there are other disturbing signs as well.
A larger proportion of those currently infected need to be hospitalized, he said. The managing director of Little Rock hospital, Dr. Steppe Mette said that once they got there, they needed a higher level of care than those who were bothered by the original variant. That is, even though they are younger.
The average age of a coronavirus patient in Arkansas has dropped nearly a decade since December — from 63 to 54 — a reflection of the fact that three-quarters of older Arkansas are at least partially vaccinated. But some patients at the Little Rock hospital are in their 20s or 30s.
Dr. “Seeing younger, sicker patients is really discouraging,” Mette said. “We have never seen this degree of disease in an epidemic before.”
Young, pregnant coronavirus patients were once rare in hospital. However, recently 4-5 of them have been taken to intensive care. Three were treated with a machine called ECMO – short for extracorporeal membrane oxygenation – one step some consider it a last resort after ventilators fail. The machine diverts blood from the body to equipment that adds oxygen and then pumps it back to the patient.
Ashton Reed, 25, a coordinator at a county attorney’s office, was about 30 weeks pregnant when she arrived at the hospital critically on May 26. To save her life, doctors delivered the baby girl by emergency cesarean section and then attached her to the ECMO machine.
In a public service announcement Her husband, who then insisted on the vaccine, said that within 10 days he went from sinus problem to life support.
“I almost died,” he said. “My thoughts on the vaccine have definitely changed.”
Last month the hospital had to reopen a coronavirus ward it closed in late spring. On Monday, a second reopened.
Many of the nurses there wore colored tags to indicate that they were vaccinated. Ashley Ayers, 26, a traveling nurse from Dallas, did not. Noting that vaccine development typically takes years, she said she was concerned that the vaccine could impair her fertility – although there is no evidence of this.
“I just think it was rushed,” he said.
One of his patients for nearly a week, 49-year-old David Deutscher is no longer a prisoner. The heating and air conditioning specialist and Air Force veteran said he fought Covid at home for 10 days before going to the hospital with a fever of 105 degrees.
The experience shook him to his core. She burst into tears while describing this, apologizing for being an emotional wreck.
“This is probably what I was most afraid of,” he said, after failing to recover with monoclonal antibody therapy. He called a friend, the daughter of a medical researcher, from his hospital bed. “Please don’t let me die,” she said.
He said that he had never been vaccinated because he thought the mask would be enough. I’ve had the flu once in the last 21 years.
“Once I started to feel better,” Mr. Deutscher said, “I picked up the phone and started calling everybody to tell them to get the vaccine.” He didn’t even wait to be discharged.
The coronavirus is “no joke,” he told his friends. Three of them made a shot.
Mr Deutscher went home on 9 July bringing with him a song he had written in his hospital bed for one of his five grandchildren. His theme was the value of life.
Robert Gebeloff contributing reporting and kitty bennett contributed to research.
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