Ahead of Hurricane Ida, the Mississippi State Department of Health (MSDH) advises residents to prepare now for dangerous storm conditions including heavy rain, possible flash flooding, high winds and possible tornadoes. Preparing a Disaster Kit Stock your home with supplies that may be needed during an emergency. At a minimum, these supplies should include: Several clean containers for water, large enough for a 3-5 day supply of water (about five gallons for each person). A 3-5 day supply of non-perishable food. A first aid kit and manual. A battery-powered radio, flashlights and extra batteries. Sleeping bags or extra blankets. Water-purifying supplies, such as chlorine or iodine tablets or unscented, ordinary household chlorine bleach. Prescription medicines and special medical needs. Baby food, prepared formula, diapers and other baby supplies. Disposable cleaning cloths, such as “baby wipes” for the whole family to use in case bathing facilities are not available. Personal hygiene items: soap, toothpaste, sanitary napkins, etc. An emergency kit for your car with food, flares, booster cables, maps, tools, a first aid kit and fire extinguisher. For more information on disaster supply kits, visit the MSDH website at HealthyMS.com/kit. Food Safety Due to power loss, food may not be safe to eat during and after a hurricane. Safe water for drinking, cooking and personal hygiene includes bottled, boiled or treated water. Throw away food that may have come in contact with flood or storm water. Throw away food that has an unusual odor, color or texture. Throw away foods (including meat, poultry, fish, eggs) that have been above 40 degrees Fahrenheit (F) for two hours or more. Throw away canned foods that are bulging, opened or damaged. Thawed food that contains ice crystals or is 40 degrees F or below can be refrozen or cooked. Food containers with screw-caps, snap-lids, crimped caps (soda pop bottles), twist caps, flip tops, snap-open, and home canned foods should be discarded if they have come into contact with floodwater, because they cannot be disinfected. While the power is out, keep the refrigerator and freezer doors closed as much as possible. Never place any type of food on a plate that previously held raw meat, poultry or seafood. Thoroughly wash your hands before preparing or eating food, after using the bathroom or changing a diaper, after handling uncooked food, after playing with a pet, after handling garbage, after tending to someone who is sick or injured, after blowing your nose and after coughing or sneezing. Drinking Water Safety Safe drinking water includes bottled, boiled or treated water. Remember these general rules concerning water for drinking and cooking if you are under a boil-water alert, or if you are not sure your water is safe to drink: Do not use contaminated water to wash dishes, brush your teeth, wash or prepare food or make ice. Tap water may be used for showering, baths, shaving or washing, as long as one does not swallow the water or allow it in eyes or mouth. Parents should supervise children to make sure water is not ingested, and caregivers should supervise disabled individuals for the same reason. Those with recent surgical wounds, who have a chronic illness or are immunosuppressed should consider using bottled or boiled water for bathing until their boil water notice is lifted. Boiling water kills harmful bacteria and parasites. Bringing water to a rolling boil for one minute will kill most organisms. Water may be treated with chlorine or iodine tablets or by mixing eight drops (1/8 teaspoon) of unscented, ordinary household chlorine bleach (5.25 percent sodium hypochlorite) per gallon of water. Mix the solution thoroughly and let stand for about 30 minutes. Unlike boiling, this treatment will not kill parasitic organisms. Carbon Monoxide Carbon monoxide (CO) is an invisible, odorless, tasteless gas, and is highly poisonous. Depending on the level of exposure, CO may cause fatigue, weakness, chest pains for those with heart disease, shortness of breath upon exertion, nausea, vomiting, headaches, confusion, impaired vision, loss of consciousness, and in severe cases, death. The following precautions can help prevent carbon monoxide poisoning: Do not burn charcoal or gas grills inside a house, garage, vehicle, tent or fireplace. Do not use gas-powered generators or pressure washers indoors or in the garage. If you suspect you are experiencing any symptoms of CO poisoning, open doors and windows, turn off gas appliances and go outside. In cases of severe CO poisoning, call 911 emergency services or the Mississippi Poison Control Center at 1-800-222-1222. For more information on hurricane preparedness and safety, visit HealthyMS.com/storm or download the free MS Ready smartphone app to get alerts sent straight to your phone. Follow MSDH by e-mail and social media at HealthyMS.com/connect.

