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Expert urges public to get vaccine boosters ahead of predicted hospital 'capacity crunch' in Fargo

Sanford Health's infectious disease chief is urging people to get booster shots to alleviate the strain on hospitals, coping with a continuing staff shortage and severe lack of medications.

Sanford Medical Center, downtown Fargo campus.
Sanford Medical Center, downtown Fargo campus.
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FARGO — Sanford Health’s infectious disease chief is warning that a hospital capacity crunch is coming as the omicron wave approaches its peak and pleading with people to get a vaccine booster as the first line of defense against COVID-19.

Dr. Avish Nagpal, Sanford’s director of infection control and an infectious disease specialist, believes the area is now halfway to a peak in new infections from the coronavirus and predicts the peak in demand for hospital services is two weeks out.

“What we’re seeing is a significant explosion of cases just like we saw everywhere else in the country,” Nagpal said Wednesday, Jan. 26.

“We are going to run into a capacity crunch in a little bit,” he said. “The next two weeks are going to be challenging. ... If you haven’t had a booster yet, I would highly recommend that you get a booster so you can rely on the first line of defense rather than a treatment that may or may not be available.”

As infections soar with an expected rise in hospitalizations to follow, antiviral pills and monoclonal antibody treatments remain in extremely short supply, forcing doctors to triage the medication with the most vulnerable getting the scarce treatments, he said.


“We are struggling to meet demand for treatment once you get infected,” Nagpal said.

Antiviral pills are highly effective, and one version of intravenous antibodies have shown benefits in treating omicron, but at most, Sanford gets 15 courses of the medication twice a week in its allocation from the state.

In order to be effective, the medication must be given within a few days of testing positive, Nagpal said.

“We are running out every day,” he said, “so it’s a real struggle.

"It’s not anybody’s fault," he added. "There’s demand all over the country.”

As hospital staffing strains persist, Sanford continues to reassign doctors and nurses from the clinic to the bedside. Traveling nurses also have helped fill vacancies, with 432 on assignment as of Wednesday, according to Dr. Doug Griffin, Sanford vice president and medical officer.

“Our biggest crunch right now has been our nursing staff,” Nagpal said.

Also as of Wednesday, 122 Sanford staff members were out sick due to COVID-19, which is down from recent days but closely watched by Sanford administrators.


In spite of the staffing challenges, Sanford hasn’t had to postpone any elective procedures as it was forced to do earlier in the pandemic. “So far, we haven’t had to cancel any surgeries,” Nagpal said.

Sanford’s COVID-19 hospital census as of Wednesday was 54 inpatients, plus another 27 who were in the hospital but not in isolation because they were no longer contagious.

Active COVID-19 cases have declined from their omicron wave heights so far, both in North Dakota and in Cass County.

The active case counts reported Wednesday were 7,713 in North Dakota, down from a high of 12,044 on Jan. 21, and 2,105 in Cass County, down from a high of 3,297 on Jan. 20, according to the North Dakota Department of Health.

North Dakota reported Wednesday that 159 patients were hospitalized statewide, including 18 in intensive care units.

Fargo's three hospital systems reported three open intensive care beds, nine staffed non-ICU beds, two pediatric ICU beds and six pediatric non-ICU beds as of Tuesday, Jan. 25.

Sanford has seen “barely any” breakthrough infection cases in the hospital among those who received booster doses, Nagpal said. “We are seeing a lot more incidental COVID,” he said, including those admitted for surgery or other ailments who test positive but have no symptoms or mild symptoms.

A new variant of the coronavirus is inevitable, but it is impossible to predict whether it will be more contagious or more virulent than the omicron variant.


If the new variant emerges while the omicron variant is still rampant, it would have to outcompete omicron by being highly contagious. But if the new variant emerges when omicron has faded, which seems likely over the summer, it wouldn’t have to outcompete omicron, Nagpal said.

Multiple studies have shown the mRNA boosters by Pfizer and Moderna are highly effective in preventing severe illness, hospitalization or death, Nagpal said.

Even those who were considered fully vaccinated with two doses are in many cases seeing waning protection from a second shot administered nine months to a year ago, Nagpal said.

Patrick Springer first joined The Forum in 1985. He covers a wide range of subjects including health care, energy and population trends. Email address:
Phone: 701-367-5294
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