COVID-19 Flooding Of Hospitals In Heart Of America

Dr Drew Miller knew his patient needed to be moved.

Vital signs of 30-year-old COVID-19 victim crashed and Kearny County Hospital in rural Lakin, Kansas simply was not equipped to handle the case . Miller, Kearny’s chief medical officer – who also serves as the county’s health official – has called major hospitals for an intensive care bed. With coronavirus cases soaring across Kansas, he said, he couldn’t find a single one.

By the time a bed opened elsewhere the next day, the young man was near death. For a full 45 minutes, Miller and his staff performed chest compressions in a desperate attempt to save him.

Somehow, Miller said, the patient regained the pulse and was sent in an ambulance to the larger facility about 25 miles away. Miller then prayed with the family, whom he knew “very well” from Lakin, a town of a few thousand people.

“It really is a miracle that he survived,” Miller said.

After pounding major American cities in the spring, COVID-19 has now engulfed rural America and small towns, appearing to infiltrate every nook and cranny of the country. According to Reuters interviews with more than a dozen medical providers and public health officials in the heart of the country, many hospitals are sorely lacking in beds, equipment and – more seriously – clinical staff, including specialists and nurses.

COVID-19 cases and hospitalizations are increasing nationwide. But the Midwest – encompassing a dozen states between Ohio and the Dakotas – has been particularly brutalized. The rates of reported cases are more than double those of any other region in the United States, according to the COVID Tracking Project, a data provider run by volunteers. From mid-June to mid-November, reported cases in the Midwest increased more than twenty times.

For the week ending Nov. 19, North Dakota reported an average of 1,769 new cases per day per 1 million people, according to the follow-up project. South Dakota recorded nearly 1,500 people per million, Wisconsin and Nebraska around 1,200, and Kansas nearly 1,000. Even in the worst week of April in New York City – with businesses shutting down and panic mounting. takes hold of the public – the state has never recorded an average of more than 500 new cases per million people. California has never exceeded 253.

Officials at hospitals in the Midwest told Reuters they were at or near capacity. Most have tried to increase uptime by reusing wings or cramming multiple patients into one room, and asking staff to work longer hours and more frequent shifts.

Facilities like Kearny, known as “critical access” hospitals, were not made for this. Often poorly funded, they mainly provide basic or emergency care to residents who live long distances from major medical centers. Now, “we have to plan to be able to take care of whoever comes in,” said Miller, who specializes in family medicine.

As cases rise in many conservative states and counties, medical workers say they often face a challenge simply to convince patients and local leaders that the disease needs to be taken seriously and is not a hoax. perpetuated by Democrats.

Such views arise from the top. President Donald Trump has often held side-by-side rallies in the Midwest and elsewhere and has treated masks as a matter of personal choice. Although Trump was not re-elected, he is about two months into his term, with little sign of a change in his coronavirus strategy, even as the crisis develops.

The White House press office did not respond to a request for comment.

Some medical officials and hospital staff find it difficult to reconcile laissez-faire policies with the illness and suffering they see.

“There’s a disconnect in the community, where we see people in bars and restaurants, or plan Thanksgiving dinners,” said Dr. Kelly Cawcutt, infectious disease physician at the University of Montreal Medical Center. Nebraska. As health workers, she said, “we feel a little bit dejected.”

In total, COVID-19 has claimed more than 256,000 lives in the United States. The virus’s death rate has dropped as doctors learned more about the disease, and vaccines developed by Moderna Inc, Pfizer Inc and others could hit the market early next year. In the meantime, small hospitals say they are using the same drugs – like remdesivir and dexamethasone – as facilities in large cities, but don’t have the same access to intensive care equipment or health care. specialized expertise.

With low temperatures sending people indoors and vacation trips underway, doctors in the area don’t expect relief anytime soon.

“I don’t think the worst is yet here,” Miller said.

FRIENDS AND NEIGHBORS

Hospital officials described the demoralization of staff members struggling to cope with overwork, grief and death.

Shortages of staff, rather than beds, are the biggest problem at many hospitals, health officials said. “Just because you can take a cot and put it in a room doesn’t mean you have the right nurses to care for a patient,” said Dr Anthony Hericks, director of intensive care at Avera Health in Sioux Falls. , South Dakota. .

Nurses must observe COVID-19 patients even more closely than others, because of the potential for rapid decline, said Melisa Hazell, an intensive care nurse at Hutchinson Regional Medical Center in Hutchinson, Kansas. She said she had recently recovered from COVID-19 on her own, returning to work as soon as she was sure she was not spreading the virus.

“I was on leave for 12 days,” she said. “Was I mentally and physically ready to go back to work? No, but my teammates needed me.”

Remote hospitals do not keep full staff on board at best. They are hiring traveling nurses as the number of patients increases. Now it’s hard to find any.

Aya Health, a nurse recruiting agency based in San Diego, Calif., Posted about 14,000 vacancies in the spring, said April Hansen, executive vice president. That number has now doubled, she said, and pay rates have skyrocketed with demand.

Mary Helland, chief nurse for CommonSpirit Health in North Dakota, said she had requested mobile nurses for the 11 critical access hospitals she oversees in North Dakota and Minnesota. But “the big hospitals use them all,” she said.

At Hutchinson Regional, which has 190 beds, head nurse Amanda Hullet started working shifts, even though she had long since graduated from a clerical job.

Physical and emotional fatigue is constant, Hullet said, and even more difficult when the patient is a close friend or colleague.

Hullet recalled the recent deaths of local couple Bill and Judy Mason, weeks apart, from COVID-19. Judy had taught dance in town for decades, Hullet said, and her students included some of the hospital workers.

Holly Thomas, 37, married to the couple’s grandson, said Judy was the “glue” that held the family together.

Referring to COVID-19 in the Midwest, Thomas said: “We sat idly by from March to August without seeing much.” Now she hears of about two deaths a day. “My high school physical education teacher and his wife also died 12 hours apart,” she said.

Hazell, Hutchinson’s regional nurse, met a patient who was a former bowling buddy. “He’s just fantastic,” she said. “Big hearted, always ready to sit down and share a story or two.”

He’s on a ventilator now, he’s not well. “Over the next week or two there will be some tough decisions,” she said.

‘TIRED’

Medical workers told Reuters that denial of the disease is frustrating among officials, community members and even patients.

A patient at SSM Health in Janesville, Wisconsin, refused to believe COVID-19 was a serious threat even if he consumed it, said Dr. Alison Schwartz, an infectious disease physician. When he died, “the family did not want to admit that this patient had died from COVID, because they did not believe COVID is killing people,” she said.

Some Midwestern states and local jurisdictions were reluctant to impose masks or social distancing.

Nebraska Gov. Pete Ricketts, a Republican, went so far as to say he would not allow municipalities to impose masked mandates.

Ricketts’ office declined to comment, but the governor said at a Nov. 13 press conference: “I am against broad-based mandates for educating people on the use of masks.”

“Masks work, but they’re just a tool,” Ricketts said, urging people to also focus on keeping their distance and avoiding large gatherings.

South Dakota Governor Kristi Noem has refused to make masks mandatory and has not placed restrictions on businesses or public gatherings, saying she would leave these matters to “individual responsibility.” In July, she hosted an Independence Day celebration with Trump at Mt. Rushmore, where the crowd was close together and many participants were without masks.

Doctors say trying to change such behavior can seem like a hopeless task. “Everyone [is] keep going about their business, ”Schwartz said, but“ we kind of feel like we’re drowning ”.

(This story was not edited by NDTV staff and is auto-generated from a syndicated feed.)