As a specialist in maternal-fetal medicine at UAB Hospital, Dr. Akila Subramaniam sees some of the most complicated pregnancies in Alabama and parts of the four surrounding states. He has never seen anything like it.
The 1,157-bed hospital has already admitted 39 pregnant women with COVID-19 so far this month. Of these ten are in the intensive care unit and seven are ventilators due to illness. In a regular week, Subramaniam told The Daily Beast, the number of pregnant women in the ICU would be one or two.
As of this week, there were no longer ICU beds available in Alabama for any patient, pregnant or not. The state Department of Health has requested staff and other resources from the federal government, and Gov. Kay Ivey has restored the state of emergency. However, more than half of the state’s population remains unvaccinated.
Dr. Subramaniam told The Daily Beast about what it is like to care for pregnant patients in these conditions. His interview has been edited and condensed for clarity.
“As doctors, we talk about who a white cloud is and who a black cloud is, which means that some people tend to have worse luck in terms of how things roll, and some people never have any patients. complicated to your service.I tend to be more on the darker side of things, for whatever reason.And I’ve never had so many [patients] in the ICU at the same time ”.
“We didn’t really have big rises in the summer of 2020, not like other people saw during the winter of 2020, in early 2021. We would have some occasional patient in the unit, maybe one, maybe two, but we never see this number… This type of change occurred in this new wave, which is mainly attributed to the Delta variant. [we saw in] From March to June, it was a manageable level. And from the end of July is when we started to see an increase in cases and how much serious illness we see ”.
“Our rates of people going well and surviving are really good, considering our numbers, resources and all that stuff. But it’s not good enough, because we don’t have any ICU beds. I just heard today that they kept trying to get someone to take him here from the [Florida] panhandle. They could not get her here and she died, because there is no bed to carry her. That would not happen in a certain normal state. “
“It’s a little harder when we have to deal with two patients instead of one, and what we do for one can hurt the other … Most patients want everything done for the baby, but it’s very difficult when you know that some of these things for the baby are putting the mother’s life at risk. “
“It’s very difficult to talk to a patient who has a high-flow nasal cannula, who struggles to breathe and ask,‘ Well, what do you want us to do when they put that tube down your throat? Do you want us to perform a cesarean section to potentially save your baby? This can end up hurting you, you could die … Do we focus on you? Do we focus on the baby? “
“Often these women are intubated. So we get consent before the tube has been put in their throat or from a partner, or we do it with two doctors urgently. I can’t imagine how dreadful it must be to wake up suddenly and know you had a baby and you had no understanding of what it was like. It sounds scary, but that’s what’s happening. “
“Even for those of us who are used to seeing maybe 30 patients a day and now see 30 more than 10 in the ICU, it’s a challenge. He is a mental engraver, he is a physical engraver. When you see 40 patients a day, don’t give each patient the same amount of time as if you saw 30 or 20. Just don’t. Women keep working, women keep having parties and all of that keeps happening. We are really facing a shortage of resources, we are doing well and we are achieving it, but there is a breaking point. “
“If you were to talk about how pregnant women are, we need to talk about vaccinated pregnant women and then we need to talk about non-vaccinated pregnant women differently … What we’re seeing, at least in our [patients] which are in our ICU and at [patients] who need extra oxygen in our work floors, if they are not vaccinated. We have no patients [in the ICU] who has completed the vaccination series “.
“All I can say is get vaccinated … I’m not saying you can’t get COVID, I’m not saying you can’t give COVID to your friends, but I hope it keeps you out of the ICU.”