The emergency department at the UC Davis Medical Center in Sacramento treated more COVID-19 patients during the first week of August than any other week so far this year. The 107 patients — up from 80 the week before — were just eight shy of the all-time high of 115 seen in the emergency room of the medical center during the week of Dec. 20, 2020. Most are unvaccinated, physicians said, and they are trending younger and younger, with 42 percent between the ages of 20 and 39 and 17 percent 19 or younger. “The numbers are astonishing, and at the same time, we are seeing no decrease in the number of non-COVID emergency department visits,” said Dr. Nathan Kuppermann, professor and chair in the Department of Emergency Medicine. “This is leading to substantial crowding of the ED, despite creating a special area for the care of patients with COVID.” “We are always ready to care for patients in any emergency, but this is stressing our capacity,” Kuppermann added. “We need to strongly encourage masking in the community and emphatically encourage those who have not been vaccinated to get their vaccine. “These two interventions have been scientifically proven to greatly prevent the transmission and the seriousness of the disease. And to be clear, COVID-19 is a serious disease that can not only lead to death, but to long-term problems.” The increase in patients seen in the UC Davis Medical Center emergency department began in June. During the week of June 13, the department saw the lowest number of COVID-19 cases in 2021 — just nine patients. But that was also the week California ended its stay-at-home order, lifted its mask mandate and allowed businesses to reopen fully. By then, the Delta variant had also begun circulating locally. It was first found in Davis by the UC Davis Genome Center in April. “We had this sense that things were beginning to return to normal,” said Dr. Nick Sawyer, a physician in the Department of Emergency Medicine at UC Davis Health. “But instead, it turned out to be the perfect storm.” The week after California’s reopening, cases doubled in the emergency department and then steadily rose. By the end of July, the the department saw 80 COVID-19 patients in one week, a number comparable to the surge in January when vaccines were beginning to roll out in California. During the week of August 1-7, the number increased to 107. They are largely unvaccinated and younger than those seen during previous surges. “We are seeing young, otherwise healthy unvaccinated patients who are coming in with varying symptoms, ranging from gastrointestinal upset, fever, coughing and sore throat to full-blown respiratory failure requiring intubation. It’s very sad,” Sawyer said. “A woman came in with her toddler, who was ill,” he said. “The mother had been vaccinated, but her boyfriend had not. Her toddler ended up getting COVID, which was very upsetting for her.” Over 80 percent of the COVID-19 patients tested at UC Davis have the Delta variant, which is significantly more contagious. “It’s very transmissible. It has an R0 of about seven, which means in an unvaccinated population, for every one person who contracts the disease, an average of seven people will also get sick. The original virus had an R0 between 2 and 3,” said Sawyer. The Delta variant may also be making people sicker, or in the parlance of many doctors, “sicker quicker.” “We had to intubate a teenager with COVID-19,” Sawyer said. His advice: “Get vaccinated.” “Vaccines are very safe and effective,” he said. But people should also consider returning to behaviors embraced early in the pandemic. “Wear a mask and social distance — protect yourself and others. We are here for people 24 hours a day, seven days a week, 365 days of the year. But I don’t like to see patients coming into the emergency department with COVID-19, unvaccinated,” Sawyer said. “For those who are critically ill with COVID-19, there still aren’t many effective medications that have been shown to save the sickest patients, so the most we can do is provide the standard advanced level supportive critical care,” Sawyer said.