A friend of ours on the Maine island where we spent our vacation told us that her husband’s surgery had been cancelled at the last minute because the hospital in Portland was swamped with COVID cases, and all elective surgery was cancelled. This notification came at the last possible minute, as they were getting ready to get on the ferry to the mainland and make the trip down to Portland.
Our friend’s husband’s surgery was not an emergency. It was spinal surgery to correct a problem that had been plaguing him for some time. The physician who diagnosed the problem and prescribed the surgical procedure had said that the window of opportunity to correct the problem by means of surgery was perhaps six months, and three of those months had elapsed, so our friend and her husband were wondering whether the surgery could be rescheduled and completed sometime in the remaining three months. Considering the current state of the pandemic, they cannot be entirely sure when he will be able to have this necessary surgery.
What is particularly troubling about their situation is that the situation at the Portland hospital is almost entirely due to COVID-19 cases in the unvaccinated.
The effect of COVID-19 cases in the unvaccinated
I have no specific data on the proportion of the COVID cases in the Portland hospital in vaccinated versus unvaccinated patients, but data from some other locations sheds light on the overall picture.
For example, state health officials in Pennsylvania have stated that 94% of the new cases due to SARS-CoV-2 (the coronavirus that causes COVID-19) so far this year have been in unvaccinated people. And the unvaccinated account for 95% of the hospitalizations and 97% of the deaths.
In King County, in the state of Washington, the data for the month leading up to the 26th of August demonstrated that unvaccinated people were 7 times more likely to test positive for the COVID infection. But they were 49 times more likely to be hospitalized than vaccinated people, and 32 more times likely to die from COVID-19 than vaccinated people.
These data will certainly vary from state to state, but the overall picture can be summed up with a high degree of confidence. We can state unequivocally that the current surge in COVID-19 cases is primarily occurring in the unvaccinated fraction of the population. However, that surge in COVID infections has the potential to affect the vaccinated as well as the unvaccinated. Although the likelihood of infection in vaccinated individuals is much, much smaller than in unvaccinated persons, it is not zero, and a vaccinated person can get an infection transmitted from an unvaccinated person. And, of course, it is in the unvaccinated population that the variant strains are likely to emerge, because that is where the virus is mostly taking residence, multiplying, and mutating.
Beyond the data, there are economic consequences. It has been estimated that the cost of treating the COVID-19 infections in the unvaccinated now tops $5.7 billion, and that figure is soaring. Here is a chart showing the costs of treating COVID-19 cases in the hospital.
These cost estimates come from Fair Health, a non-profit enterprise that advocates for price transparency in health care. As you can see, the arithmetic average charges are significantly higher than the median charges. Even after insurance, the unpaid balances are quite substantial.
There has been discussion of ways to deal with those costs, a large part of which are simply absorbed by the hospitals and health-care providers. Suggestions have ranged from having health insurers refuse coverage to the unvaccinated, to permitting hospitals to refuse admission and treatment to the unvaccinated. Obviously, these suggestions are impractical and there is no chance of their being adopted. Moreover, leaving the unvaccinated who are infected with COVID-19 untreated and unsequestered from the general population only increases the spread of the disease.
However, suggestions of that kind are a sign that the frustration that the vaccinated feel