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Banner chief: COVID hospitalizations have 'plateaued,' warns against Ivermectin use

The chief of Arizona largest hospital network said Wednesday that hospitalization from COVID-19 have plateaued in recent weeks, and that about one-quarter of all patients were hospitalized because of the novel coronavirus.

She also said that Banner's Poison and Drug Information Center has experienced an increase in calls because of Ivermectin, an antiparasitic drug that people are taking in an attempt to prevent or treat COVID-19.

"While we are pleased to no longer see exponential growth in our markets, I will point out that this is a very high plateau," said Dr.  Marjorie Bessel, chief clinical officer for Banner Health during a virtual press conference. "The duration has extended for much longer than we saw in prior surges, when cases peaked and then quickly descended. I will also remind you that Banner’s forecasting tools predicted a lengthy plateau followed by a continued increase of hospitalizations next month."

Bessel said that they expect increases from COVID, as well as seasonal increases in Arizona driven by tourism in the fall and winter.

Based in Arizona, Banner Health manages 30 acute-care hospitals, including hospitals in this state as well as California, Colorado, Nebraska, Nevada, and Wyoming. This includes Banner University Medical Center and Banner University Medical South, as well as the Cancer Center and the Diamond Children's Medical Center in Tucson.

Bessel said her network had not experienced an uptick in cases after the Labor Day weekend, yet. However, she said that Banner's hospitals "remain very busy, both with COVID and non-COVID patients."

"The number of patients that we have ventilated and in our ICUs is higher than what we experienced in last summer's surge," she said. "All of you that are out there can help us keep our hospitals open for care of COVID and non-COVID patients by getting yourself, your friends, and your family vaccinated. Please do so today if you have not yet done that so that our hospitals can remain open for everybody who needs our care."

The pandemic has made it more difficult for patients to get preventative care, she said, and "therefore there has been delay of treatment for some of these patients, there has been late diagnosis for some of these patients."

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She also said there was an unseasonably high amount of activity recently for RSV, a common respiratory virus that normally breaks out during the winter months.

During a press conference last week, Bessel said that Banner hospitals were seeing a rapid increase in cases of children infected by both COVID-19 and RSV. Bessel said that while forecasting models predicted COVID cases would slow over the next month, the hospital network could face an increase in patients because of RSV. Increasing RSV cases and COVID, combined with outbreaks of flu could mean a hard winter for Banner’s hospitals.

From Aug. 1 to September 13, around 2.9 million people were hospitalized with COVID-19, according to data from the CDC. And, over the last seven days,  an average of 11,261 people were in the hospital with COVID nationwide.

On Sept. 13, 22 people were admitted to Arizona hospitals to be treated for COVID-19 that day, and overall 2,090 people were hospitalized for COVID-19, according to the Arizona Department of Health Services. This is a slight decline from the summer's peak on Saturday, when 2,103 people were hospitalized. During the peak of the pandemic over the winter, more than 5,000 people were hospitalized on Jan. 12.

Since the pandemic began, nearly 75,000 Arizonans have been hospitalized because of coronavirus infections, and during the pandemic’s peak last January, 577 COVID patients were admitted to Arizona hospitals on Jan. 8 alone.

Overall, there have been more than 1 million cases of COVID-19 in Arizona, and 19,333 people have died. On Wednesday, 29 people in the state died from COVID-19, and there were 2,432 newly reported cases of infection. COVID-19 transmission remains "high" across the entire U.S., including Pima County and all other Arizona counties, according to the CDC.

The rate of fatalities from COVID-19 in Arizona has risen to nearly 269 people per 100,000, ADHS said.

Bessel said that the number of pediatric patients remained steady, adding that most kids have not required ICU care, and most have been released within four days. She also noted that school outbreaks, including those in Maricopa County, occurred at schools without mask mandates. CDC data shows that around 4,661 kids have suffered from Multisystem Inflammatory Syndrome in Children, or MIS-C, a rare and serious condition linked to COVID-19. Of those cases, around 41 children have died from MIS-C, and the median age was about 9-years-old.

CDC data also shows that 61 percent of kids who suffered from MIS-C were Hispanic or Black. More than 100 MIS-C cases were in Arizona.

