Jessica Vaughn, a 33-year-old mother of five, was found dead in her Asheville apartment. The cause: COVID-19.
Brianna Justus, a 31-year-old expectant mother, went from healthy to COVID intensive care patient at Mission Hospital in less than a week. Her baby, delivered by emergency cesarean section, survived. Brianna Justus did not.
Thomas Turner of West Asheville waited nearly two hours at an urgent care center without being seen before driving himself to Mission, his family said. He never made it inside. Turner, 59, died in the parking lot while his wife, who also had COVID, was being treated in the emergency room.
Their deaths are just a few from a current surge that is overwhelming Buncombe County’s health care system, taxing already exhausted doctors and nurses, and afflicting a large swath of Western North Carolina in numbers not seen since the pre-vaccine pandemic peak.
At Mission, where the number of COVID patients has reached record levels, some patients have been turned away and rerouted to other area hospitals that are also at or near their limits.
Buncombe County Emergency Services is requesting that people not dial 9-1-1 unless it’s a life-or-death emergency. “We’re running out of ambulances,” the agency’s director, Taylor Jones, said.
“What it looks like,” Drew Reisinger, Buncombe County Register of Deeds, said this week, “is there are so many people infected, and [the delta variant of the coronavirus] is so aggressive, that our death rate is going to be on par” with the peak numbers of last winter, before vaccines were widely available.
Record number of COVID patients
Mission Health reported 166 COVID-positive patients in its six-hospital system on Thursday, including 127 at the flagship Mission Hospital in Asheville. Two months ago, the entire Mission system had just seven COVID patients.
Pardee UNC Health Care in Hendersonville had 25 COVID patients as of Tuesday. “We had an average of 1 to 2 patients hospitalized for COVID-19 the first week of June,” said Dr. David Ellis, chief medical officer.
The Charles George VA Medical Center in Asheville had 27 COVID patients this week, nearly tying its record from January, said Dr. Ashfaq Ahsanuddin, chief of staff.
“They’re younger, they’re sicker, they’re staying longer,” he said. “They’re progressing faster from being admitted and ending up on oxygen.”
At AdventHealth Hendersonville, COVID-19 hospitalizations are “at or above the highest peak since the pandemic began in 2020,” said spokeswoman Victora Dunkle. And the hospital is anticipating a post-Labor Day spike “that could push the numbers even higher,” she said.
All six of AdventHealth’s intensive care unit beds are full and the hospital is caring for critical care patients outside the ICU, Dunkle said.
“Like most hospitals in North Carolina, we are caring for record numbers of COVID patients,” said JC Luckey Sadler, a vice president and spokeswoman for Mission Health and HCA Healthcare North Carolina. “There have been occasions in recent weeks when our high census of COVID patients has meant that we have had to divert some of these transfers from other emergency departments and hospitals.”
But, she said, “Our ER doors are always open to any patient who comes to us with an emergency or in trauma.”
Ellis, Pardee’s chief medical officer, said Tuesday that only four of Pardee’s 16 intensive care unit beds were available. But, he said, “Pardee is not diverting any heart attack or pre-heart attack patients, or any emergent needs of patients living in Henderson and Transylvania counties. We are prepared to care for these patients 24 hours a day, seven days a week.”
After early summer lull, 51 died in August
Early in the summer, it appeared the worst of the pandemic had passed, thanks to widespread acceptance of masks and vaccines. Six people died in Buncombe County in June, and six in July, Reisinger, the county registrar, said.
At least 51 died in August, and that number is expected to rise as more death certificates are recorded.
“It’s a drastic change,” Reisinger said. “There was some early hope that if we do get another big bump like we had this past winter … the death count won’t be as high because people are vaccinated.”
The most vulnerable people, including seniors and those with underlying health issues, have mostly been vaccinated. But as of Wednesday, four in 10 Buncombe residents had yet to receive the vaccine, which is free, widely available and approved by the federal Food and Drug Administration for anyone 16 and older.
Children 12 to 15 are eligible for the vaccine under emergency FDA authorization. According to the American Academy of Pediatrics, children accounted for 22.4 percent of all new COVID-19 cases reported in the week prior to Aug. 26.