The Eighty-fourth Annual Mississippi Poultry Association Convention is just around the corner, and the Mississippi Poultry Association (MPA) invites all to join them at the Hilton Sandestin Beach Golf Resort and Spa on the Emerald Coast of Destin, Florida. The yearly event kicks-off Thursday, September 16, and runs through Sunday, September 19. On the agenda are multiple industry speakers, business sessions, a golf tournament and a fishing tournament, as well as a special ladies program with guest speaker Jackson television personality and author Barbie Bassett. MPA was formed in 1937 to promote the health of the state's poultry flock. Mississippi produces about 750 million birds per year. The poultry industry in Mississippi has grown to be the fifth largest in the nation and exports about twenty percent of its production to more than seventy countries around the globe. Poultry is Mississippi's largest agricultural industry and the MPA represents all aspects of the industry. The association offers educational seminars for its members and seeks to educate the public and government officials about the value of the industry to Mississippi. Even as the Mississippi Poultry industry has grown to have a global impact, the concerns remain, bird health, producing a healthful product and ensuring a vibrant industry. With $3 billion paid to growers and direct employment of 28,500 people, the industry has a total impact on Mississippi's economy of $20 billion, according to the National Chicken Council and the U.S. Poultry and Egg Association. That same report estimates the industry pays $1.5 billion in federal, state and local taxes. In addition to the 1,700 family-run poultry farms around the state, Mississippi has fifty processing plants, hatcheries, feed mills and egg farms. These businesses interact with banks, real estate firms, insurance agencies, farm supply stores, grain farmers, plant and poultry house equipment manufacturers who are allied members of the association. Registration fees are broken down into three categories: the Formula/Allied member's single or couple registration fee at $375; the non-member single or couple registration fee at $475; and the MPA grower member's single or couple fee at $50. MPA accepts Master Card, Visa, American Express and Discover credit cards. A $100 late registration fee will be charged on registrations received after August 31, 2021. Visit MPA 2021 Conference Registration, www.mspoultry.org/registrations/index.cfm, to learn more, register or donate. MPA is located at 110 Airport Road, Suite C, in Pearl. To contact MPA, call 601-932-7560.

Commissioner Andy Gipson announced that the Mississippi Department of Agriculture and Commerce (MDAC) is currently offering a cost-share program for Mississippi organic producers and handlers receiving certification or continuation of certification by a United States Department of Agriculture (USDA) accredited certifying agent. “This is a great opportunity for farmers that have received the USDA Organic Certification in the past year to help offset some of the costs associated with this certification,” said Commissioner Gipson, “I am glad that we are able to offer this program again for 2021, and I encourage our farmers to take advantage of this opportunity.” Funding is available for those that received the certification between October 1, 2020, and September 30, 2021. Individual organic operators are eligible for reimbursement of 50 percent of their fiscal year 2021 certification costs up to a maximum of $500 per certification scope. The National Organic Certification Cost-Share Program currently recognizes the following certification scopes eligible for reimbursement: crops, wild crops, livestock, and handling (i.e., processing). To be eligible for reimbursement, the following must be provided to MDAC by applicants: proof of valid certification issued by a USDA accredited certifying agent, a reimbursement application form, an itemized receipt that identifies allowable costs paid within the qualification period, and an IRS W-9 form. Applicants must be Mississippi organic producers and handlers located within the State of Mississippi. Funds are available on a first-come, first-serve basis until the funds are depleted. Operations may receive one reimbursement per year. The deadline to submit applications is November 1, 2021. For more information about this program or to obtain an application, visit www.mdac.ms.gov/market-development/national-organic-cost-share-program or contact Susan Lawrence at susan@mdac.ms.gov or (601) 213-7542.

The Garden Club of Jackson recently hosted the Natchez Trace District spring workshop at the Country Club of Jackson. In attendance on behalf of Wesson Garden Club (WGC) were Denise Jackson, Debbie Hoaglin, Jennifer Peets, Jean Ricks, Debbie Smith and Dixie Thornton. The ladies of Wesson Garden Club enjoyed a luncheon and attended several informative presentations. The Garden Clubs of Mississippi President, Pat Young, and Executive Secretary, Angelia Wade, held workshops for those in attendance. Additionally, workshops were presented by members of The Garden Club of Jackson. Wesson Garden Club is a member of The Garden Clubs of Mississippi, Inc. and The National Garden Clubs, Inc.