Bessel reiterated her support for masks in school, saying that Banner was "very much aware that school outbreaks occurring in Maricopa County are occurring at a much higher frequency in those schools and school districts where masking mandates are not in place," she said.

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Data from the CDC shows a sharp decline in transmission among children over the past two weeks, especially among children aged 5-19.

Bessel said that the "vast majority" of patients at Banner facilities for COVID-19 were unvaccinated, and that COVID patients "continue to require extensive care for prolonged periods."

COVID patients stay on average 7 to 8 days, while non-COVID patients spend around 4 to 5 days, she said. The increasing number of COVID patients has come even as Banner attempts to manage what she called an "unseasonably high volume of non-COVID patients."

Bessel said that the Delta variant remains the dominant variant of COVID in Arizona, adding that around 99.1 percent of all COVID-19 variants in the U.S. are the Delta variant. While a new variant, known as Mu has begun to circulate, she said the amount remains small and Delta is "so dominant at this time that it is not currently a variant of concern for us."

Bessel also cautioned people against taking Ivermectin, adding that in August Banner's own poison center managed 10 cases of people poisoned from the drug, some "so severe that they required hospitalization." 

"Ivermectin is not usually something that our poison center gets many calls about, so this is very concerning to us to see this growing trend," Bessel said.

"I want to make very clear that Ivermectin is not an FDA- approved treatment for COVID," she said. "Clinical trials are ongoing to assess Ivermectin for COVID, but no clear findings have been released that confirm this drug as a safe or effective form of treatment for COVID. For this reason, it is not currently a drug that Banner hospitals or providers will prescribe."

Ivermectin was discovered in 1975, and won the Nobel Prize in 2015 for its use as a treatment for river blindness, however, in recent months widespread misinformation about the drug has claimed that Ivermectin is beneficial for treating and preventing COVID-19. Several studies are ongoing about the drug's efficacy, but while the jury's still out about the drug, some have purchased the drug through "unauthorized" sources, Bessel said.

"As is the case with many drugs, there are risks associated with consuming them," she said. "This is especially true for high doses of Ivermectin such as the tablets that are intended for treatment of livestock, which can cause serious illness or death."

Even the levels of Ivermectin approved for human use to treat non-COVID conditions can interact with other medications, leading to health complications," Bessel said, asking people to speak with primary care providers.

"As a reminder, we currently have a very effective form of treatment for COVID. Monoclonal antibodies received emergency use authorization from the FDA late last year and have been proven to safely prevent hospitalizations and reduce severity of COVID symptoms," Bessel said.

Bessel also discussed the network's announcement in June that all of its 52,000 employees hospital staff be vaccinated by November 1.

"It is Banner Health's absolute intent to have every one of our team members be compliant by November 1st with our mandatory COVID vaccination process," she said. "That includes granting individuals religious exemptions if they meet those criteria, as well as granting individuals medical exemptions if they meet that criteria." 

Bessel did not outline how many employees may have left Banner hospitals, saying "any numbers that we have today are not really applicable since we are not yet at the deadline."

Banner has followed several other major companies in announcing a vaccination mandate, and last week, President Joe Biden ordered the Labor Department to create a rule that companies with more than 100 employees to require vaccinations, or require unvaccinated employees to face weekly testing.

Bessel said that the network has about 1,000 "core" nursing positions that remain open, and Banner is working to recruit 537 more contract workers in a variety of different positions, including nursing and respiratory therapists to help staff hospitals through next January.

"Our staffing is our number one priority at this time, to make sure that we bring in as much available staff as we possibly can to meet the demands that we know will be upon us in the upcoming fall and the winter season," she said.

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"We manage hospitals every day. This is what we do," she said. "We constantly adjust and tweak and manage the patient flow and our staffing models to meet the needs of the community."

She said the pandemic has had an "impact on patients getting preventative care, and therefore there has been delayed treatment for some of these patients, there has been late diagnosis for some of these patients," she said.

Nonetheless, the surge of COVID and non-COVID cases has forced some hospitals to "postpone or curtail" some elective surgeries she said.

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