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OHIOHEALTH

A Closer Look: How Vaccination Against COVID-19 Impacts Hospitalization

Recently, OhioHealth has started sharing information about hospitalized OhioHealth COVID patients. Specifically, the breakdown between vaccinated and unvaccinated or partially vaccinated patients. The goal of sharing this information is to demonstrate the difference being vaccinated against COVID-19 can make when it comes to hospitalization.

In a recent Facebook Live event, Joe Gastaldo, MD, System Medical Director of Infectious Diseases at OhioHealth walked us through the hospitalization graphics for further explanation.

You can watch the video above and read the transcript of that conversation below.

OhioHealth COVID-19 Hospitalizations on September 20, 2021

Missy Gleason

(00:18) Moving on to our next topic, this is our next graphic. We have been sharing these graphics on OhioHealth social channels like here on Facebook, to help demonstrate the effect of getting your COVID vaccine and how that the effect that can have on helping you stay out of the hospital if you do happen to contract COVID. So earlier in the broadcast, we talked about how vaccines do not prevent getting COVID, but they prevent keeping you out of the hospital or having severe cases. So that is what these graphics are intended to share with our community. Dr. Gastaldo can you kind of just break down what these numbers are?

Dr. Joe Gastaldo

Yeah, so let’s look at this in detail. So this is September 20 2021, from OhioHealth, all of our care sites, and we had a total of 282 people in the hospital with COVID:  unvaccinated 232, vaccinated 50. In the intensive care unit, there were a total of 65 people – 59 unvaccinated, six vaccinated. On ventilators, there were a total of 36 – 31 unvaccinated and five vaccinated.

What I want to do is really explain the people who were vaccinated, and I look at this every day. When you look at the people in the hospital who have COVID who have been vaccinated, there is a underlying theme that you can see.

Many people are on this spectrum of ages 85 and above. Vaccines don’t work as well in them. The other thing that you’ll see in the pattern is many of those people have weakened immune systems – cancer patients, transplant patients, dialysis patients.

So collectively, if you look at that, like I said earlier [in the Facebook live broadcast], the vaccines are performing very, very well with what we want them to do to prevent severe disease and severe disease is being hospitalized with COVID.

Missy Gleason 

(2:05) Okay, so when we look at these numbers – unvaccinated can be completely unvaccinated, can be one dose, and can be two doses before that two week timeline. So we wanted to make sure we made that clear, but why does it make a difference – why do we just consider if you haven’t completed all of your doses you’re unvaccinated?

Dr. Joe Gastaldo

After you get vaccinated, you have a rise in your antibody titers, and you have stimulation of your B and T memory cells along with other parts of your immunity. To have that full immunity of the vaccine, it’s two weeks after the second dose or two weeks after J&J.

So if you only receive one dose of Pfizer, and it’s three or four days later, you’re still on the charging component of getting your immune system up to speed of the full benefit of being vaccinated. So there’s a lag behind getting vaccinated before you get the best immune response – the best level of human protection.

Missy Gleason

(3:07) What kind of strain, if any, is COVID having on our hospitals right now?

At OhioHealth, and all the hospitals in Central Ohio, we’re really trying to walk and chew gum at the same time. There’s a lot going on in the hospital. We are still catching up on people who have been delinquent in their COVID care. We still have a lot of people catching up on colonoscopies, hip replacements, and things like that.

We have more COVID patients in the hospital. We typically have more traumas this time of the year from being in the summer with car accidents. We have all of that going on. In addition, in the hospital, we – like everybody else in the community – have COVID fatigue. People are emotionally tired, people are physically tired. It really takes a lot out of your spirit to take care of COVID patients. They’re very sad case, visitation policy is hard for families and patients, and it’s not the way most doctors and nurses have really been trained to take care of patients. It’s not how we are used to providing compassionate care.

It’s a different way of doing things, and everybody has a yearning to get back to what that prior COVID healthcare delivery was.

Missy Gleason 

(4:32) Okay. When we’re looking at our graphics, does it make a difference for OhioHealth’s numbers that we’re sharing, if a person is hospitalized for COVID – or if they are hospitalized for something else, and we learn that they have COVID?