Football season is officially back in action, and as the coaches and players start gearing up for the season, the Mississippi Department of Transportation (MDOT) has its own game plan to get you there safely before kickoff. To avoid the congestion on your game day road trip drivers can download the free MDOT Traffic mobile app; it gives users real-time access to tools that show road conditions and traffic alerts. The alerts are interactive, providing users with more information at the touch of a finger. The public can also access this same travel information by visiting MDOTtraffic.com. “MDOT’s Road to Game Day” is about more than just getting to and from the game with no delays. MDOT’s main goal is to keep drivers safe behind the wheel and roadside workers safe along the highways. With more vehicles on the road on game days, it’s important to be patient and drive smart. “Our men and women work so hard to ensure Mississippi highways are safe for the traveling public, and we ask each person heading out to see their favorite team to do the same for each MDOT worker as well,” said Commissioner Tom King, Chair, Mississippi Transportation Commission. “Pay attention in work zones, slow down and use caution so that everyone makes it to their destination safely.” Here are some tips to stay safe behind the wheel and keep crews safe in the field: Never drink and drive, and always have a designated driver Pay attention to the road and your surroundings when you are behind the wheel Drive the speed limit Use extreme caution when traveling through work zones Make sure to buckle your seat belt and wear it correctly Secure your load Stay updated with live travel information at MDOTtraffic.com, download the MDOT Traffic mobile app. and like and follow @MississippiDOT on Facebook and Twitter.

Trustmark is pleased to announce that its convenient, contactless customer offering, myTeller Interactive Teller Machine (ITM), is now available in Wesson. myTeller allows customers to experience face-to-face interactions with a Trustmark teller through audio/video delivery in a safe and convenient way. Customers can deposit checks, make withdrawals, transfers or loan payments, and even cash checks to the penny. myTeller offers additional benefits, including extended banking hours Monday - Friday, 7 a.m. – 7 p.m. and Saturday, 9 a.m. – 12 p.m. myTeller also functions as a traditional ATM for convenient 24/7 banking, with same day credit for most deposits made by 9 p.m. on weeknights. “We are proud to offer the myTeller machine at our Wesson location,” said Mark Lewis, Trustmark Regional President. “Customers are enjoying the convenience of banking with extended hours, and the safe, contactless interaction with our associates.” The Wesson Chamber of Commerce will join Trustmark is hosting a ribbon cutting to showcase the new myTeller located at 1027 Spring Street at 10 a.m. on Thursday, August 26, 2021. From 10 a.m. – 1 p.m., customers are invited to get a myTeller lesson and walk away with a treat! For more information, contact Layla Essary at 601-208-2533 or lessary@trustmark.com.

Co-Lin's Carlon Brabham and Cera Blanchard continue to receive postseason honors. The pair have been named 2021 National Junior College Athletic Association’s (NJCAA) Division II Second Team All-Americans. Brabham, a sophomore from Amite, Louisiana, led the team in batting average (.449), home runs (18), RBIs (63), hits (61), slugging percentage (.912) and on base percentage (.506). The Lady Wolves third baseman was second on the team with nine doubles and 20 walks. Brabham was named Mississippi Association of Community College Conference (MACCC) First Team All-Conference, National Fastpitch Coaches Association (NFCA) All-South Region First Team, and NJCAA All-Region 23. Blanchard, a freshman pitcher from Metairie, Louisiana, was third in the NJCAA with a 1.55 ERA. She was 15-4 on the season with 16 complete games, 140.1 innings pitched, 138 strikeouts, and 47 walks. At the plate, Blanchard was second on the team with a .470 on base percentage. She batted .367 with three home runs, 40 hits, eight doubles and .541 slugging percentage. Blanchard was also named Mississippi Association of Community College Conference (MACCC) First Team All-Conference and National Fastpitch Coaches Association (NFCA) All-South Region Second Team, and NJCAA All-Region 23. The Lady Wolves, coached by Meleah Howard,­­ finished the 2021 season with a 32-11 overall record and a 22-6 conference record.

