FARGO — Local health care providers and community leaders are making a "cry for help" and urging people to do their part by getting vaccinated and taking precautions to slow the spread of the coronavirus that threatens to overrun hospitals.

Both Sanford Health and Essentia Health hospitals have been running at or near capacity, straining caregivers exhausted by the unrelenting pandemic, now more than 18 months old and experiencing a fourth wave driven by the delta variant.

"It is very much a hard-fought battle every day for our frontline workers," said Brittany Sachdeva, a registered nurse and Sanford's vice president of operations. "It is time for the community to step up and take action. Get vaccinated, please. Our health care heroes are counting on you."

Nicole Christensen, Essentia's chief nursing officer, echoed those points, emphasizing that nurses and other caregivers have gone without adequate rest since the start of the pandemic.

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"It's not just the past three or four months," she said. "These are hard jobs with many demands."

Health officials and community leaders made their pleas Friday, Sept. 24, during an online briefing. Most made separate appearances remotely as the virus was spreading in Cass County at triple the rate considered out of control.

Providers have been offering incentives for existing and new employees, hiring traveling nurses and reducing elective surgeries. But doctors, nurses and other frontline health workers are fatigued from the unending demands.

Also, the surge of COVID-19 patients is compounding the burden already imposed by patients needing hospital care for trauma, cardiovascular disease and cancer, among other illnesses.

Getting vaccinated and taking other precautions is a way, health providers stressed, to keep beds open for heart attack victims and others with serious medical problems requiring hospitalization.

It's also important to protect children under 12, not yet eligible to receive vaccines, and now one of the most vulnerable groups.

"What are you doing to protect the children next door who might be mowing your lawn?" West Fargo Mayor Bernie Dardis said. "What are you doing to help your grandchildren."

He added: "Ladies and gentlemen, this is reaching a new level. It's affecting our children."

Dr. Tracie Newman, a pediatrician and health officer for Fargo Cass Public Health, said children now account for a third — 30% to 33% — of COVID-19 cases in North Dakota.

So far, the number of children who have been hospitalized for COVID-19 remains small, but hospitals have relatively few pediatric beds, and those beds are filling with children with other health problems, she said.

Health providers hope approval of the Pfizer vaccine for children ages 5-11 will come by the end of October. But it takes five weeks for the vaccine to become fully effective, Newman said.

Hospitals also are straining under an unseasonal burden from other respiratory viruses — and are bracing for a feared "twindemic" as seasonal influenza cases join COVID-19 in making people sick.

Speakers repeatedly pointed out that more than 90% of those getting sick from COVID-19 and more than 90% of hospitalized COVID-19 patients in North Dakota are unvaccinated. North Dakota ranks 47th among the states — near the bottom — in the rate of vaccinated residents.

"This is a cry for help from our health systems," said Fargo Mayor Tim Mahoney, a surgeon.

Dr. Doug Griffin, vice president and medical officer at Sanford, said the unvaccinated shouldn't assume that they can be saved by monoclonal antibodies.

Because of high nationwide demand, the antibodies are in scarce supply, and providers have had to ration the treatments, which have been effective in preventing hospitalization for those at risk of severe illness.

Chad Peterson, chairman of the Cass County Commission, and other speakers stressed that people are protecting not only themselves but their family members and neighbors by getting vaccinated.

"I'm not giving up on you yet," Peterson said to those who haven't yet gotten the shot. "I think you're smart enough to realize what's going on. I'm not worried about you. I'm worried about the 10 people you'll give it to before you even realize you're sick."

Sanford and Essentia and other providers are offering flu and COVID-19 shots, which can be safely given at the same time, Dr. Richard Vetter, Essentia's chief medical officer, said.

A team at Essentia in Fargo has worked to place patients from around North Dakota who must be transferred because their local hospital is full, he said. So far in December, they have arranged more than 130 transfers, sometimes hundreds of miles from home.

Even in breakthrough cases, vaccines are effective in preventing serious illness resulting in hospitalization or death, Vetter said.

Providers also are providing or preparing to provide booster vaccine doses to those who are eligible, including those who are 65 and older and those with serious underlying health conditions or compromised immune systems.