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As ICU beds fill up, Colorado hospitals beg public to get vaccinated against COVID — and the flu

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As ICU beds fill up, Colorado hospitals beg public to get vaccinated against COVID — and the flu

Colorado intensive care units are almost full, and a bad flu season could push them to the edge if coupled with continued spread of COVID-19.

Dr. Stephen Cobb, chief medical officer for Centura Health’s Denver region, said that hospitals are managing by postponing non-emergency surgeries and shifting staff around, but how the winter goes is at least partly up to the public.

It’s important to get vaccinated against both COVID-19 and the flu, to wear masks and maybe to avoid crowds for a while, he said. While most people don’t become seriously ill from the flu, older adults and young children are at higher risk.

“We desperately need the community to get vaccinated,” he said. “We’ve learned how much our behavior affects the kind of respiratory season we’re going to see.”

Last fall and winter, hospitals faced a tsunami of COVID-19, but a drop in other health care needs helped them withstand it. The flu season was almost nonexistent, due to masking and social distancing, and accidents were down as people spent more time at home. Now, people are out and about again, giving each other common viruses and getting injured.

COVID-19 patients are a minority of all patients in Colorado intensive-care units, but there’s little room to spare if the virus continues spreading.

On Sept. 10, the state reported fewer beds were available in intensive-care units than were during the worst days of the winter: 197. Scott Bookman, the state’s COVID-19 incident commander, said hospitals were activating their surge plans and converting general rooms to accept more intensive-care patients. Some also were closing outpatient clinics so they could move staff to higher-need units, he said.

The number of beds available fluctuates from day to day, and that number has risen and fallen since the state’s announcement. On Tuesday, the state reported 238 ICU beds were ready to use, but by Thursday, that dropped to 187. That’s about 11% of total capacity — the lowest level available since the pandemic started.

Those are statewide figures, though, and conditions are worse in some parts of Colorado.

Larimer County late last week alerted residents that ICU capacity in the county’s hospitals had been at or above 100% since Aug. 30 — and was at 107% on Thursday. COVID-19 hospitalizations in the county grew from 10 to 76 in the last two months, and nearly 40% of patients in the ICU in August and September had COVID-19, the county health department said.

“Once again I am pleading with our residents to take this situation seriously,” Tom Gonzales, director of the Larimer County Department of Health and Environment, said in a message to residents. “We can no longer ask our hospitals to carry the burden of this preventable disease.”

“Taking up our ‘just in case’ bed”

Colorado’s relatively fortunate to have more than 10% of beds available statewide, and hospital leaders urged residents not to delay seeking care if they’re experiencing potentially dangerous symptoms, like chest pain. While many facilities are putting off non-emergency surgeries, they still have space to treat heart attacks, strokes and other life-threatening conditions, Cobb said.

That’s not the case in some parts of the country.

In much of the South, at least 95% of ICU beds are full, and reports of patients dying for lack of a bed have started to emerge. An Alabama man died of a heart condition in early September after a full hospital called 43 intensive-care units but still couldn’t find him a bed, and a Texas man died of complications from gallstones, which could have been treated if a hospital had had space for him.

All of Idaho and parts of Alaska recently announced they were moving to “crisis standards of care,” a designation that provides legal cover for doctors and hospitals if they can’t give everyone an acceptable level of medical care. In practice, that may mean that a person who’s less likely to survive doesn’t get an intensive-care bed, to allow limited staff to focus on those who have the best chance.

Still, the situation isn’t exactly rosy in Colorado: about one in five hospitals reporting to the state said they could be short on staff in the next week, and 15% expected a shortage of ICU beds.

Colorado hospitals are managing by postponing elective procedures, discharging patients promptly, adjusting staff and declining to take transfers from other facilities when they don’t have a bed available, said Cara Welch, spokeswoman for the Colorado Hospital Association.

J.P. Valin, chief clinical officer for SCL Health, said about 90% of the people in the ICUs of their Colorado facilities are there for something other than COVID-19: accidents, strokes, emergency surgeries. They also have accepted some patients from neighboring states that have run out of space, he said.

The situation isn’t a “crisis,” but it’s important to reduce the strain on the system, so that beds are available for anyone who needs one, Valin said.

“We think a fair amount of this is still the legacy from delayed and deferred care,” he said. “What COVID patients are doing, they’re taking up our ‘just in case’ bed.”

