When the COVID-19 pandemic began, OBHG’s clinical site directors worked very closely with our hospital partners across the country to lead initiatives for the entire labor and delivery unit – from developing and implementing new procedures to training colleagues on proper PPE usage.
OBHG site directors have remained closely aligned with hospital leaders during the delta variant that is particularly dangerous for pregnant patients. When the rise of the delta variant began bringing younger, sicker patients to the hospital, OBHG clinicians started to see an increased rate of pregnant people hospitalized due to COVID-19.
“In late August, our COVID encounters peaked,” said OBHG Chief Medical Officer Dr. Mark Simon. “Over the last week, we’ve seen a 17% decrease, which is encouraging. Unfortunately, 65% of the positive patients are presenting positive at term and we’re seeing about 8% with pneumonia. For October, we’ve seen the most encounters in Wisconsin, Kentucky, and South Carolina.” Dr. Simon recently wrote an op-ed in The Hill about the dangers that pregnant women face with COVID-19.
Observations from OBHG hospitalists
We recently spoke with several OBHG hospitalists to learn how they’ve supported our hospital partners throughout the pandemic and the recent Delta wave.
Tennessee – Dr. John Wilters
“We are seeing many more pregnant women with the Delta variant. They are getting sicker, and Delta is much worse for pregnant women. Placentas look old and odd. It’s a different beast than version one. It morphed so quickly. The average age on a ventilator has dropped 10 years.”
Dr. Wilters works at two OBHG hospital programs in Tennessee. “Both hospitals now have monoclonal antibodies/infusion clinics. That is making a difference. Some of the offices will send their COVID patients over to the Obstetrical Emergency Department (OBED) for non-stress tests and for evaluation by our teams. There are several IV infusion centers in the TriStar network that are giving IV monoclonal antibodies to COVID-19 pregnant patients. Patients we see in the OBED who are newly diagnosed with COVID-19 and pregnant are referred to one of these centers.”
Texas – Dr. Bernard Lynch
“We have started to see a decline in admissions currently. But when the increase in cases caused by the Delta variant began, we saw a significant increase in the number of symptomatic pregnant women being admitted. With the Delta variant, we saw both an increase in number and the severity of infection.
At our hospital, we see all the pregnant women who present for evaluation. The OB hospitalists are the ones who were seeing these patients, admitting them, and calling the necessary consults. Our hospital also serves as a high-risk referral center for much of South Texas, so we get transfers from the Rio Grande Valley to Laredo and everywhere in between.”
California – Dr. Diana Glasser
“There was a level of fear at the beginning of the pandemic. But now that has changed. Now we wear PPE, are vaccinated, and have policies in place – now I feel protected by the vaccine. It’s in a controlled setting, I feel very safe. Now that we have the knowledge to protect ourselves and it has made it easier for us to treat these patients who are symptomatic.”
Dr. Glasser worked with hospital administrators to establish protocol rules for triaging pregnant patients with COVID-19 symptoms. The protocol helped to minimize exposure on the labor floor by keeping COVID-19 pregnant patients in specially assigned areas, including negative pressure rooms, so that other pregnant moms did not interact with them.
South Carolina – Dr. Anita Leis
“We have partnered with community physicians in several ways to care for patients. COVID-positive pregnant patients who are having difficulty with symptom management at home have been able to receive IV fluids, antinausea medication, and antitussive meds in the OBED. In addition, for those patients who are within 10 days of symptom onset and do not require oxygen or hospitalization, patients are being scheduled for monoclonal antibody therapy in the OBED or in the labor room. For those patients who do require hospitalization, we coordinate with community docs and the MFM department to provide care for the patient.
Because the Delta variant attacks a younger patient population and seems to be more virulent, we are seeing more pregnant patients contract and require assistance in managing their symptoms from COVID-19. With prior variants, most pregnant patients seemed able to manage their symptoms at home. With the Delta variant, they are presenting to triage with gastrointestinal symptoms in addition to cough, shortness of breath, and general malaise. Most present reporting inability to take food or fluids by mouth for 24 to 48 hours.”
If you are interested in learning more about the leadership support our clinical teams provide, a member of our team would be happy to speak with you.