Mississippians looking for a COVID-19 cure or preventative are potentially putting their lives in danger by taking the drug Ivermectin, sold at livestock supply stores as a treatment for heartworms and parasites in cows and horses. “There’s no evidence that Ivermectin can either prevent or treat COVID-19, and the risk of attempting to use this is much greater than any potential benefits,” said Dr. David Vearrier, a toxicologist and professor of emergency medicine at the University of Mississippi Medical Center. Ivermectin is not approved by the FDA for COVID-19 treatment or prevention. The COVID-19 vaccine and monoclonal antibody treatment, however, have been approved by the FDA through an emergency use authorization. Both the vaccine and monoclonal antibodies are expected to have full FDA approval in coming weeks. Misinformation on social media is driving people to purchase Ivermectin from their local feed stores or livestock supply businesses. “When these things become viral, a lot of people will jump on them,” said Vearrier, who works with the Mississippi Poison Control Center, which operates under UMMC’s umbrella. “Folks are believing that it’s somehow possible that this medication will either reduce transmission, or reduce the degree of symptoms of COVID-19, none of which is correct,” he said. One of the biggest dangers of human Ivermectin ingestion is how easily a person can overdose, said Vearrier and Jenna Davis, a family nurse practitioner and the Poison Control Center’s managing director. “People are buying a livestock medication intended for an animal five to 10 times their weight,” Davis said. “Generally it’s safe for animals, but depending on the dose you take, it could potentially lead to side effects that could cause death.” Side effects can include neurological events such as dizziness, seizures and confusion; sudden drop in blood pressure; elevated heartbeat or cardiovascular issues; liver injuries such as hepatitis; and severe skin rash, “all of which can land you in the hospital,” Vearrier said. That’s in addition to nausea, vomiting, diarrhea, stomach pain, facial or limb swelling, and abnormalities that include a decrease in white cell count. The Mississippi State Department of Health confirms at least one person has been hospitalized for Ivermectin toxicity and Friday issued a health advisory warning against ingestion of the drug as a COVID-19 treatment or preventative. “People don’t understand that with all prescriptions, the dose matters,” Vearrier said. “People are buying formulations of Ivermectin that you’d use for a 1,200-pound cow or horse, compared to a 120-pound human. That’s a big difference.” Ivermectin is commonly sold as paste in a tube, although it’s also marketed in topical cream, liquid that can be ingested or injected, and pill form. “You can feed the paste to the 1,200-pound animal, but because it’s a paste, it’s difficult for a human to measure a dose,” Vearrier said. “People who are squirting this tube in their mouth or putting the paste into orange juice are using super concentrations that can result in toxicity.” The Poison Control Center has taken a number of calls recently from people wanting to know if the misinformation about Ivermectin is true, and whether it’s safe for humans, or how best to use it for their animals. “We appreciate that,” Davis said. Other callers have been individuals who Googled the drug and then gave it to a family member, adults who took Ivermectin themselves and suffered side effects, and accidental ingestions by children, Davis said. People report ingesting Ivermectin by drawing up the liquid into a syringe and squirting it into their mouth, Davis said. Others “are going online to try to find out how to take it, and they are inaccurately dosing it. We’ve referred at least one person to the hospital for doing that.” And although they were hospitalized for severe cases of COVID-19, some UMMC patients have reported they took Ivermectin, Davis said. Ivermectin does have a legitimate, FDA-approved use in humans when it’s prescribed for treatment of scabies, a contagious, intensely itchy skin condition caused by mites that burrow into the upper layer of skin and lay eggs. “When it’s used as prescribed for scabies, it’s a relatively safe treatment,” Vearrier said “It’s only available by prescription, so if you are using it to treat COVID, the difference in dosing between a tablet for human use and the livestock formulation is where you’re going to get in trouble.” The MSDH advisory urges those who have become ill from taking Ivermectin to call the Poison Control Center at 1-800-222-1222. Vearrier and Davis advise people not to request an Ivermectin prescription from their provider. “Most physicians, including physicians who are knowledgeable about COVID, know not to prescribe this medication for COVID,” Vearrier said. “Any physician who is doing so is not following the currently known science. They are increasing the risk to their patient and to the population in general who might believe it to be safe.”

