Oregon and Idaho have joined the list of states that are running out of intensive-care beds as they confront dramatic rises in coronavirus infections.
The Oregon Health Authority reported Saturday that only 50 of the state's 638 beds were still available. Gov. Brad Little of Idaho, a Republican, said last week that just four of the state's nearly 400 beds were open.
The national delta-driven surge has filled hospitals in many states. Only a handful have more than 30% of their ICU beds still available, according to data from the Department of Health and Human Services, and many have less.
Little and Gov. Kate Brown of Oregon, a Democrat, each mobilized members of their state's National Guard to add extra hospital staff last month.
[Video not showing up above? Click here to watch » https://www.youtube.com/watch?v=YYRyjHoRk2U]
"We are dangerously close to activating statewide crisis standards of care," Little said. "In essence, someone would have to decide who can be treated and who cannot."
Little's state is grappling with its highest surge in hospitalizations to date. Idaho had a seven-day average of 512 hospitalizations Friday, a number that has grown rapidly since July, according to a New York Times database.
In Oregon, the seven-day average of hospitalizations hit 1,219 on Friday, almost double the previous high reached in December.
The dire numbers do not do justice to the mounting crisis that is overwhelming hospitals and health care workers in both states, officials said. Little said that even as Idaho hospitals made room for extra ICU beds, they filled up -- fast.
Patrick Allen, director of the Oregon Health Authority, said 127 patients in the state were waiting in emergency departments for beds to open up. He said hospitals in southern Oregon, where vaccination rates were lowest, were especially hard-hit.
"We're on the edge of what we can manage right now," he said, looking ahead to children returning to school in the most populous parts of the state. "There is not much room for things to get a lot worse."
FIRST RESPONDERS
March 11, 2021. It was supposed to be a turning point in the pandemic for Erin Tokley, a longtime Philadelphia police officer, Baptist minister and 47-year-old father of three. It was supposed to be the day of his vaccine appointment.
Instead it was the date of his funeral.
Tokley -- "Toke" to his friends and family -- died March 3, becoming the Philadelphia Police Department's sixth confirmed covid-19 death.
Philadelphia officers became eligible for shots in late January, and Tokley was eager to get it as soon as he could. But he fell ill in early February, before it was his turn.
The resurgence of covid-19 this summer and the national debate over vaccine requirements have created a fraught situation for the nation's first responders, who are dying in larger numbers yet pushing back against mandates.
It's a heartbreaking situation for Tokley's widow, Octavia, as the 21st anniversary of their first date approaches. She said she has moved beyond her anger at other officers who are refusing the vaccine, and is now disappointed. Her husband's life couldn't be saved, but theirs still can.
"I don't want to have to be there to support your family for this," she said. "Nobody deserves this, especially when it can be prevented."
Her husband is one of 132 members of law enforcement agencies who are known to have died of covid-19 this year, according to the Officer Down Memorial Page. In Florida alone last month, six people affiliated with law enforcement died over a 10-day period.
In the first half of 2021, 71 law enforcement officials in the U.S. died from the virus -- a small decrease compared with the 76 who died in the same period in 2020, according to the National Law Enforcement Officers Memorial Fund. Last year, the total figure was 241 -- making the virus the leading cause of law enforcement line-of-duty deaths.
Despite that, police officers and other first responders are among those most hesitant to get the vaccine, and their cases continue growing. No national statistics show the vaccination rate for America's entire population of first responders, but individual police and fire departments across the country report figures far below the national rate of 74% of adults who have had at least one dose.
Frustrated city leaders are enacting mandates for their municipal employees -- including police officers and firefighters -- as the delta variant surges. The consequences range from weekly testing to suspension to termination. It's a stark contrast from the beginning of the vaccine rollout when first responders were prioritized for shots.
"It makes me sad that they don't see it as another safety precaution," Octavia Tokley said. "You wear masks, you wear bulletproof vests. You protect each other. That's what you do, you protect and you serve."
Nearly 3,000 miles away, San Francisco firefighter Christopher Salas offers his condolences to Tokley's family. "I feel for her, I feel for her husband," he said.
Salas, 58, has nearly 28 years on the job -- 21 of them in the city's tough Tenderloin district. He wears a mask and washes his hands and sanitizes himself. But he stops short at getting the shot -- and plans to retire early instead of acquiescing to the city's ultimatum.
"I'm not an anti-vaxxer," he said. "I have all my other vaccines. I'm just not taking this one."
He considered it, just to be able to finish out his career with three decades of service. But after praying about it with his wife, he remains concerned about the efficacy and side effects.
"I don't think I'd be comfortable with myself if I did something that went against my belief," he said. "It's about liberty and having your own choice to be your own person."
Public health professionals and elected officials contend it's bigger than that.
Dr. Jennifer Bryan, a family physician and member of the Mississippi State Medical Association's board of trustees, says she's working to change minds a half-hour appointment at a time in a state with one of the lowest vaccination rates in the country. With first responders, she reminds them that they can become patients too.
"It's harder when you want to protect those who are on the front lines," she said. "When you share air with someone, there's a risk. If you share more air with sick people and your job is more public-facing, then you are at risk."