Other hospitals also have seen a rise in patients. HealthOne reported admissions for COVID-19 had tripled in recent weeks, though they still are a relatively small fraction of all patients. About one-third of those patients need ICU care, which is in line with previous waves, spokeswoman Stephanie Sullivan said.

“There is no question that the current surge has put a strain on staffing across Colorado and the entire region, but we are grateful that our hospitals have been able to meet the needs of our patients,” she said in a statement.

Number of beds dependent on staff

As of 2018, Colorado had about 3.2 ICU beds for every 10,000 people, according to the Kaiser Family Foundation. That’s higher than the national average, but still doesn’t leave much room for surges. Hospitals don’t build substantially more space for patients than they expect to need on a regular basis, let alone employ enough nurses to handle unusually high levels of demand for months on end.

The discussion about beds is really about staff to care for the people in them, Valin said. Some ICU nurses have gone to work on less-demanding units, while others have left hospitals altogether or taken higher-paying jobs as travel nurses in the Southern states that are dealing with worse surges, he said.

“We have plenty of beds. We have plenty of ventilators. We have plenty of PPE,” he said, referring to personal protective equipment like masks and gloves.

Dr. Adit Ginde, an emergency medicine physician at UCHealth, said hospitals also are dealing with some vaccinated staff having to stay home because of COVID-19 symptoms. They haven’t become seriously ill, but it’s one more strain on a system that’s at capacity, he said. While severe illness is rare after COVID-19 vaccination, milder breakthrough infections are less so.

“We’re asking the community to do their part” by getting vaccinated and taking precautions, he said.

As of Thursday morning, UCHealth had 265 COVID-19 patients, which is just over the number at the peak of the first wave in April 2020, and some hospitals are following “surge plans” to free up beds, spokesman Dan Weaver said.

Both the UCHealth and SCL hospitals have been postponing some non-emergency care. That’s a category that includes anything that can be scheduled, including removing tumors or performing open-heart surgery, Valin said.

“You can imagine how hard that is for patients and families,” he said.

El Paso County Public Health announced late last week that it was changing its regional hospital capacity designation from level orange to level orange-red as beds continue to fill.

Dr. David Steinbruner, chief medical officer for UCHealth Memorial in Colorado Springs, said the network’s hospitals in the Pikes Peak region were seeing record numbers of patients seeking care for COVID-19 and other health issues. On Thursday, UCHealth’s hospitals in the region were treating 90 patients with COVID-19, a number not seen since the deadly winter wave was subsiding in January.

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Five things we learned from the Ravens’ 41-17 loss to the Cincinnati Bengals

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The Ravens had their worst performance of the season in a lopsided 41-17 home loss to the Cincinnati Bengals. Here are five things we learned Sunday afternoon:

The Ravens cannot dwell on a humiliating defeat any more than they did on a proud victory.

The Ravens entered with a 5-1 record built on one-score victories and a single blowout. They exited as victims of a pummeling that sent them into their bye week facing serious questions about their status as an AFC contender.

We’re talking about what happened Sunday, right? Well, yes, but we could also be describing the events of Oct. 21, 2012, when the Ravens fell, 43-13, to the Houston Texans. That story ended 3 ½ months later in New Orleans, with Joe Flacco clutching a Super Bowl Most Valuable Player award.

This is not to say the Ravens are destined to win the Super Bowl because they ate a blowout in Week 7. It’s just to say that one week is one week in the NFL. It’s not unusual for an eventual champion to be embarrassed on a given Sunday. Need more recent evidence? The Tampa Bay Buccaneers fell, 38-3, to the New Orleans Saints in Week 9 last season.

This was not a disqualifying loss for the Ravens any more than their 34-6 blowout of the Los Angeles Chargers, just seven days earlier, was a certification of their AFC preeminence.

“It’s always week to week; it’s always game to game,” coach John Harbaugh said. “There never is any running narrative, it just doesn’t exist.”

Please don’t read this as an excuse for the Ravens’ performance. They tackled and covered poorly against a talented, hungry opponent that was eager to pounce on every mistake. They did not run the ball with any consistency against a defense that yielded 404 rushing yards to them in Week 17 of last season. Quarterback Lamar Jackson waited too long for plays to develop and took five sacks as a result. They were much the lesser team on their home field in an early battle for AFC North supremacy.

“This one’s going to burn a little bit,” defensive end Calais Campbell said, and you could hear from his humbled tone that he meant it.

