By Ashley Benkarski
Tennessee remains the state with the highest volume of new coronavirus cases per capita in recent weeks.
The Centers for Disease Control and Prevention (CDC) estimate that the delta variant is responsible for 82 percent of COVID-19 cases and was found to be 55 percent more transmissible than its predecessor, said Dr. April Kapu, President of the American Association of Nurse Practitioners.
The majority of current COVID-19 patients are unvaccinated.
“It’s also important to note that unvaccinated patients are more likely to be hospitalized with the delta variant, and we are seeing younger patients in our hospitals and intensive care units (ICUs),” she said.
“According to a study published in the journal Nature, the density of viral particles in the human body is approximately 1,000 times greater than in alpha, making it much easier for the virus to spread and, potentially, to cause severe disease among people who become infected,” she continued.
“We still have large pockets of the country that remain unvaccinated, and this means millions of patients are at significant risk of contracting this more aggressive variant,” Dr. Kapu said.
“Further, in cities like New Orleans, Orlando and Nashville — where I practice — we’re seeing hospital beds filling up with younger and younger patients. Here in Nashville, as of September 18, 2021 we have over 164 COVID positive patients in VUMC hospital, with 36 in the ICU and 14 totally ventilated,” she continued. “Given the severity of this strain and our collective desire to keep our schools and economy open, we absolutely need to increase vaccination rates and encourage the use of masks in accordance with guidance from the CDC and local governments.”
She added that “the latest data suggests that we may need to get vaccination rates above 80% to achieve herd immunity. We can get there, but we need everyone eligible to roll up their sleeves,” she said.
The emergence of the gamma variant may have the potential to hamper the vaccine’s protection.
Despite the vaccine being readily available and free of cost the state’s wealthiest county, Williamson, leads all others in vaccination rates. Data from the Tennessean shows most counties remain below 43 percent in vaccination rates and a good chunk of that cohort lags under 25 percent.
Of the 95 counties that make up the state, 82 percent are rural. These are communities whose access to healthcare has been hamstrung due to poverty and geography.
As a result rural hospitals see a higher rate of disparities, such as lack of a viable workforce, physician and other healthcare professional shortages, and a predominantly older, sicker population, the Tennessee Hospital Association’s website reads.
The closure of 13 rural hospitals within the last decade made those communities nearly defenseless against the virus.
The organization explained that rural residents are often underinsured and are afflicted by chronic health problems while the remaining rural hospitals are straining to break even, let alone generate profit for stakeholders. This dual impediment continues “the struggle of providing quality care and further increase[s] the gap in access to care.”
“For too long, rural communities have lacked access to health care. With the economic pressure posed by COVID-19, this trend has been exacerbated by the closure of rural hospitals,” Dr. Kapu said.
“As a result, NPs are increasingly bringing health care to rural communities, making house calls, going door-to-door to deliver vaccines, and organizing mobile clinics to deliver necessary care. Last month, Delaware became the 24th state in the nation to enact legislation granting patients direct access to NP-delivered health care, which will help to meet the needs of patients in rural communities and many other areas. For states that have yet to modernize licensure laws, the message is clear: Giving patients access to high-quality NP care is a no-cost, no-risk, no-delay solution to bringing more care today to patients in rural communities and in other areas of desperate need,” she continued.
People infected with the delta mutation may experience symptoms different from the alpha strain. Cough, shortness of breath, congestion, gastrointestinal effects and body aches are still common but the loss of taste and smell– a notable sign associated with the original strain– may not occur, Dr. Kapu said, noting that it’s important to get tested for COVID-19 and quarantine in the case of a positive result.
The CDC recently updated its guidance to encourage vaccinated people to wear masks indoors in public places if in areas with substantial or high transmission, she added. “As of last week, it was reported nearly 67% of U.S. counties fall under this guidance. Additionally, the CDC is encouraging immunized people who are immunocompromised — and those who live with them — to consider masking, regardless of the transmission level in their area.”
“We’re all in this together — people who are immunocompromised, children who are not old enough to get vaccinated, young adults, grandparents, moms and dads,” Dr. Kapu remarked. “Whether you are afraid of needles or of something you’ve read online, talk to an NP or another health care provider if you are worried about getting vaccinated. These vaccines are available. They’re safe, and they’re effective. Vaccination is our path to safety — for you, your family, and your community. We need you with us.”