At least three who died in Buncombe in the past six weeks were in their 30s, including Brianna Justus and Jessica Vaughn, the 33-year-old mother of five who died at her Asheville apartment July 29. Her father, Donald, said he was too distraught to discuss his daughter or the circumstances of her death.
“I’m still heartbroken,” he said. “You’re not supposed to bury your children.”
The unvaccinated are spreading the virus
Local healthcare officials say unvaccinated people are spreading the virus, are sicker and more likely to need hospitalization when they get infected, and are far more likely to die.
The North Carolina Department of Health and Human Services reported last week that during the four-week period ending Aug. 21, the latest figures available, unvaccinated people were 15.4 times, or 1,540 percent, more likely than vaccinated people to die from COVID-19.
Of the 415 COVID-19 deaths reported at Mission Hospital since the pandemic began, none was vaccinated, Dr. William Hathaway, chief medical officer of Mission Hospital, told Buncombe County Commissioners this week. He later corrected his statement and said two vaccinated patients had died.
“I cannot repeat enough the importance of vaccination,” said Carriedelle Fusco, a family nurse practitioner at MAHEC, the Mountain Area Health Education Center that serves much of Western North Carolina. “It is hard to hear people say that [COVID] is not a big deal. The [anti-vaccine] misinformation out there is pretty staggering, and I’m continually shocked and saddened by things we see on social media.”
The current spike, while alarming, is still well short of the record 151 COVID deaths in Buncombe County in January, before vaccines were widely available. But infections and hospitalizations have returned to the record levels of January and February, and deaths, Buncombe County Public Health Director Stacie Saunders said Wednesday, typically follow in a predictable ratio.
Almost all of the COVID deaths identified by Asheville Watchdog since late July were at Mission Hospital or its affiliate, CarePartners Hospice Solace Center; one died at the VA Medical Center; another at a nursing home; and two at home. They ranged in age from 31 to 93 and included a pastor, a UPS truck driver, a retired aeronautical engineer, and two former police officers.
Failing heart, emergency C-section
Brianna and Cory Justus of Hendersonville were childhood sweethearts, active in their church, and busy raising two sons, aged 5 and 4. She was also pregnant with their third child.
“They were advising pregnant ladies at the time to not be vaccinated,” her father-in-law, Don Justus, told Asheville Watchdog. At the time, the COVID vaccines had not been formally approved by the federal Food and Drug Administration.
“Sadly, when she got it, it was a severe case and she fell extremely hard,” Don Justus said. “The doctors told our son that one of the major side effects to severe cases is blood clots, and the blood clots went straight to her heart.”
“They had to do an emergency cesarean section, and the baby was born at 30 weeks, severely premature,” Justus said. “And the baby did test positive for COVID.”
Immediately after the birth, Brianna Justus was put on a ventilator, and her baby girl, Logan Elyse, was rushed to the neonatal intensive care unit. Then Brianna’s heart gave out. She was 31.
“To prove the power of prayer, the baby spent five weeks in the NICU, and Cory got to bring her home this past Sunday,” Don Justus said.
‘Operating on a knife edge’
At the VA hospital, “The staff is tired. We were on high alert for over a year. We got through our big crush in January,” Ahsanuddin, the chief of staff, said. “People are really having a tough time controlling their feelings when they feel like some of this was really preventable.”
Unlike at Mission and AdventHealth, where staff are encouraged but not required to be vaccinated, the VA mandates vaccinations among its health care workers. But with the high infection rates in the community, some employees are still testing positive, making staff shortages worse, Ahsanuddin said.
He described the VA hospital as “operating on a knife edge right now.”
“The thing that bothers me,” Ahsanuddin said, “is our ability to continue to provide care. At the same time that we’re running out of beds and running out of staff, there’s more and more people that are sick, so that’s not a sustainable situation.”
First Responders Stretched
The surge is straining the health care system at every turn. Pharmacies that once had same-day COVID testing appointments are now full for days.
Jones, the Buncombe County Emergency Services director, said the current COVID spike is “definitely a challenge.”
“We’re seeing younger folks and we’re seeing unvaccinated folks. We are also seeing people who are vaccinated, but they’re not as sick as those who are unvaccinated,” he said.