There’s only so much use in self-flagellation, however. The Ravens, under Harbaugh, have always done a good job of treating each week as a discrete problem. Seasons rarely get away from them, and there is no reason to think this one will.

“We can’t really treat a bad loss any different than a win,” said cornerback Marlon Humphrey after one of the worst individual performances of his career. “This bye week helps us because we can kind of study into it a little bit more than usual. But you look at it, you fix your problems. You’ll probably take this one [for] two or three days, and then you kind of flush it, and you move on.”

Fans won’t take comfort from such answers, which border on cliché. But there’s a reason successful players and teams learn to think this way. What else is there but next week?

All of the Ravens’ flaws resurfaced.

The completeness of their triumph over the Chargers wiped our memories of the first five weeks a little too quickly. Yes, they found ways to win those earlier games, but they did so in spite of shoddy tackling, a declining ground game and flimsy pass defense.

All of these old enemies showed up at M&T Bank Stadium on Sunday.

The Ravens actually started well on defense, pressuring Bengals quarterback Joe Burrow into an inaccurate first quarter and keeping rookie wide receiver Ja’Marr Chase off the stat sheet. Then, Cincinnati tight end C.J. Uzomah left Humphrey sucking dust on a 55-yard touchdown catch in the second quarter, and the troubles followed.

This was the rare game in which Humphrey was not the best Ravens cornerback on the field. In the two-minute drill before halftime, he let Chase get away from him on a crossing route; Chase not only picked up 26 yards, he made it all the way to the sideline to stop the clock. Cincinnati capitalized with a field goal to go up 13-10.

Uzomah scored again on the Bengals’ first drive of the second half after Ravens safety Chuck Clark abandoned him in hopes of jumping a sideline route. To make matters worse, DeShon Elliott missed a tackle on the 32-yard catch and run.

The afternoon reached its nadir a few minutes later when Chase beat Humphrey on a quick third-down route and wiggled out of the cornerback’s grasp on his way to an 82-yard touchdown that put the Bengals up 27-17. Humphrey briefly reopened the window for his team with an interception in the end zone at the start of the fourth quarter, but the Ravens went just 18 yards on their ensuing drive, and that was that.

“I lost that matchup, so a lot of it … is on me,” Humphrey said of his showdown with Chase.

Outside linebacker Tyus Bowser offered a broader and simpler epitaph: “We would have been OK if we had just tackled.”

Burrow finished with 416 passing yards, Chase with 201 receiving yards. Their gaudy statistical lines echoed those surrendered by the Ravens in earlier games against the Raiders, Chiefs and Colts.

“Up and down,” Campbell said of the defense. “Hot and cold. Not very consistent yet.”

The Ravens could have made life easier for their defense if they had seized the initiative on offense like they did the week before. But they are no longer capable of playing bully ball against quality resistance. It’s telling that their best running performances of the season have come against defensive horror shows such as the Chiefs and the Chargers. Jackson (12 carries, 88 yards) was their only effective runner against the Bengals, and he took significant punishment as he tried to scramble his team out of trouble. The Ravens got 29 yards on 11 carries from their running backs; it’s hard to imagine such totals if they were working with J.K. Dobbins and Gus Edwards instead of faded stars Devonta Freeman and Le’Veon Bell.

Jackson made some terrific downfield throws, but he also held the ball too long as he waited for chunk plays to develop, perhaps lacking faith that the Ravens could mount long drives built on more modest bites. They managed just one scoring drive longer than four minutes, meaning they never played the game on their terms.

The Bengals announced themselves as a legitimate threat to take the AFC North.

We can list the Ravens’ flaws on a never-ending crawl for the next two weeks, but the fact is they might have gotten away with their subpar performance against the 2020 Bengals. This was a more formidable foe that spent the week uttering confident words and backed them up with confident play.

Burrow knew he would face pressure, and he missed on eight of his first 13 attempts as Ravens outside linebacker Justin Houston lived in the Cincinnati backfield. The former No. 1 overall pick did not shrink from the difficulty, however. He made correct reads and accurate throws with defenders in his face, and his receivers turned quick strikes into touchdowns of 55, 32 and 82 yards (49.4% of his passing yards came after the catch, according to Pro Football Focus). The Ravens opened the door with missed tackles and poor communications. Burrow and the Bengals sprinted through it.