Dr. Joe Gastaldo

Well, what we do when people get admitted to the hospital, you know, the bedrock of what we do is patient and associates safety. All the healthcare systems in Columbus are doing testing on everybody admitted to the hospital. We do PCR testing, and if there’s any suggestion that anybody has infection, we have to put them in isolation to provide protection for all associates and patients.

That’s what everybody’s doing. It kind of goes back to that difference between infection and disease. So really, the test does have some pitfalls into it, but we have to err on the side of caution. If somebody has a positive PCR test, do they have infection or not? It’s sometimes difficult to say, and we put them in isolation.

Missy Gleason

(5:42) If you don’t get the third booster, will you no longer be considered fully vaccinated?

No, absolutely not. That’s not the case at all. Fully vaccinated right now is defined as two weeks out from Pfizer or Moderna, or two weeks out from J&J.

That definition of being fully vaccinated has not been changed by the CDC, and I don’t see that changing at all because not everybody is going to need a booster.

Missy Gleason

(6:12) What are the treatments when someone is hospitalized with COVID-19? (48:11)

Nothing’s changed that much over the last six months. First of all, when people come in the hospital and have COVID, a lot of what we do is provide supportive care. We give them fluids. We make sure they eat. We check their oxygen level. We make sure they are supported as well as they can be. We watch them for any type of kidney or heart problems. We watch them closely to see if they happen to get a bacterial infection, which by the way, most people don’t.

Depending on where they are in their disease process, earlier on, they may get an IV antiviral agent called Remdesivir. The one thing that we really give them that has the biggest impact on mortality or actually surviving is giving a medicine called Dexamethasone, which is an anti-inflammatory corticosteroid, and that ship has sailed. Clearly that medicine does decrease mortality and keeps people from dying with COVID-19 if they are admitted to the hospital and they have an oxygen requirement.

The steroid that I just mentioned, Dexamethasone, is not meant to be used with people who have COVID and are on room air. If you’re in the hospital for oxygen requirement, you should be on the steroid dexamethasone.

OhioHealth COVID-19 Hospitalizations on September 20, 2021

Missy Gleason 

(7:31) Okay, we have one more graphic to look at. It’s basically the same information presented in a different way. It is the percentages as opposed to the numbers that we looked at last. So do you want to just kind of explain with this one is?

Dr. Joe Gastaldo

Yes, the same thing. So this is OhioHealth hospitalizations as of September 20 2021. 82 percent of our hospitalized patients are unvaccinated. 91 percent of our ICU admissions are unvaccinated, and 86 percent of those on ventilators are unvaccinated.

Like I said before, our vaccines are performing very, very well with what matters the most. Those people in the hospital, most of the people in the hospital with COVID  are not vaccinated, there’s no surprises there.

The very old 85 and above – I recently saw a 90 year old person in the hospital who’s fully vaccinated who came in with COVID. And those with a weakened immune systems, vaccines don’t work as well in those individuals.

Missy Gleason  

(8:29) There’s one small little sentence along the bottom that says 96 percent of patients hospitalized with COVID-19, under the age of 50, are unvaccinated.

Dr. Joe Gastaldo

Yeah, that’s a powerful statement. That is a very powerful statement, and a lot of that has to do with the reflection of the fact that in the state of Ohio, over 80 percent of those 65 and above are fully vaccinated.

In Ohio, as you go lower in people’s age, there’s less vaccine uptake. So really, we want people to get vaccinated. I don’t want to see anybody in the hospital with COVID. It is not a fun experience to come in the hospital with COVID. It is very challenging from a patient perspective and their family members.

Missy Gleason  

(9:13) Another question we tend to get when we share these graphics – our audience, our community members will look at this and say like, “Oh, so you have 282 patients with COVID in the hospital? That doesn’t seem like a lot spread across the 12 OhioHealth hospitals”.

 I know there’s a difference in where people go and the kind of care they receive. Can you explain that?

Dr. Joe Gastaldo

Yeah. OhioHealth is a big system, and the hospitals all support each other. Patients do get moved around according to the level of care that they need.

COVID patients, when they are here, they are here for a long time. They’re very labor intensive from a nursing and physician perspective because they’re all in isolation. You have to put a mask on, take the mask off, your PPE. They really are more labor intensive to provide appropriate care for.

To watch the full Facebook Live from September 20, 2021 or read the accompanying transcript– click here.

For more information on COVID- 19 check out our COVID-19 toolkit.

 

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