"This vaccine really is about not just protecting yourself but protecting your co-workers, your community, people who go to your church, people in your kids' school," said Seattle Mayor Jenny Durkan, whose city requires all employees to be fully vaccinated by Oct. 18 or face termination.
Unions across the country are fighting back. Shon Buford, president of San Francisco Firefighters Local 798, is urging city leaders to delay their Oct. 13 vaccinate-or-terminate deadline.
Twenty workers who did not disclose whether they had received a shot by a previous deadline may get 10-day unpaid suspensions. One firefighter has sued San Francisco, which was the first major U.S. city to adopt a mandate for its workers. The overwhelming majority of the city's workforce of 36,000 is vaccinated, according to The San Francisco Chronicle.
Buford, who is vaccinated, says he needs more time to educate his hesitant members, and he's disappointed that San Francisco took such a harsh stance from the beginning. Firefighters like Salas have threatened to retire, and others say they will risk termination.
"To me, they deserve more than an ultimatum," Buford said.
Octavia Tokley, the 41-year-old Philadelphia widow, got her first dose just three days after her husband died, collapsing in a stranger's arms in grief as they waited in line. Her 5-year-old daughter, Amethyst, constantly asks why her father didn't get one too.
He tried, her mother says, but the shot wasn't ready for him yet.
Every night, their child struggles to fall asleep.
"I miss Daddy, I miss Daddy," she cries. "I feel so lonely, I miss Daddy."
CRUISE SHIP RULES
Carnival Cruise Line announced it will keep its vaccine requirement policies in place for sailings in November and December while also announcing more restart plans from U.S. ports including Tampa, Fla., and Miami, but pushing several other restarts to 2022.
The line is advising its guests already booked that they will need to present both proof of vaccination and a negative covid-19 test at check-in, although it will continue to allot a number of capacity-restricted exemptions to children younger than 12 and others who cannot be vaccinated.
Also beginning Sept. 13, following new guidance from the Centers for Disease Control and Prevention, those covid-19 test results need to come within 48 hours of sailing, which is up from the previous 72-hour window. So if a person is sailing on a Saturday, the test has to have been taken Thursday or Friday, with results back before departure. The cost falls on the customer.
"Let me be clear, this is the CDC, and if we don't adhere to this, we don't cruise," said Carnival Brand Ambassador John Heald. "It's that simple ... The cases are rising, and I can understand why the CDC have said this in a way. And as I have said many times, we have to do it. We have to follow their rules. It won't be forever, but if we don't do it now, there won't be a forever for the cruise industry."
To accommodate the testing requirement, the line announced it is working to set up mobile pre-cruise rapid testing sites at all of its homeports for vaccinated guests who are not able to make arrangements beforehand, but details have yet to be announced.
"Please don't use that as a crutch," Heald said. "Don't think, 'Well I won't bother because by the time I cruise, it's going to be there.' I don't know when they're going to be ready, and certainly I think value-for-money-wise, you're probably better off getting it locally where you live."
The sailing plan also at this point includes the requirement to wear masks in indoor public spaces.
Carnival already sails Mardi Gras and Carnival Magic from Port Canaveral as well as Carnival Horizon and Sunrise from PortMiami, in addition to four more ships out of Texas, Washington and California.
Carnival Pride's return to service from Tampa is scheduled for Nov. 14, while Carnival Liberty from Port Canaveral, Carnival Paradise from Tampa and Carnival Ecstasy from Jacksonville are being delayed to 2022.
IVERMECTIN IN DEMAND
Public health warnings against using the antiparasite medication ivermectin as a treatment for covid-19, especially in the large doses meant for livestock, appear to have made little dent in its surging popularity.
Hospitals and poison control centers across the the country are treating a growing number of patients taking the drug, even though every clinical trial has failed to show that it helps patients with covid.
The CDC reported that almost 90,000 prescriptions for ivermectin were being written per week in mid-August, up from a pre-pandemic weekly average of 3,600. Veterinary supply store shelves have been emptied of it.
The CDC reported that one person had an "altered mental status" after apparently taking five ivermectin pills -- which he had purchased on the internet -- daily for five days. Another person drank an ivermectin formula intended for cattle and was hospitalized for nine days with tremors and hallucinations.
Despite the warnings, ivermectin has been promoted by celebrities like podcasting giant Joe Rogan and Alex Jones, the conspiracy theorist who has been banned from Facebook, YouTube and Twitter.
Ivermectin was introduced as a veterinary drug in the late 1970s, and it was later approved for use in humans infected with parasites. Since 1987, its U.S. maker, Merck & Co., has donated billions of doses that have spared hundreds of millions of people in Africa from river blindness and other parasitic diseases.
Two scientists shared a Nobel Prize in 2015 for their work in developing the drug. But in the United States, it has limited human applications, including treating lice and rosacea, and has been used primarily to deworm horses, cows and pets -- until now.
On Twitter last month, the Food and Drug Administration warned that the drug was not approved for use against covid and that taking large doses could cause serious harm. "You are not a horse," its tweet said. "You are not a cow. Seriously, y'all. Stop it."
Information for this article was contributed by Alyssa Lukpat and Emma Goldberg of The New York Times; by Stefanie Dazio and Claudia Lauer of The Associated Press; and by Richard Tribou of the Orlando Sentinel (TNS).