On September 2, 2021, providers and staff of Watauga Medical Center held a care vigil to share their experiences with our community. Speakers candidly described what it’s like inside the hospital right now with the current COVID surge of the Delta Variant, and shared what the community can do to protect themselves and others. View all COVID-19 information for testing, vaccines, and more >
Dr. Lisa Kaufmann - Transcript
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.
Dr. Jennifer Nelson - Transcript
Hello, my name is Dr. Jennifer Nelson and I am an Emergency Room doctor here at Watauga Medical Center. Myself and my family are full-time Boone residents.
The impact COVID-19 has had on healthcare providers is difficult to describe in words. The first wave broke our backs, but I’ve never been more proud to stand beside my brave colleagues facing an unrelenting foe. This wave has broken our spirits. We have more patients. They are sicker. They are younger. The overwhelming majority are unvaccinated. Many patients have expressed to me profound regret just prior to speaking to their families for what may be the last time just prior to being placed on a ventilator.
Those that are vaccinated can still get COVID-19. The vaccines are 92 to 96% effective, meaning on average, five people out of 100 could get COVID-19. However, these patients tend to be far less ill than the unvaccinated patients we see. This is so important as we look to our ASU students, coming up this year.
By simply getting vaccinated, you can save a life. There have been patients who have presented to the emergency room with vaccine-related side effects and symptoms. However, these generally very mild. There are currently no patients admitted with vaccine-related side effects or symptoms. All of our COVID-19 patients that are admitted currently are unvaccinated.
The hardest challenge of all as an Emergency Room doctor is that I have several patients coming in that need emergency surgery, or need services that aren’t available up here in the High Country. These patients are often in an emergency room for what can be days, waiting for a bed in an outside facility. I personally have called up to eight hospitals in two different states looking for a bed for a patient who needed emergent specialty surgery. This is 100% because of COVID-19.
I see the fatigue on my colleagues’ faces, many cannot do this much longer, and won’t. To those who feel that their personal liberty is at stake, we are not asking you to do something against your will. We are asking you voluntarily to step up and do the right thing.
The vaccine has been out for nine months now; it is safe and effective. This is supported by the very institutions whose sole purpose it is to study the safety and efficacy of vaccines, drugs, foods. To those that feel this is all about some political agenda, I can guarantee you I have no political agenda. What I can guarantee you is that my and my colleagues’ agenda has been, and always will be, about saving lives. I hope you can see the sincerity in our voices. I wish you well and be safe.
Dr. Kevin Wolfe - Transcript
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.
Amy Hempfling, RN - Transcript
Good morning, thank you for having me. My name is Amy Hempfling. I’m an ICU nurse that has worked many hours in our COVID ICU here at Watauga Medical Center. I’m privileged to have this opportunity to speak to our beloved community regarding the effects of COVID-19 and what each of us can do to make a difference.
As a nurse, our goal is to aid in healing and supporting the patient during an illness. COVID-19, the delta variant in particular, has made any type of healing for a nurse feel absolutely impossible. We come to work and we are tackled by COVID. There’s more mourning for our patients than any type of healing.
Patients come in extremely sick from the virus. They come to us in ICU maxed out on any type of oxygenation possible before intubation. Many times, before we have to intubate them, we give them an opportunity to speak to their family. When they speak to their family, I many times fear that those will be their last spoken words, and lately this has rung true many times. That’s really hard for a nurse to know that those will be their last words.
With the help of Melanie Childers, our chaplain, she goes around with FaceTime and is able to keep that communication with the family. FaceTime has also helped us during the last days of their life when we have to take them off the ventilator and keep the family right there at the bedside. But as the nurse, we have to communicate those last moments with the family. And as the nurse I have to tell them, “Your loved one – they have now stopped breathing. Your loved one – their heart has stopped beating. They’ve stopped breathing they have passed.”
The major population that is presenting during the surge is different than the last. The majority of the community members in COVID ICU are not generally sick folks. They don’t have a laundry list full of health problems. The majority are healthy. They are young and they are unvaccinated. I know I speak for most of us that we don’t want to worry about COVID anymore. We crave that old life before COVID and we want that old way of life back.
And with that said, our minds tend to rationalize “I’m healthy, my family’s healthy, there’s no need to put an extra vaccine in my body. But masks feel like an inconvenience – they’re uncomfortable and they don’t work. Many people get so sick, but not many have to go to ICU and get intubated. A lot of people just get symptoms like cold symptoms and they’re just fine.”
