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CoxHealth built a separate COVID-19 unit at the beginning of the pandemic. It's been full the past several weeks. Photo: CoxHealth

The pandemic in Missouri right now almost has been as bad as ever, with cases soaring and ICU beds filling up with COVID-19 patients. Vaccination rates remain low.

What they're saying: Steve Edwards, CEO of CoxHealth, a six-hospital system based in Springfield, Missouri, has been using Twitter to beg people to get vaccinated and admonish those who try to downplay the virus or vaccines.

This interview has been edited for brevity and clarity.

Axios: Your latest update painted a pretty grim picture of the state of the COVID-19 outbreak in your area. Can you break it down a little more?

Steve Edwards: We know that hospitalization and mortality are trailing indicators, and those numbers are still very high for us. We do have some encouraging data on seven-day rolling average for new cases.

But one of the challenges for us is, we are an early outbreak area. As we begin to be in a position to take a break, other hospitals will be overwhelmed. We are really worried about drowning our staff. We're getting about 50 to 75 requests for transfers a day to our hospital. We can't fulfill many of them because we're virtually full ourselves.

A: How burned out is the CoxHealth staff?

SE: I don't think we'll know how severe it is until the pressure of these inpatient admissions comes down. I think that's when you begin to see staff say, "I'm done." ... But it is exhaustion, extreme exasperation because 95% of our patients are unvaccinated.

A: Why aren't more people getting vaccinated?

SE: My instinct is ... people are overwhelmed with competing information. People telling them to get vaccinated, people telling them not to get vaccinated. I think it's in our human nature that when we are overwhelmed, we become paralyzed and choose not to act. Mistrust of the government and medicine also is a common denominator.

A: Has CoxHealth tried going to employers, places of worship and people's homes in essence, bringing the vaccines to people instead of waiting for people to come to you?

SE: We've tried so many things in our own employee base. We have been finding success by holding forums and have different physicians stand there for an hour answering questions. We've done that with businesses as well. We've done home visits. We've sponsored "get a vaccine, get a beer" with a local brewery. But I think there's this hardcore group of people who are going to be hard to reach, and there are political, ideological, faith-based reasons with their reluctance.

A: You are in the minority of hospital executives who use social media to communicate. You've told vaccine opponents to "shut up." You've mentioned how many people who have died lately are parents with young children.

SE: I'm really not that sophisticated when I'm tweeting. A lot of it is kind of visceral. That last tweet was really recognizing a friend of mine who lost a brother. I'm frustrated that people want to minimize or diminish the severity of the disease. I know it hurts people who've lost someone.

A: So why have you been tweeting more during the pandemic?

SE: Beginning in March of 2020, I read three different books on pandemics. John Barry was the best I read, and his lesson was, millions died because we didn't tell the truth. That resonated with me.

I think [using Twitter] has built some credibility. Early on, we didn't hide behind how we didn't have enough personal protection equipment, and the community raced to help us. But it also does make you a lightning rod. I've gotten death threats; I was approached by a guy who served me papers. I'm not an outgoing person, honestly, and I'm rather introverted. But I told myself if there's ever a crisis, that's a time to stand up.

Go deeper

Updated Oct 19, 2021 - Politics & Policy

Coronavirus dashboard

Illustration: Aïda Amer/Axios

  1. Vaccines: Mix-and-matching gains momentum — Boosters overtake first doses in U.S. — Pfizer to vaccinate Brazilian cityPanel endorses J&J booster.
  2. Health: Age is still a huge coronavirus risk factor — Unvaccinated 11x more likely to die from COVID — 5x more police officers died from COVID than guns.
  3. Politics: Over 30 states limited public health powers — Pope Francis calls on companies to release vaccine patents — Melbourne, "world's most locked-down city," to lift stay-at-home orders.
  4. Education: Education secretary reveals limits to Biden’s mask push on states — LA extends deadline for school employee vaccinations — Parent sues Wisconsin school district after child tests positive.
  5. Variant tracker: Where different strains are spreading.
Oct 19, 2021 - Health

Puerto Rico leads U.S. COVID vaccination rates

A mass vaccination event at the Puerto Rico Convention Center in San Juan, Puerto Rico, on March 31. Photo: Ricardo Arduengo/AFP via Getty Images

Puerto Rico has the highest percentage of people fully vaccinated against the coronavirus in the United States as of Oct. 19, according to data from the Centers for Disease Control and Prevention.

Why it matters: The island has managed to accomplish such feats amid frequent power outages, earthquakes and high dependence on imports of health technologies from outside the region.

Oct 19, 2021 - Health

Virginia governor has had long COVID for more than a year

Gov. Ralph Northam. Photo by Zach Gibson/Getty Images

Virginia Gov. Ralph Northam still has long COVID-19 symptoms more than a year after his initial infection, he said in an interview with the Virginian-Pilot.

Why it matters: The Democratic governor is one of millions of Americans suffering from symptoms of long COVID, which could have serious implications for employers and social programs if enough people can no longer work because of it, per Axios' Caitlin Owens.