HAMMOND, La. — Officials in Louisiana have been willing to try just about anything to jolt the state’s lagging Covid-19 vaccination rates, from a $1 million cash giveaway to a public service announcement featuring the recent 14-year-old national spelling bee champion.
But when Madeline LeBlanc relented and got her first vaccine dose this week, she was motivated by something entirely different: fear.
After seeing news reports about the Delta variant raging across the state, Ms. LeBlanc, 24, had come to see that without a vaccine, she risked not just her own life but those of others around her. “I don’t want to be the one inhibiting someone else’s health,” said Ms. LeBlanc, who lives in Baton Rouge.
The new push for vaccinations has been driven by an explosion in coronavirus cases. But it takes time for vaccines to bolster immune systems, and the state — which now leads the country in new cases — could still be weeks away from relief.
Hospitals are overflowing with more Covid-19 patients than ever before. Even children’s hospitals have packed intensive care units. And the Delta variant has alarmed doctors, who described seeing patients in their 20s and 30s rapidly declining and dying.
“These are the darkest days of our pandemic,” said Dr. Catherine O’Neal, the chief medical officer at Our Lady of the Lake Regional Medical Center in Baton Rouge.
The Delta variant has unleashed a rush of diagnoses across the United States, but Louisiana has emerged as a troublesome hot spot, with the highest per capita rate of cases in the country and a beleaguered health care system straining to keep up.
“That’s a miserable place to be, I know it,” Gov. John Bel Edwards said, describing the swirl of frustration and shame expressed by government officials, epidemiologists and frontline medical workers as their state suffers the catastrophic consequences of a failure to vaccinate more people.
The state is averaging more than 4,300 new cases per day, according to New York Times data. Resources have been taxed — especially in the state’s southeastern corner — as cases have surged from the Gulf Coast into the northern reaches of the state.
In Baton Rouge, one hospital called in the kind of federal emergency support staff usually reserved for the aftermath of a hurricane. In Hammond, a city of some 21,000 people in the toe of Louisiana’s boot, nurses were ordered to pick up extra shifts.
Vaccination rates are increasing in many states, as employers and universities have started requiring the shots to return to work and class. In the Southeast, where vaccinations have lagged behind the national rate, those upticks have come in states like Mississippi and Florida just as reported cases began spiking.
In an effort to help temper the spread of the virus in Louisiana while pushing for more vaccinations, Governor Edwards reinstated a statewide mask mandate that went into effect on Wednesday, requiring anyone 5 or older to cover their face indoors.
But the governor’s orders have produced fierce resistance from the outset of the pandemic. On Monday, exasperation bled into his voice as he urged residents to heed the mask order and listen to the parade of doctors and hospital officials he had summoned to describe the growing crisis.
“Do you give a damn?” Mr. Edwards asked. “I hope you do. I do. I’ve heard it said often: Louisiana is the most pro-life state in the nation. I want to believe that.”
Public health experts are frustrated to find Louisiana in such a crisis, especially given its recent history. The state had a horrifying introduction to the coronavirus, as Mardi Gras festivities in 2020 turned out to be an ideal incubator for Covid-19 to spread, plunging New Orleans into an early season of death and despair.
Now, largely because of the new wave of illness, lines have returned to vaccination sites across the state. Thirty-seven percent of the population is now fully vaccinated, climbing roughly three percentage points from June but still trailing the national rate, with just shy of half of the country fully vaccinated.
“The public is finally hearing how bad it has gotten,” said Dr. Robert C. Peltier, the chief medical officer for North Oaks Health System in Hammond, an hour east of Baton Rouge.
For many younger people, fear of the vaccines has been overtaken by fear of the virus itself, after hearing stories of people their age succumbing to Covid-19.
“It’s definitely scary that it could be you who ends up in the hospital,” a 22-year-old woman who gave only her first name, Brianna, said as she waited for her shot on Tuesday at a vaccination site run by the Louisiana National Guard in Baton Rouge.
Ashlynn Robert had avoided getting vaccinated because of a fear of needles, but her mother started pressing her as hospitalizations rose. “It wasn’t that bad,” Ms. Robert, 24, said after her shot. “I was being dramatic.”
Among the hardest-hit spots in the state is Tangipahoa Parish, a collection of small, mostly working-class towns where life had defiantly marched forward, even as the virus spread.
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In Hammond, the largest city in Tangipahoa Parish, North Oaks Medical Center has been slammed with Covid-19 patients: 93 on a recent day, ranging in age from 20 to 85. Before this wave, the highest number of patients had been 65 in December.
Patti Hilbun, 65, had been there nearly two weeks. “I will be blatantly honest,” she said. “This is as real as smallpox and polio when I was a kid.”
Ms. Hilbun was reluctant to get vaccinated. She had once had a poor reaction to a flu shot, she said, and she has Hashimoto’s disease, an autoimmune disorder. Her husband kept pushing her to get the shot. “I just talked myself into it,” she said. But before she actually had a chance to get vaccinated, she went to a wedding and did not wear a mask.
Soon, she felt tired. Her breathing became more labored. It worsened until July 21, when she came to North Oaks, the main hospital in the parish. “I had to will myself to live,” she said.
On Tuesday afternoon, Ms. Hilbun finally got some good news: She could leave the hospital.
“She’s definitely one of the lucky ones,” said Stacy Newman, her doctor. The same day, she said, a 31-year-old man had died of the illness. He had two children, and his wife was also a patient with Covid-19.
For Dr. Newman and her colleagues, the North Oaks hospital and the community it serves have sometimes seemed to exist on different planets.
Inside, the gravity of the pandemic is inescapable, leading them to take as many precautions as possible. Outside, people largely stopped wearing masks. The virus was regarded by some as a hoax.
Some of the thinking doctors and nurses found baffling: The vaccines were seen as dangerous, yet one feed store had to post a sign telling people that ivermectin, a worm medication for pets and livestock, could not be used to treat Covid-19.
Friendships have been tested. One nurse told her husband to get vaccinated or move out.
“I feel less safe in the community than I do in the hospital,” said Dr. Justin Fowlkes, a pulmonary and critical care physician.
The hospital has space for more patients, but not adequate staffing. More than 60 employees were out with Covid-19 this week. Roughly 40 others were out for other illnesses. There were also 400 vacant positions.
Brooke Moran, a North Oaks nurse, has been working long hours before returning home at night to her husband and daughter. She said she was relieved that many in her extended family had gotten vaccinated. They listened to her. They trusted her. She just wished others had gotten the message before the virus escalated to this point.
For 15 months, she has been surrounded by suffering. This time was different, she said. It was worse and unnecessary.
“I am still dedicated,” Ms. Moran said, her voice breaking, tears welling behind her glasses. “I still have compassion. I care for these people. But it’s just frustrating. It’s preventable and I don’t want these people to die. But they still do. It’s really out of our hands.”