Becker's Hospital Review

37 FINANCE CMO / CARE DELIVERY Breakthrough infections may not pose major transmission risk, immunologists say By Erica Carbajal T he virus shedding from people with breakthrough COVID-19 infec- tions may be less infectious than that coming from an unvaccinated COVID-19 patient, NPR reported Oct. 12. Immunologists said preliminary research has indicated the virus coming from an infected vaccinated person is less infectious because it's coated with antibodies generated from vaccination. While the antibodies don't nec- essarily prevent infection, they still "should be coating that virus with antibody and therefore helping prevent excessive down- stream transmission," Ross Kedl, PhD, an immunologist at the University of Colorado School of Medicine in Aurora, told NPR. e news outlet cited a study of breakthrough infections among healthcare workers in Isra- el that found for all 37 case patients where data on the source of infection was available, the suspected source was an unvaccinated person with COVID-19. While the Pfizer and Moderna mRNA COVID-19 vaccines are injected into the arm muscle and generally expected to generate only the kinds of antibodies that circulate through- out the body, findings published in the preprint server medRxiv showed antibodies also showed up in mucosal membranes. "is is the first example where we can show that a local mucosal immune response is made, even though the person got the vac- cine in an intramuscular delivery," said Jennifer Gommerman, PhD, an immunolo- gist at the University of Toronto in Canada who was involved in the research. In July, a CDC report made headlines aer it found 74 percent of people who contracted COVID-19 aer a number of large gatherings in Barnstable County, Mass., were vaccinated. However, Dr. Kedl said it's difficult to confirm whether the majority of these breakthrough cases were spread between vaccinated people. "In all these cases where you have these big breakthrough infections, there's always unvaccinated people in the room," he told NPR. n Hospitalizations due to delayed care put extra stress on health systems By Mackenzie Bean M any hospitals are reporting an influx of patients who delayed care during the pandemic and now require acute care for their worsening conditions. This demand is placing extra stress on organizations already facing capacity issues amid a surge in COVID-19 patients. As of Oct. 12, Pennsylvania had 567 intensive care unit beds avail- able — the lowest amount seen during the pandemic, according to WITF. During the first surge in April 2020, about 1,600 ICU beds were available in the state. Jonathan Goldman, MD, an infectious disease specialist at Pittsburgh-based UPMC , said rising COVID-19 cases are not the only reason for this spike. The organization is seeing more patients who have avoided seeking care during the pandemic and now require hospitalization. "So for example, I do infectious disease, so we're seeing a lot of peo- ple with severe diabetic infections, and I think that some of these are a result of not getting as much care last year," Dr. Goldman told WITF. North Dakota hospitals are reporting a similar trend. While high COVID-19 volumes are fueling hospitalizations and stretching ca- pacity, the issue is compounded by staffing shortages and a wave of patients who can no longer delay care for other conditions, Joshua Ranum, MD, vice president of the North Dakota Medical Association, told The New York Times in October. About 36 percent of adults reported skipping or delaying care during the pandemic, according to a Feb. 16 analysis funded by Robert Wood Johnson Foundation. n Good Samaritan Hospital CMO resigns after 18 months By Lauren Jensik K laus Thaler, MD, stepped down from his CMO role at San Jose, Calif.-based Good Samaritan Hospital after 18 months on the job, NBC Bay Area reported Sept. 22. His last day was in October. "I'm proud of the work I accomplished at Good Samaritan Hospital," Dr. Thaler stated in an email sent to Becker's Sept. 23. "My decision to leave is for my family and I am looking forward to rejoining them in the Midwest." "While Good Samaritan Hospital's policy is not to discuss personnel matters publicly, the in- tensity of the pandemic during the past year and a half has made it common for healthcare professionals to re-evaluate their life priori- ties, choosing to spend more time with their loved ones or furthering their careers," a hos- pital spokesperson told Becker's Sept. 23. "We encourage our colleagues to be true to them- selves and their families." n

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