Jaco: The worst is yet to come as St. Louis hospitals fill with COVID and stupidity

With the St. Louis region facing a new wave of COVID infections that will probably rival the worst of the pandemic last year, the St. Louis County Council has voted to remove the county mask mandate put in place by County Executive Dr. Sam Page. At the same time, state Attorney General Eric Schmitt has gone to court to overturn both the county and the city mask mandates. All of which goes to show that even as hospital beds are already filling with new COVID patients, neither the city nor the county is immune to the hashtag #MOstupid.

Thanks to people who’re refusing to be vaccinated, St. Louis hospitals will face a surge in COVID cases in the next few weeks that will be as bad, or worse, than anything we saw last winter.

The good news is that the approaching tsunami of the COVID Delta variant will mostly take out the unvaccinated. The bad news is that it will also make children too young to get the vaccine sick, along with adults who received vaccines but whose systems are so immunocompromised that their bodies can’t manufacture antibodies, vaccine or not.

“The case rate data shows we’re on a straight-up course now. There’s more trouble ahead,” said Dr. Clay Dunagan, acting head of the St. Louis Metropolitan Pandemic Task Force and Chief Clinical Officer at BJC Health. “The trajectory of this looks just like what led to the worst of this last winter.”

“Over the next six weeks, we’ll see what happens,” he added. “Remember, we still haven’t seen a peak of COVID Delta in southwest Missouri. It’s still climbing.”

That’s important because, even as the St. Louis area braces for an onslaught of the Delta variant — six times more contagious and carrying a viral load 1,000 times greater than the original COVID strain — hospitals here are already packed with unvaccinated COVID patients, many of them transferred from rural Missouri, where the few hospitals in those anti-vax hotbeds are overloaded.

According to emergency room physician Dr. Brad Gregg, the ICU at St. Luke’s Hospital in St. Louis County is already full, with half the patients suffering from the COVID Delta variant. All but one of them need a machine to allow them to breathe. All of the St. Luke’s COVID patients, except one, are unvaccinated. The one vaxed patient with COVID is so immunocompromised that his body can’t produce antibodies.

All of the St. Luke’s COVID patients are between the ages of 45 and 60. And almost all of them were transferred to St. Louis County from southwestern Missouri, where COVID is rampant and hospitals have been over capacity for weeks.

In the 13 BJC hospitals in the St. Louis metro region, roughly 20 percent of the beds are already taken up by COVID patients, 95 percent of them unvaccinated. Unlike at St. Luke’s, almost all of the COVID patients suffering from the Delta variant are from St. Louis city and county. Many of those patients are African-American, from low-vax regions of north city and north county, especially the northeastern part of the county in the Spanish Lake/Bellefontaine Neighbors area.

Among the unvaccinated, there are three basic subgroups: People who haven’t been paying attention and are simply putting off the vaccine; Black conspiracy theorists who think the vaccine is another version of the Tuskegee experiment designed to harm African-Americans; and white Trump-supporting anti-vaxers from exurban and rural areas for whom rejecting the vaccine and science is part of their tribal political identity.

“If you’re talking about politically conservative, more rural people who are unvaccinated, they tend to be more hostile toward the vaccines,” Dunagan said. “If you’re talking about the urban and suburban historically underserved communities, they tend to be more hesitant than outright hostile, and concerned about the motives behind the vaccine.

“For those communities, it takes personal interactions with people they trust to overcome that hesitancy. It’s hard for me as a white physician to go into those areas and say ‘Get the vaccine.’ It has to come from people who are knowledgeable and trustworthy, whether community leaders, pastors, or their personal physician.”

But what it comes down to, in the end, is that many (or most) of the unvaccinated don’t really care about their friends, family, neighbors or communities. They’re so marinated in self-regard and conspiracies that they feel no obligation to anyone except themselves. That makes them the equivalent of a 5-year-old throwing a “You’re not the boss of me!” tantrum. It also, by textbook definition, makes them sociopaths. And it leaves people such as Dunagan feeling stumped.

“I feel like people should have the personal accountability to do this on their own,” he said, sighing. “There shouldn’t have to be mandates or decrees to make them do it.

“I know this is going to be politically difficult. Do we need a mandate? I know it’s going to be politically difficult, but I think it’s reasonable and worth a try, particularly in St. Louis city and county.”

Remember, St. Louis area ICU’s are already at capacity, or almost there. So far, the ability to care for COVID patients hasn’t been compromised, but it is impacting people who may need the ICU for other reasons, such as post-surgery complications.

“We can’t physically staff 100 percent of the beds we have in our ICU’s, because we just don’t have enough staff to do it,” Dunagan added. “And the travelling nurses from other parts of the country we used earlier in the pandemic aren’t available, because so many of them burned out the first time around and are just no longer willing to go on the road for perhaps months at a time.”

And remember: We’re already facing hospital overloads and shortages weeks before the next expected Delta wave is expected to pound St. Louis.

But none of this matters to the kind of smug anti-vax extremists who packed the St. Louis County Council meeting last Tuesday, who shouted at County Executive Page, “God doesn’t love you.”

And it doesn’t matter to Missouri’s right-wing ruling class. AG Schmitt is using the courts to try to stop masks while Gov. Mike Parson accused the state’s two biggest newspapers of spreading “COVID propaganda” for daring to reprint COVID statistics that come directly from the state’s own health department.

So prepare to hunker down again. Eventually, COVID may go away, but MOstupid seems to be permanent.                    

Charles Jaco

Charles Jaco is a journalist and author. He has worked for NBC News, CNN, KMOX, KTRS, and Fox 2. He is best known for his coverage of the first Gulf War, and for his "legitimate rape" interview with Senate candidate Todd Akin. He is the winner of three George Foster Peabody Awards, and the author of four books.

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