I am Dr, Lisa Kaufmann, medical director of the adult Inpatient Physicians Group here at Watauga Medical Center. Our community is experiencing a health care crisis, affecting our families and neighbors. 

We can choose which news and social media we follow, and our natural human tendency is to look at news that fits what we already decided back in early 2020, when we did not know much about COVID, and everything about the vaccines was unknown.  One way to balance that is to look at what is happening right here in the high country – happening to our friends and neighbors. 

While most people who get COVID will recover, some become seriously ill, and some die. To make a wise decision, people need to know what it is like for people who do get severe COVID. We cannot bring you into the hospital COVID units because we have to respect the privacy of our patients. Those of us who work in those units doing our best to help people suffering with COVID are here to share with you some of what things are like for our patients, before we go into work today to keep taking care of them. 

The few vaccinated patients we see admitted with COVID are typically people who already have severe chronic illness and most of the time these are people we have admitted in the past for their underlying diseases

Unvaccinated patients we have admitted were often pretty healthy before they got COVID, so they did not believe they would get sick.  If they did have health problems, they were often things like high blood pressure or being overweight that did not interfere with their lives much; but these conditions increase the risk of getting severe COVID. Unvaccinated COVID patients are younger on average, sometimes in their 20s and 30s.

We don’t see multiple members of vaccinated families getting admitted, but we sometimes have multiple unvaccinated people from the same family in the hospital at the same time. Unvaccinated people are sick much longer, even if they eventually survive to go home. 

As of yesterday, we’ve had 30 COVID deaths in 2021. 28 were people who were not vaccinated. Two were vaccinated people who had serious underlying chronic illness. This matches results across North Carolina, that an unvaccinated person is  four times more likely to get sick with COVID than a vaccinated person, but compared with someone else the same age, an unvaccinated person is 15 times more likely to die of COVID than a vaccinated person of the same age.  

Like the rest of North Carolina, our hospital resources are stretched very thin. Our dedicated staff keep working, but we have days that no matter how hard we work, there are just too many seriously ill patients. Surgeries for other serious illnesses are having to be postponed because we don’t have enough staff to take care of all the COVID patients and still care for all the other problems like strokes and heart attacks that people continue to have even when you add a pandemic on top. 

COVID is not like the seasonal flu; the last time Boone experienced an epidemic like this was the 1918 flu epidemic, and very few of us were around to see how bad that was. Most of our unvaccinated patients genuinely had no idea that it was possible for them to get so sick, or that it typically takes days of getting gradually sicker and more short-of-breath before the sickest people require a ventilator to breathe for them. 

I believe that long time to think about what they’re going through is why so many people tell us they wish they had gotten vaccinated. It’s not like the movies, where someone gets shot and dies in minutes.  This is a hard illness, and if you are sick enough to come into the hospital, it is not quick and painless. 

Everyone, please wear masks. Despite what some people say on social media, chemists and physicists who study this have proven that they do help, even though they are not 100% 

If you are not already vaccinated and you are eligible, we urge you to choose get vaccinated.  If you choose to not get vaccinated, please avoid crowds and avoid any indoor space where people outside your household are not all wearing masks. 

My name is Dr. Wolfe. I’m the lung specialist here at Watauga Medical Center, and as a physician we have a lot of different conversations with family and patients here at the hospital. And I think that if I think about the good conversations that I have, the good conversations are always about the patient getting better.

For example, we may have a patient who comes to the emergency department with abdominal pains. They get some x-rays, some blood work done, they’ve got appendicitis or maybe they’ve got an infected gallbladder. They’re whisked off to the operating room and a few hours later the surgeon comes back and talks to the family members and says, “We found out what was wrong. We took care of it. And in a few days after recovery your loved one’s going to go home with you.”

Or maybe the patient comes to the hospital because they can’t breathe. They’re having chest pains, they have an EKG performed and it looks like they’re having a heart attack. So you call the cardiologist and the patient is taken to the cardiac catheterization laboratory and they’re found to have a blockage. A couple hours later the cardiologist comes out and talks to the family and says, “There was a blockage of one of the blood vessels around the heart. We were able to open that blood vessel up and your loved one’s going to be okay. And in a day or two, they’ll be able to go home and recover fully.”

