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This COVID surge is not like the last. Berkshire Health Systems officials explain why

In virus fight at BMC, frontline nurses, doctors vow: 'We have to ... be the strength' for patients (copy)

Dr. William DeMarco, chair of medicine at Berkshire Medical Center, says this year's COVID-19 surge does not look anything like last winter's. “[Last year] we talked about having to ration care,” he said. “[Now] that’s not even on our radar screen.”

While the hospital inpatient count rises, Berkshire Health Systems leaders say this COVID-19 surge looks nothing like last winter’s.

This time last year, Halloween and Thanksgiving sent cases shooting up and dozens of people ended up in the hospital’s COVID, intensive care and progressive care units.

“We had people on ventilators,” said Dr. James Lederer, chief medical officer at BHS. “It was a really tough time for the patients. The impact was significant.”

This year, with cases as high as they were last winter, the picture is much different.

“We have a third of the number of admissions that we had from our last surge,” Lederer said. “More importantly, we don’t have any ventilated patients.”

Though the rise in COVID cases has also led to a rise in hospitalizations — with almost 20 people in the hospital with the virus as of Monday — those hospitalized cases have tended to be milder.

As of Tuesday morning, Lederer said, there were no patients in the ICU and none ventilated.

Lederer credits the vaccines for that. Sixty-eight percent of people in the Berkshires were fully vaccinated as of last week, according to state data. More than 80 percent have received at least one shot.

“The vaccinated [who are] coming in tend to be older, with more comorbidities,” he said. “They have a much shorter length of stay, and the impact on the patient is much less severe. So vaccination is doing something very positive. Even if it didn’t protect against infection, it is certainly protecting against severe disease and worsened outcomes.”

The patient mix has shifted with the vaccines, according to Berkshire Health Systems. Many of the severe cases are now happening among people in their 40s and 50s who did not get vaccinated, Lederer said, while older, vaccinated people have been experiencing less severe illness than they would have one year ago.

Hospital leaders declined to say how many of the current COVID-positive inpatients are vaccinated, though they said three of the four COVID patients admitted in the last 24 hours were unvaccinated.

“The more important message is that, if you simply look at vaccine status, it doesn’t tell the whole story,” said Dr. William DeMarco, chair of the department of medicine.

He pointed out that the vaccinated people admitted to the hospital are largely people with multiple underlying conditions, from lung disease to diabetes to chronic kidney disease — and, even still, those patients are largely staying out of the ICU and off of ventilators.

“They may end up needing to get admitted, but the severity is not where we were before,” said DeMarco.

Even today’s busy COVID unit is better than last year’s situation, DeMarco said. He remembers regular planning meetings, one year ago, to deal with the possibility of running out of ventilators.

“We talked about having to ration care,” DeMarco said. “[Now] that’s not even on our radar screen.”

Hospital leaders gave some credit to monoclonal antibody infusions — which BHS continues to administer apace — for keeping people out of the hospital. Monoclonal antibody therapy works best if administered early in the course of an infection.

Lederer also said recent admissions have been predominantly from North County and Pittsfield. State data shows that North County and Pittsfield have lower vaccination rates than South County, though second-home owners and other data issues make it difficult to pin down precise town-by-town rates.

Lederer encouraged vaccination, boosters and testing. “There are other circulating illnesses,” he said. “To be complacent, and to assume what you have is the common cold, may be an assumption that puts not just yourself but your loved ones, your family members, your friends at risk.”

Francesca Paris can be reached at fparis@berkshireeagle.com and 413-447-7311, ext. 239.

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