In the 2020 version of COVID-19, most children infected did not show symptoms that developed into serious health conditions. That’s not the case today, as nationally and in Mississippi, the Delta variant of COVID-19 is driving up the number of children hospitalized at Children’s of Mississippi. On Monday, 22 children were hospitalized in Children’s of Mississippi due to COVID-19, including three children in intensive care. Inside the state’s only children’s hospital, the beds are full. “The pediatric COVID-19 cases are going up, but the other cases we traditionally see aren’t stopping,” said Dr. Jennifer Hong, associate chief medical officer for Children’s of Mississippi. “The RSV cases keep coming. We are still seeing traumas – like car wrecks and gunshot wounds, sepsis, cancer, and heart failure. Those haven’t stopped. It’s unrelenting.” Just as in the adult hospital at the University of Mississippi Medical Center, Children’s of Mississippi is also under stress as medical teams work to care for large numbers of children infected with respiratory viruses and a rising number of children with COVID-19. “We’re now seeing new COVID-19 admissions who are otherwise healthy children,” said Dr. Mary Taylor, Suzan B. Thames Chair, professor and chair of pediatrics at the University of Mississippi Medical Center. Patients like Keelyn Green, 16, a senior at Jim Hill High, have faced life-threatening illness after being infected with COVID-19. After first experiencing symptoms Aug. 4, Green came to the Pediatric Emergency Department at Children’s of Mississippi Aug. 7 with problems breathing. “I was scared for him,” said his mother, LaKeitta Brown. “He had double pneumonia. His oxygenation was low, and his heart rate was elevated. His liver and kidneys were being affected.” He went to the pediatric intensive care unit, moving to a hospital room in a medical-surgical unit Thursday. Dr. Laura Wright-Sexton treated him there four days for acute hypoxic respiratory failure and bacterial and COVID pneumonia. Green and his extended family were unvaccinated, choosing instead to be careful and wear masks, Brown said. “Keelyn had been inside most of the summer, but he was exposed to COVID from a family member who didn’t know he had been near someone with COVID. Everyone in the family got it but his uncle, and he was vaccinated.” Keelyn and his family plan to get vaccinated soon. While Keelyn was healthy prior to his COVID-19 infection, “some of our patients with COVID-19 have other conditions, and some have COVID-19 plus RSV,” Taylor said. “Many are here with just COVID.” RSV, or Respiratory Syncytial Virus, brings on cold-like symptoms and can cause serious illness in young children as well as in older adults. A common virus spread via respiratory droplets when a person coughs or sneezes, RSV is the most common cause of pneumonia and bronchiolitis in children younger than 1. Usually, RSV is seen in winter months, but this year, the virus surged among children in the summer. “The things people can do to protect themselves and their families from COVID-19 also work to protect against RSV and other viruses,” Taylor said. “Wearing face masks, good hand hygiene and social distancing protects everyone.” Children’s of Mississippi Chief Nursing and Clinical Services Officer Ellen Hansen said availability of beds in the state’s only children’s hospital fluctuates. “Sometimes we have beds and children are admitted right away,” Hansen said, “and other times, they may wait in the Pediatric Emergency Department for a bed to open for a few to many hours.” While hospital staff are exhausted, they’ve been rising to the challenge, she said. “Staff are tired, as we all are, with the constant changes and unknown. However, we remain focused on providing excellent care to the children and families we serve.” Hansen said parents should still seek medical help for their children when needed. “When people avoid care, children get sicker or we have delayed diagnoses, both of which could be fatal.” Dr. April Palmer, chief of pediatric infectious diseases, said most children with COVID-19 are being hospitalized for either pneumonia, an infection that inflames the lungs’ air sacs, making breathing difficult, or MIS-C, or Multisystem Inflammatory Syndrome in Children, a severe inflammatory reaction throughout a child’s body that occurs about four weeks after a COVID-19 infection. Both situations can be life-threatening, Palmer said. “This is why, in school, we strongly recommend vaccination for those who qualify and universal masking.” Dr. Roberto Santos, professor of pediatric infectious diseases, agrees. “We need to let the families know that we really don’t know the long-term effects of COVID-19 in children, and we are seeing those long-term effects already in adult patients.” Because fewer children were seriously ill with COVID-19 during the pandemic’s earlier surges, there is less data available on best treatments, said Dr. Charlotte Hobbs, stressing that protecting children who are not eligible to be vaccinated is essential. “Plus, we have few treatment options for prevention of progression to severe disease or treatment – especially in younger children – as compared with adults.” Emergency use authorization of some treatments used successfully on adults does not apply to children younger than 12, she said. If more Mississippians were vaccinated against COVID-19, fewer children would be in the hospital with it, Taylor said. Though the Pfizer-BioNTech vaccine can’t be given to children younger than 12, adult vaccinations reduce the chances children will contract the virus. “Those who are eligible to receive a COVID-19 vaccination should do it,” she said. “We have an increasing number of children who are needing hospitalization for COVID-19. Adults should get vaccinated to protect those who are not eligible to be vaccinated.”