A lot of people feel this way because they have youth and health on their side. They feel that COVID will not land them in ICU. And really – I really, really, really wish this was the case, because it’s not. The number of ventilated patients in our hospital may appear very small to you in the big scheme of things, until it’s someone you love – until it’s potentially you – until it’s you lying in that bed and you can’t catch your breath. And the doctor comes in and he tells you, “It’s time that you potentially have to go on a ventilator.” Then those numbers that you see on media that felt so small – they’re not small anymore. They’re big; they’re all consuming. Then it’s about life and it’s about death.
Please let us use our tools that we have been given. The last COVID surge we had, we didn’t have the vaccine. We’re blessed to have another tool that has been given to us. Let us use those tools to stop the spread, to lower the numbers, to stop deaths due to COVID-19. Let us use the vaccine which is free and available. And we can say that here in America but so many other countries don’t have that luxury. They don’t even have oxygen; they don’t have healthcare.
We have clean water to wash our hands. We have masks to wear when we’re gathered in groups. I urge you, please utilize the tools that we’ve been given so we can help stop the spread of COVID-19 for the community members that we love so much. Thank you.
Jimmy Phillips, RT - Transcript
Transcript coming soon
Dr. Beverly Womack - Transcript
I’m Dr. Beverly Womack, I’m an OB/GYN at AppFamily Medicine. I’m here today to talk to the community that I’m a part of – to the people that I love and the people that I want to thrive. I’ve spent my adult life taking care of women, and right now we’re in hard times.
All of us – men, women and children – we’re tired. We’re fearful. And we’re tired of the isolation that this pandemic has given us. You know, when COVID first came here we weren’t really sure about what COVID would do to pregnant women and children. We were hopeful that it wouldn’t affect pregnant women in a worse way.
Now we know the Delta Variant is here and we do know, with our worst fears coming true, that COVID is very dangerous for women during the pregnant and postpartum periods. Those dangers right now that we’re seeing include an increased risk of depression and anxiety, and our population is already extremely vulnerable. We’re seeing more domestic violence due to the pandemic. COVID infections in pregnancy increase your risk for a need for C-section. They increase your risk for developing hypertension in pregnancy, for needing to be admitted to the hospital, for needing to be transferred to the ICU, for a pregnant woman to be put on a ventilator, and an increased risk of a pregnant woman dying.
What I want to say, is I think it’s okay. You’ve heard all of us express our fatigue and our anger and our fear. But what isn’t okay is us accepting the situation that we’re in. We need to use all the energy that makes us mad or fearful and motivate ourselves to do anything that can protect our moms and our babies from suffering.
So, here’s what we can all do, pregnant or not. You can wear a mask if you’re with other people outside of your home closer than six feet. Put your mask on. We can wash our hands. And most importantly we can get a COVID vaccine.
For the past over nine months now, we’ve had people all over the world that have been very brave and decided to get their vaccine. And from that time, from the first vaccines given around the world until now, what we know is that the vaccine is safe for almost everybody 12 and up. If you’re not sure if you’re a candidate for the vaccine or if the vaccine poses any dangers for you, talk to your healthcare provider. Talk to somebody you trust that’s taken care of you for years. They’re not going to steer you the wrong way.
If you have children that are 12 and you’re not sure – should they get the vaccine? Talk to their doctor that’s taken care of them since they were tiny babies. They’re not going to steer you the wrong way.
We know now that the vaccine is safe for women who are considering pregnancy or are already pregnant and in fact it’s not just safe for pregnant ladies it’s part of standard prenatal care now. If you are unvaccinated at the time of your conception, we recommend that you get a COVID vaccine while you’re pregnant. It’s a gift you give to your baby, because when your baby’s born the baby has protection against COVID.
And lastly, the COVID vaccine is not causing infertility. It’s not causing trouble getting pregnant. It’s not causing miscarriages, and it’s not causing birth defects. I stand behind these statements with all that I am. Many of you that are hearing this know me, and if you’re listening to me you know that I love you. I only want what’s best for you. If you’re unvaccinated, get over your fear. Get over your anger. Or get over the apathy – the just waiting until “I really have to do it.” And let’s get vaccinated and protect our community.
Melanie Childers - Transcript
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 tragedies 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.