“This might have been his best game as a pro,” Campbell said of Burrow. “We made it hard on him early, and he made some adjustments and did what he had to do. You have to tip your hat off to him. His playmakers made plays for him, too. That team is talented.”

On the other side, the Bengals made it clear their 26th ranked defense from 2020 is a relic of the past. They covered well enough downfield to give their pass rushers, Sam Hubbard and Trey Hendrickson, time to reach Jackson, and they ate the Ravens alive at the line of scrimmage. They have stars at all three layers.

Based on seven weeks of evidence, nothing about the Bengals screams fluke. Their defense is the best in the AFC North (yes, they have outplayed the Steelers). Burrow and Chase are gifted enough to punish any opponent. Their self-belief is growing. Remember, Jackson and the Ravens took off faster than anyone expected in 2019. Could this blowout be tinder for the Bengals?

“I think it was a big statement,” Burrow said.

The Ravens cannot afford to lose Patrick Mekari.

Harbaugh offered no postgame update on his right tackle, who left the game with an ankle injury before halftime.

The Ravens had spent the first six weeks playing catch-up on the offensive line after Ronnie Stanley went down with an ankle injury that turned out to be season-ending. Mekari’s play on the right side was a legitimate bright spot in that effort. He came in with the second-best pass-blocking grade among the team’s starting linemen, according to Pro Football Focus, and Harbaugh has praised him unreservedly.

The Ravens love Mekari for his willingness to step into any breach. With him excelling at right tackle and Alejandro Villanueva looking more comfortable at his familiar spot on the left, the loss of Stanley felt less catastrophic than it probably should have.

Mekari’s injury might turn out to be minor, and it came at the right time, with the Ravens going into their bye week. But it reminded us how thin they really are at tackle. Tyre Phillips, who has rarely excelled as a pass blocker on the outside, stepped in for Mekari, and Cincinnati’s best pass rushers, Hubbard and Hendrickson, rolled up pressures against him and Villanueva. Practice-squad call-up David Sharpe was one more turned ankle from playing significant snaps.

Do not be surprised if Ravens general manager Eric DeCosta tries to pick up a tackle before the Nov. 2 trade deadline, though the leaguewide supply is thin.

Even in a bad loss, we saw evidence the Ravens have found the right formula at inside linebacker.

It was just Patrick Queen’s luck that he played one of the better games of his career in an ugly performance for the defense.

The Ravens stuck to their plan from the Chargers game, using the second-year linebacker as a complement to veteran Josh Bynes. Queen played 27 defensive snaps and earned the highest grade of any Ravens defender, according to Pro Football Focus. Early in the game, he moved decisively to fill a gap and dropped Bengals running back Joe Mixon for a loss. The 2020 first-round pick avoided the glaring mistakes that haunted many of his teammates.

Bynes also played well, contributing six tackles as the Ravens held Mixon (12 carries, 59 yards) in check for most of the game.

The Ravens trust Bynes to bring order to the middle of their defense, and they hope Queen will rebuild his confidence and run free to the ball playing the WILL spot. This wasn’t the scenario they envisioned heading into Week 1, but it’s a logical attempt at trying to make the best of a disappointing start to Queen’s career.

Week 9

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Nov. 7, 1 p.m.

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©2021 Baltimore Sun. Visit baltimoresun.com. Distributed by Tribune Content Agency, LLC.

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Ravens coach John Harbaugh on defense’s ‘biggest problem,’ Patrick Mekari’s ankle injury and more | NOTES

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The Ravens’ biggest problem on defense this season hasn’t changed. If they can’t tackle, they can’t succeed.

Tackling woes again plagued the Ravens in their 41-17 loss Sunday to the Bengals, with Cincinnati quarterback Joe Burrow amassing nearly half of his career-high 416 passing yards after the catch, according to Pro Football Focus. Running backs Joe Mixon and Samaje Perine also ripped off fourth-quarter touchdowns against a defense that couldn’t bring them down.

As the Ravens enter their bye week on a low note, their defensive fundamentals are under the microscope. That has been the case seemingly all season, even after spirited wins.

“The biggest problem we have on defense right now, in terms of big plays, is not getting guys on the ground, whether it’s been underneath slant routes or screen routes or, in one case, we got the screen-and-go,” coach John Harbaugh said Monday, referring to Bengals tight end C.J. Uzomah’s 32-yard catch-and-run touchdown in the third quarter Sunday when he slipped past safety DeShon Elliott in the open field.