Contrast those conversations to the conversations that we have to have with many of the families who have family members who are hospitalized with COVID infection. These conversations are often on a different matter and a different tone altogether. These patients have come into the hospital with respiratory problems and they wind up on life support. They wind up on breathing machines because they can’t breathe on their own. They wind up with chest tubes between their ribs because their lungs have collapsed and we have to get their lungs re-expanded again. And they wind up on medications and solutions that help support their blood pressure because without these medications these patients would die from shock.

And this goes on for days, sometimes weeks, and for others often longer than that. And despite the heroic efforts of the nurses and the therapists and the physicians involved, sometimes it’s just not enough. Eventually these people who have been sedated because they’re on all of this equipment, and they can’t really speak with their friends or their families on a spontaneous way, and these people have feeding tubes that are giving them the nutrition that goes in a tube from the mouth down into the stomach because they can’t do it on their own – there comes a point in time where sometimes everything that we did just wasn’t enough. And eventually the physician has to go out and talk to the family.

And the conversation usually starts like this: “I’m sorry there’s nothing else that we can do. All of the treatable things have been treated. All of the fixable things have been fixed. We just can’t get enough oxygen into your patient’s lungs, and despite what we do the inflammation from the virus has overwhelmed the body and they don’t have much longer to live.” That’s a horrible conversation to have with the family, and yet we have to do this on a daily basis almost. And this conversation – if that conversation isn’t bad enough – then we have to talk about how are we going to keep this patient comfortable, how we’re going to keep this patient as pain-free as possible during the final moments of their life here on this earth. And during those final moments we’re removing the very equipment that kept them alive for so long. It’s a tough situation. It’s a tough conversation. And yet we deal with this in the intensive care unit, day in and day out.

So the best solution is to not get the virus and for many of you out there, the best way to accommodate that is to get the vaccination. Thank you.

Transcript coming soon

My name is Melanie Childers. I am the director of spiritual care for Appalachian Regional Healthcare System. I have been a chaplain at this institution for 23 years. My job is to provide support to people who are in crisis—whether that’s by trauma, or debilitating illness or injury. So, I am accustomed to walking with families through suffering and death.

But never in my 23 years have I encountered anything so horrific as the last 18 months. Illness and death during the COVID-19 pandemic is qualitatively different. With COVID, you constantly face overwhelming numbers of very sick patients, a lack of resources, exhaustion and extreme fear, pain, anger, and regret.

As others have said, we often see multiple members of the same family or the same faith community hospitalized simultaneously, yet still isolated from each other. The ones who survive are not necessarily the ones you might think. An elderly woman might be discharged while her son tragically dies. 

I sit with patients who are racked with guilt when they realize they unintentionally infected their parents or grandchildren with the virus.

I facilitate video calls almost daily, allowing COVID patients and their family members to see and speak to each other. In some of these calls, the patient expresses a desire to die, while the family members plead with them to keep fighting. In other calls, the family has to do all the talking because the patient is so short of breath they cannot speak. In still other calls, the patient does not respond at all because they are sedated and on a ventilator. Video calls are the best option we have for connections during a pandemic, but they are nothing like being at the bedside, holding your loved one’s hand, and being completely “with” them.

Our healthcare professionals are extremely caring and skilled individuals. And, we are very tired. We have witnessed heart-wrenching trajedies that left our entire staff in tears. And yet we can’t stop long enough to grieve or support each other, because that bed is already being filled by another person who is in dire need.

Faith and spirituality are a strong component of our Appalachian culture here in the High Country. Of course, the Good Samaritan didn’t have to stop to bind up the wounds of the stranger on that road to Jericho. Neither do citizens have to wear masks and get a vaccine. But from where I stand, my faith says to me “Yes, you are your brother’s keeper.” “Yes. Love your neighbor as yourself.” Every major world religion has some form of the mandate to “Do unto others as you would have them do to you.”

Friends, we are a community. Our priorities and political persuasions and spiritualities vary wildly from each other. But we are in this together. We are interdependent. There is no – no win – without caring about each other. Please get vaccinated. Please wear your mask. Masks and vaccines are temporary inconveniences for most of us. But they can make the difference between life and death, and death is not temporary. It’s time for us to rise to the occasion and decide to work together rather than suffer or die alone. I believe that together our community is strong enough to change the trajectory of this pandemic. Thank you. And on behalf of my colleagues, I thank you all for listening today.