Delta Variant - The Mississippi Way

Delta Variant

Dr. Jennifer Bryan

Delta… a word that used to conjure up warm memories of being at my grandparents’ home in Greenwood, family holidays together, playing in the park with cousins and then coming back to my Granny’s kitchen to some of the finest Southern cooking around. This word that once meant something so wholesome and genuinely “Mississippi” to me has taken on an entirely different and ominous meaning now associated with one of the worst periods in modern history. This is a blog post from a Mississippi physician’s perspective on the Delta variant.

For me, 2020 had started off on a great foot. The kids were glad to back in school from Christmas break, we had taken a family vacation to Washington D.C. and we had just begun enjoying a little Mardi Gras season on the gulf coast with family. A virus in Wuhan, China had piqued my interest and concerned me some, but I tried to distract myself from it. I wanted to believe that it would go away, but down deep I knew this felt different from other outbreaks in recent history. The rest of 2020 really is history to most of us. We know of the COVID-19 pandemic, how it evolved and spread around the globe. It rapidly changed how we lived, shopped, educated, worshipped and interacted in general.

We homeschooled our children and awaited the arrival of the vaccine. We called it “the year we stayed home”. As a physician, my practice changed as the telemedicine portion grew, and staff grew accustomed to screening patients and deep cleaning exam rooms after each use. We all wore masks and bemoaned not having enough protective personal equipment and having to reuse it more than we normally do. In between peaks of the virus, we learned to deal with it. Our children still played outdoor sports and beach vacations kept us sane. We entertained outdoors and attended virtual church services. Life had changed, but we were still able to find joy in the “new normal”.

By the summer of 2021, with vaccinations on board, community spread of the virus low, and availability of tools such as monoclonal antibodies and steroids in event of an infection, life had returned even more to a pre-pandemic level. We ventured to indoor dining some again and an outdoor concert with friends. At the Mississippi State Medical Association we began planning for the Healthcare Heroes Gala in conjunction with our upcoming August meeting, and our children were thrilled after a year at home to return to school and their friends. Again, similar to the beginning of the pandemic, I had heard rumblings of the dreaded “Delta variant”, but it was almost like I could not process it. I didn’t want to. I hoped and prayed it would not affect us, but deep down, I knew that Delta was different.

At the start of the COVID-19 pandemic, I had taken to writing on social media to try to reach as many as I could with educational efforts as a physician. Once Delta variant entered the scene, my pleas to the community and family to mask up and vaccinate escalated. It was clear we were on a timeline to collide with disaster. Leadership meetings turned darker as we talked about the tsumani ahead and that we wouldn’t be able to take care of all the sick. By vaccinating as many as possible and heavily utilizing monoclonal antibodies, we began implementing plans intended to mitigate as much of the damage as possible.

In medical school, we learned about pandemics and the ethics of rationing care in disaster or scarce resource scenarios. Even as I read about those things, in the back of my mind, I always knew they wouldn’t happen here. Boy was I wrong. We are low on manpower and beds. Resources have been scarce and they are getting scarcer as Delta surges here. Field hospitals are going up. The intensive care units have overflowed to the emergency rooms which have overflowed to the clinics who also full testing patients for COVID and administering antibodies.

In my day to day practice, things have tightened up again although we never entirely let go of our infection control practices. We utilize telemedicine heavily for respiratory infections and swab them offsite at our lab. If positive, we set them up for monoclonal antibodies. I moved out of my personal office space which has an exterior entrance and we utilize that space now to administer subcutaneous antibodies to those with COVID. Each day brings more and more COVID positive patients to the clinic. I am grateful to be able to have a tool now to help them as it is very rewarding work, but the sheer volume of people calling who are sick is unnerving. One of our staff quit due to hitting a “breaking point”, and I worry that soon we will have to turn people away due to not having enough manpower or space to take care of them. I worry about the toll all of this will have on families as they lose their loved ones, particularly the children. The mental effects of much of this will last a lifetime and perhaps beyond.

When I look to the future, I know that what’s ahead will be exceedingly challenging and even catastrophic. I hold onto hope, though, as I see the vaccination numbers tripling, and I have a very real hope that on the other side of this nightmare surge, that this will be the final one. As people are personally affected by the virus, many of them are now vaccinating. This gives me a lot of hope for our future, and I also look ahead to the future vaccination battles at the legislature and am really hopeful that this will finally put some of that to rest. Vaccines clearly save lives. Perhaps these arguments will lessen going forward as people have witnessed firsthand, the effectiveness of vaccines and how they save lives. I hope research scientists will be able to continue to build off the knowledge gained from COVID-19 to prepare even better for coming pandemics so that next time, perhaps, we won’t experience this magnitude of devastation. In the meantime, each day I find value in the fact that what we are doing as physicians is very personally rewarding and is making an impact in our state one person at a time.