The Institute for the Advancement of Minority Health, the NAACP-Clinton Branch, and Holy Ghost Baptist Church will host a COVID-19 vaccination clinic Saturday, August 28, 2021, from 10 a.m.- 2 p.m. The clinic will be held at Holy Ghost Baptist Church, located at 203 Northside Dr., Clinton, MS. The Pfizer vaccine will be administered. “As more and more Mississippians are impacted by the COVID-19 virus, it is critical that residents get vaccinated as soon as possible,” said Sandra Melvin, CEO, Institute for the Advancement of Minority Health. Sponsored by the NAACP-Clinton Branch, Holy Ghost Baptist Church, and the Institute for the Advancement of Minority Health, this effort is made possible through a grant from the CDC Foundation with support from Amerigroup Foundation. For more information or to register, contact Monica McInnis at monicamcinnis@bellsouth.net .

Through a joint effort, the number six hole at Wolf Hollow Golf Course has a new bridge. Years of erosion and weather damage caused the need for a completely new concrete bridge, built to withstand the elements. The costly project was funded by multiple college entities partnering to produce the funds. The Co-Lin Foundation donated all proceeds from their annual golf classic to the bridge replacement project, which totaled $18,000. In response to that generous contribution, Wolf Hollow Golf Course matched their donation and put another $18,000 towards the project. The Lincoln County Board of Supervisors also provided project assistance. Wolf Hollow Golf Course is an 18-hole course situated on the Wesson Campus of Copiah-Lincoln Community College. For more information or to book a tee time, visit www.wolfhollowgolfclub.com or call 601-648-8379.

It’s a Tuesday morning in the Emergency Department at the University of Mississippi Medical Center, and four gurneys are lined up end to end just inside the entrance. Paramedics stay with their patients. They can’t unload them into an exam room bed, a responsibility of ambulance services, because all 50 are full. So are most of the Medical Center’s 15 or so parking places for ambulances. At 11 a.m., 23 people are “bed boarding,” or admitted, but waiting for a regular floor or intensive care unit bed. On some days, it’s 35 bed boarding, or 40, or more. Emergency Department staff gather at a corner room to put a patient on a ventilator, a frequent occurrence in a busy ED or ICU. An electronic board mounted on the wall lists patients en route by ambulance or medical helicopter transports. Many are COVID-positive transfers from other facilities, including a young pregnant woman. They’re all labeled “urgent” or “critical” or “high risk.” One was in a car wreck but not wearing a seat belt. Another was a transfer, already intubated. Don’t be fooled by the relative calm interrupted by equipment beeps and dings, patients on oxygen being pushed across the floor when it’s their turn for a room, or overhead announcements. “Chest X-ray in Trauma 2.” Then, “Possible Code Gray,” a patient who might be having a stroke. Unvaccinated COVID patients are “having a huge effect,” said Dr. Alan Jones, associate vice chancellor for clinical affairs and former chair of the Department of Emergency Medicine. “We know that 90-plus percent of new infections are unvaccinated. If we didn’t have all those patients to deal with, we wouldn’t be this strained.” “It’s not quiet. It’s the calm before the storm. Almost every room in this department is full,” said ED technician Hilton Rahaim. He and other caregivers are focused on their patients in the area where COVID patients are observed. It will hit capacity, and the overflow will spill into the rest of the department. It’s not a disaster waiting to happen. It’s happening. * “If you think about the entire state as being one huge health system, trying to function in unison, when your input is more than your capacity, you’re in a disaster situation. That’s what we are experiencing now,” said Dr. Kendall McKenzie, professor and chair of the Department of Emergency Medicine and a veteran battlefield surgeon. “The Smith County Watermelon Festival. The Neshoba County Fair. The opening of schools without a mask mandate. I’m waiting for that shoe to drop,” said Dr. Andy Wilhelm, division chief of Pulmonary and Critical Care Medicine and a regular presence in the ED, seeing that many of its patients are destined for the ICU. “That could be the catastrophe that pushes us over. When the ER fills up and we (UMMC’s four ICUs) fill up, it’s a logjam. At UMMC and other