When the Ravens return in Week 9 for their home game against the Minnesota Vikings, there will be little letup for the defense. Running back Dalvin Cook averaged a broken tackle every 9.5 carries last season, according to Pro Football Reference, though his elusiveness has slipped this season. Wide receiver Justin Jefferson, who starred alongside Bengals rookie Ja’Marr Chase at LSU, is ninth in the NFL with 542 receiving yards.

“Until we get [tackling] fixed, we’ll be a very mediocre defense, generally speaking,” Harbaugh said. “Our guys understand that. … When we play really good defense, we’re tackling. And that’s got to get done. And there’s a lot of reasons for that. Sometimes they’re not pushing to the right zone, so there’s more space in there than there should be. Other times, we take a bad angle. Sometimes a guy’s not covered.

“There’s different reasons for it, but the results are uniformly not good. And you’re a consistent, good defense when you consistently do all the little things well. And when we start doing all the little things well, then we’re going to be a better defense.”

Mekari hurting

Harbaugh declined to comment on right tackle Patrick Mekari’s condition, saying only that he has an ankle injury. The NFL Network reported Monday that Mekari, who was hurt in the second quarter, suffered a high-ankle sprain and is “seeking more feedback.” High-ankle sprains generally take at least a month to recover from.

Mekari is the Ravens’ highest-rated tackle, according to PFF, and played every offensive snap from Week 2, when he took over after Alejandro Villanueva moved to left tackle, to Week 6. Harbaugh said last week that he “couldn’t ask for a better player there [at right tackle] right now.”

With Ronnie Stanley (ankle) sidelined for the season, the team will likely turn once more to Tyre Phillips, who started at left guard in Week 1 before suffering a minor knee injury. He replaced Mekari on Sunday and struggled against Cincinnati’s pass rush.

“We’ll just see where it goes,” Harbaugh said of Mekari’s injury.

Extra points

  • Harbaugh called the Ravens’ performance Sunday “our worst game of the season, worst game in a long time.” But he stressed that the team is not even at the midpoint of a long season. “We’ve got 10 games left,” he said. “We need to keep growing as a football team and building on what we’ve done and what we haven’t done and make the strongest run we can for the next 10 weeks, and that’s what we’re planning on doing.”
  • After Ravens running backs combined for 29 rushing yards on 11 carries Sunday, Harbaugh was asked about the position’s struggles on the ground. “We just have to block better, scheme better, run better,” he said. “There are specifics in there in terms of schemes, and every play stands on its own. But we can’t go through all — how many run plays have we had this year that haven’t been successful? You can go through every one of them and you get the specific answer.”
  • Defensive lineman Derek Wolfe (hip/back) is “very close” to returning to practice, Harbaugh said. Wolfe has yet to play this season after suffering an injury in training camp. “This week, next week, hopefully, and we’ll see,” he said.

©2021 Baltimore Sun. Visit baltimoresun.com. Distributed by Tribune Content Agency, LLC.

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Patriots-Chargers injury report: Devin McCourty not listed, 15 limited Wednesday

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Oct. 28—The Patriots listed 15 players on their initial practice report Wednesday — and that meant good news in New England.

Why?

Veteran safety Devin McCourty, who missed the second half of last Sunday’s game with an abdomen injury, was not listed. As a full participant in Wednesday’s padded practice, McCourty should be expected to play this weekend at the Chargers.

None of his teammates were absent Wednesday, including rookie corner Shaun Wade, who had missed the last three weeks with a concussion. Pats linebacker Dont’a Hightower has also recovered from the hurt elbow that contributed to him missing Sunday’s win over the Jets. He’s now only limited because of an ankle injury.

The Patriots’ complete injury report is below. The Chargers’ will be released later Wednesday evening.

Limited

C David Andrews (ankle)

LB Ja’Whaun Bentley (ribs)

WR Kendrick Bourne (shoulder)

DT Carl Davis (hand)

S Kyle Dugger (neck)

K Nick Folk (left knee)

DT Davon Godchaux (finger)

LB Dont’a Hightower (ankle)

LB Brandon King (thigh)

G Shaq Mason (abdomen)

TE Jonnu Smith (shoulder)

LB Josh Uche (shoulder)

LB Kyle Van Noy (groin)

CB Shaun Wade (concussion)

DE Deatrich Wise (knee)

(c)2021 the Boston Herald Distributed by Tribune Content Agency, LLC.

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