The service has 11 ambulances, and runs three shifts of responders a day, he said. Average response time is just under 12 minutes, he said. The Asheville Fire Department also responds to 9-1-1 emergency calls and has its own paramedics and emergency medical technicians (EMTs).
Jamie Judd, Buncombe County Emergency Medical Services (EMS) division manager, said that 9-1-1 is averaging about 110 calls a day compared to about 75 in the pre-pandemic period. Nearly a quarter of the current calls are for COVID, Judd said.
The volume is so high that at times all ambulances are busy, he said, and supervisors respond to calls until an ambulance crew becomes available.
Ned Fowler, EMS coordinator for Western North Carolina and veteran emergency staffer since 1974, said the crush is taking a mental as well as physical toll on emergency crews. “They have no breaks between calls like they used to get,” Fowler said. He said the county is providing mental health support.
Scott Groce, of Groce Funeral Home & Cremation Service, one of the largest mortuaries in Asheville, said, “In August, we’ve seen a pretty severe increase in COVID and COVID-related deaths. We’re into double digits since the beginning of August.”
Even with three locations, demand means “we sometimes have to put families off a day” Groce said.
“It’s tough on everyone, Groce said. “It’s a high stress environment with high emotions. We have a lot of staff with a lot of experience, but how far can you stretch your people?”
Vaccinated couple got COVID, one died
Breakthrough infections are rare, but hospitals report seeing vaccinated patients who test positive for COVID-19. About 30 percent of COVID patients at the VA center fall into that category, Ahsanuddin said.
“It’s probably because our vaccinated veterans have a lot of multi-system disease,” he said. “And if they get the delta, they don’t just clear it, they have some exacerbation of their other illnesses.”
Glenda Turner, who has diabetes, said she and her husband, Thomas, of West Asheville, were vaccinated and wore masks when they ventured out. But last month, both became ill.
On the morning of Aug. 17, Glenda Turner visited her doctor. “They told me to go on to the hospital because I had COVID and I was just depleted,” she said.
While at the Mission emergency room being treated, Turner said she talked by phone with her husband, who was struggling to breathe. She said Thomas Turner went to Mercy Urgent Care on Patton Avenue, signed in and waited in his vehicle.
At least 90 minutes passed with no one coming to check on him, according to both his wife and his daughter Mikaela, and Turner drove himself to Mission.
“He let me know that he was there, he was coming in,” Glenda Turner said. “I didn’t hear anything else until they came in and told me he had passed away.”
A passerby found him slumped in his truck, she said.
Turner, 59, died of cardiac arrest caused by “suspected COVID 19 infection,” high blood pressure and morbid obesity, according to his death certificate. Mikaela Turner wonders if the outcome would have been different had he been seen at Mercy. “Maybe my dad would still be here.”
Rachel Sossoman, president and chief executive of Mercy Urgent Care, told Asheville Watchdog, “I am so sorry to hear about the passing of one of our own community members, and express my deepest condolences to the family for their loss.” She declined to answer questions about Turner or his family’s concerns, citing patient privacy.
The Turners said they are frustrated and angry at people who refuse the vaccine and continue to spread the virus.
On the night of her husband’s death, Glenda Turner said her cousin sent her a message on social media “about how fake COVID was, and the government was trying to force vaccinations on everyone.”
Her response: “Leave me alone. I just lost my husband, and I have it, too.”
Buncombe County requires face coverings to be worn in all indoor, public spaces regardless of vaccination status, unless a medical exemption applies. The order expires at the end of September.
Anyone aged 12 and older can visit the Buncombe County Health Department at 40 Coxe Ave., Asheville, Monday through Friday from 9 a.m. until 4 p.m. to receive a vaccination at no cost.
Asheville Watchdog is a nonprofit news team producing stories that matter to Asheville and Buncombe County. Sally Kestin is a Pulitzer Prize-winning investigative reporter. Peter H. Lewis is a former reporter and editor at The New York Times. Barbara Durr is a former correspondent for The Financial Times of London. Contact them at firstname.lastname@example.org, email@example.com, and firstname.lastname@example.org.