hospitals, there’s a significant nursing shortage that is intersecting with front-line caregivers home sick with COVID – or hospitalized - in record numbers. Those on the job are exhausted, but they’re putting patients and each other first by their very presence. As the state’s sole Level I trauma center and academic medical center, UMMC has a unique mission: care for the most gravely ill patients, including dozens with COVID-19 whose survival could depend on the state’s highest level of care found only at the Medical Center. No beds? It’s not that simple. “When all of the beds are filled up in every ED across the state, and you still have more input into the system, there’s no way to take care of them in a timely fashion to keep them from building up,” McKenzie said. “People generally believe that emergency care will be available to them when they need it,” Jones said. “What people need to understand is in situations like this, the ED is a finite resource. You might have a disease process that’s very treatable, but if you can’t get to the treatment you need because of the strain on the health system, you might have a different outcome.” There’s a domino effect.” It’s a confluence of issues coming together that is creating a massive disaster situation,” McKenzie said. They include: The ED is bed boarding more patients than ever. Exam rooms each contain one bed, and “if you have 35 admitted patients who are boarding, you are trying to run a Level I trauma center out of 15 beds,” McKenzie said. “Sometimes, it’s tighter than that.” The Emergency Department’s trauma section has four trauma and six treatment rooms. “When your resuscitation rooms are all filled with very sick people and you have a trauma patient come in who must have a room, there are inherent challenges,” McKenzie said. “Over the past 18 months, our trauma numbers have actually gone up. That adds an additional burden to the system.” When ambulances can’t offload patients in the ED, “that means those ambulances aren’t out on the street, able to take 911 calls. And those people can’t get to the hospital because of a lack of ambulances,” McKenzie said. The Medical Center can’t accept some requests from hospitals wanting to transfer patients, some with COVID-19, so they can get a higher level of care. “If there’s a need to send a patient here, our philosophy has always been to accept them with open arms,” McKenzie said. “We have not been able to do that to the level we’d like.” UMMC’s ED never turns away an ambulance. But if a transfer is declined, Jones said, it would be because ER beds are full and the patient doesn’t need UMMC’s unique services. An example would be a patient with a broken leg. Conversely, when there are no beds, people who need time-sensitive treatment through a higher level of care might not get it, Jones said. “Every hour of every day is different.” Because caregivers can’t get to all walk-in patients in a timely fashion, some of them will get frustrated and leave. “We haven’t seen these kinds of waits historically,” McKenzie said. “Some of the people who are leaving need to be in the hospital.” It's important to note that not all patients who are bed boarding have COVID-19. Some have suffered urgent heart attacks or stroke, gunshot wounds or other trauma. Some might require emergency ventilation. A pregnant mom with COVID-19 might need an emergency C-section. “People have been putting off medical care for the past 18 months, and their disease processes advance,” McKenzie said. “We are seeing sicker patients than we have historically, and the number of critically ill patients coming into the ED on a daily basis is higher than any other time in our history.” Three ED triage beds normally used to assess early on the extent of a patient’s injury or sickness are sometimes repurposed for treatment. The same is true for the family counseling room and a decontamination room for patients who have come into contact with hazardous materials. “We are utilizing as much space as we can, but there are limitations to that,” McKenzie said. Front-line providers are more fatigued than ever. “ED personnel are extremely resilient. We pull our pants up, put our shoes on and show up prepared to handle what comes our way,” McKenzie said. “Eighteen months of doing that with very little break, being understaffed while caring for incredibly sick people, is very taxing. We are seeing the ramifications of that on every level.” Every time the Medical Center reaches a new high on COVID-19 inpatients, “it creates a lot more pressure on