Nitesh N. Paryani is a radiation oncologist in Tampa and medical director of Tampa Oncology & Proton.
But the surge has also affected non-covid patients, such as the Texas shooting victim who had to wait more than a week for surgery. Louisiana stroke victims who can’t get admitted to hospitals. And the cancer patient I recently had to turn away.
On Aug. 3, I received a call from a hospital that does not have a cancer program. Such calls are routine at the regional referral center where I work. A doctor at the outlying hospital had a patient with metastatic brain cancer. She was unable to walk, and without urgent radiation treatments there was no hope for any meaningful recovery.
Typically, I would authorize a transfer and start that patient’s treatment the same day. But conditions are no longer typical.
My hospital, one of the largest in central Florida, was full of covid patients, more than 90 percent of whom were unvaccinated. We had no beds available. We had paused elective surgeries the previous week and have been trying to control the influx of patients. Our emergency department had a 12-hour wait that day.
This was an emergency, but I had no resources to help. When I started my oncology practice, and even before I became a physician, I intended to honor the principle my grandfather had set when he began practicing in the 1950s — one that our family had upheld over six decades of caring for people with cancer: Never turn away a patient, regardless of their ability to pay or other circumstances.
But I had no choice. For the first time in my career, I had to say no.
At a Florida Medical Association meeting last month, we heard that state Department of Health data indicated that this wave would peak in late October. We also heard that with school resuming in August, a continued increase in cases was expected for the next month. Already, the number of infected children being admitted to intensive-care units was steadily climbing. Pediatric cases have surged as the delta variant has spread, though the virus’s long-term impact on children remains unclear.
When the conference was planned months earlier, things looked rosy: Vaccinations were rolling out to the general public, and infections were declining. None of us anticipated this wave of unvaccinated patients flooding our hospitals and emergency rooms. We thought the worst of covid-19 was behind us.
Now we wondered: How were we going to handle this type of onslaught for three more months? We were already close to running out of hospital beds. And after more than a year of this strain, how would doctors, nurses, emergency medical technicians and other front-line health-care workers continue to function at peak capacity?
Those questions hang more heavily each day as the numbers grow worse.
There is more to worry about than the current crisis. After covid hit, patients stayed away from hospitals and clinics for fear of catching the coronavirus. Many people put off routine screenings. Delaying care, whether screening or procedures, leads to patients’ conditions growing worse. Already in my practice, I am seeing more advanced cancers than I have ever seen before. A study of seniors published last November found a decrease in screenings for breast, colon, prostate and lung cancers last year from 2019 levels. There were also fewer biopsies, surgeries and office visits.
When people avoid or delay preventive care, the result is a strain later on our health-care system. And as hospitals again fill with covid patients, there is less and less room to treat others — a dangerous cycle.
We are all struggling to regain a sense of normalcy — and eager to resume living life without social distancing and shutdowns. The single most powerful weapon to help end the pandemic is at our fingertips: the amazingly effective coronavirus vaccines that have been given to almost 200 million Americans with limited side effects or complications.
Americans must heed the call to get vaccinated. We must do this for ourselves, for our children who are too young to be vaccinated, and for our neighbors who may not be able to access medical care for other conditions as hospitals deal with waves of unvaccinated patients.
I wasn’t able to admit the brain cancer patient for treatment, but I contacted a colleague from medical school who works in the next county at a hospital in the same health system as mine. He was able to authorize a transfer to his facility, which still had bed space available, and get her the treatment she needed. Last week, his hospital stopped performing elective procedures due to decreasing capacity.
Please, do your part and get vaccinated. I for one don’t want to have to turn away more people who need care.