the resources, beds and staff,” Jones said. “Not only do these COVID patients have an impact, they are staying for a longer time, on average two weeks. The effect on the health system is decreased turnover of beds. You become less efficient in managing your capacity issues,” Jones said. * “All right! Let’s get some pictures, OK?” Registered nurse Maria Wilson has just entered the room of a patient in the COVID observation area. He needs encouragement, and she offers it. “I got ya,” she said. “I hear ya. “No, darlin’. Keep that on,” she says when he touches his oxygen cannula. “We’ve got to take some pictures now. I got you some pain meds. We’re going to go ahead and swab you for COVID, OK?” That area was used for chest pain observation pre-pandemic. “If they’re back here, the majority have COVID,” said registered nurse Cindy Wilson. “I had a patient in that room over there a little whole ago who was negative on the antigen test, but we’ll get his long test back tomorrow.” ED staff pack an incredible amount of work into a shift, usually either eight hours or 12. “They’ll ask us to work a 12 instead of an eight if we can stay late and if they need us,” Rahaim said. “We just have so many employees out with COVID.” Gordon Gartrell was a veteran ED registered nurse and supervisor before recently being named pediatric ICU nurse manager. This day, he’s back in the ED for a staffer who needs his emotional support. “It’s a nightmare, but we take care of our own,” Gartrell said. The patients they are seeing are very sick. “We typically have patients on our wards that in other hospitals might meet the criteria for their ICU,” Wilhelm said. UMMC is helping meet the demand for more beds by opening a second medical ICU with six beds in the area formerly used as a pediatric ICU, he said. What would happen in the ED if a mass casualty happened in the metro area or out in the state? A horrific bus or plane crash? An explosion or fire? A mass shooting? It’s a hypothetical that must be discussed and managed, McKenzie and Wilhelm say. “The system is already full. We’d have to be creative,” Wilhelm said. “The rules of the game would have to change, and our way of managing patients would have to change. The standard of care would not change. We’d be doing our best to provide it.” “On the days when we are busting at the seams with patients, maybe a waiting room of 40 patients and 35 boarding ... our ability to handle that would definitely be impacted,” McKenzie. “We’d have to attempt to spread the patients to other facilities who are also equally at capacity. “We might send teams to an alternate site and treat (the injured) there through a more robust triage system before they ever get to the ED. Med-Com and AirCare would be instrumental.” * Get vaccinated, everybody. “The way through this pandemic is through herd immunity. If people are not willing to get vaccinated, we have to hope that natural immunity lasts longer,” Jones said. “If people are not willing to get vaccinated, it could mean thousands and thousands more deaths and hospitalizations.” At least 97 percent of patients admitted to UMMC “from a COVID standpoint are not vaccinated,” McKenzie said. “All of us own this problem in the health care system today. It’s been preached for months – get vaccinated. That’s the bottom line, and it’s stressing the health care system to the breaking point. It’s as simple as getting a shot in the arm.” As the number of Mississippians testing positive grows by the thousands, so does the urgency for the state to increase an overall vaccine percentage that doesn’t even hit 40 percent. “That’s why it’s important for people to do their part,” Jones said. “Medical care is a finite resource, and it can be depleted. It can be broken. “If there’s no place to put you, we can’t take care of you. If there are not enough nurses, we can’t take care of you.” Editor’s note: As of 10 a.m. Thursday, August 19, there were 10 patients in the Emergency Department waiting for an ICU room to become available, nine waiting for a regular room, and three COVID-positive patients en route by ambulance. A couple of the 50 total ED exam rooms were open, but all were expected to be filled before noon. UMMC’s overall COVID-19 patient count as of 8 a.m. Thursday, August 19, stood at 135, with 26 of the adults in the ICU. There were 28 pediatric COVID-19 patients, with eight of those in the ICU. Of all COVID-positive patients, 74 percent are unvaccinated and just 8 percent are fully vaccinated. None of the children 12 and older are vaccinated.