Covid-19 patients overwhelm busy hospitals

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The latest wave of Covid-19 hospitalizations is crashing into patients returning for treatment for other illnesses, overloading some facilities and draining their doctors and nurses.

Surgeries and treatments for cancer, heart disease and other common ailments have rebounded this year, filling beds in many hospitals. At the same time, other respiratory viruses, such as RSV, have reappeared with public gatherings, adding to hospital pressure.

Now, some hospitals are treating more Covid-19 patients than ever before as the highly contagious Delta variant spreads, especially where vaccination rates are lower. This new chapter in the protracted pandemic has exhausted hospital staff.

“The physical, mental and emotional toll of this pandemic is taking its toll,” said Linnette Johnson, chief nurse at AdventHealth Central Florida, who said last week she would stop non-essential surgeries to free up staff and health. space for Covid-19 patients.

The resurgence risks stretching hospitals and healthcare workers so little that patient outcomes could suffer, medical and disaster planning authorities have said. Influxes of patients can leave hospitals without enough doctors, nurses, space or equipment to treat patients as they normally would.

In Florida, the epicenter of the current outbreak, hospitalizations of Covid-19 patients have increased over the past five weeks, according to data from the CovidActNow monitoring group. The climb is steeper than last winter, when it took almost three months for a smaller surge to peak in Florida. AdventHealth Central Florida was treating 1,060 Covid-19 patients on Friday, surpassing a previous peak of 900 in January.

Nationally, the seven-day average of Covid-19 hospitalizations peaked at around 137,470 in January, well above current levels of around 44,600, according to federal data. The seven-day average of new Covid-19 cases nationwide reached 85,459 on Monday, according to data from Johns Hopkins University.

Daily deaths have increased, but much less dramatically. Vaccines remain highly effective in preventing hospitalizations and deaths, research shows, and daily vaccination rates in the United States have increased in recent days after being stranded for weeks.

Some hospitals have said the pressure on their operations is exacerbated by unvaccinated staff being sidelined after being exposed to the virus.

Some hospitals require staff to be vaccinated, but others do not.

“We are struggling to make sure we have enough staff on hand to keep our hospitals open,” said Dr Sarah Nafziger, vice president of clinical services at the University of Alabama Hospital in Birmingham. She said the hospital had 62 employees as a result of the pandemic, including 55 who tested positive for Covid-19.

Federal and academic researchers reported last month that while the survival rates of Covid-19 patients have improved overall during the pandemic, coronavirus patients are at a higher risk of dying in hospitals with influxes of patients. higher.

“Gains in survival have been somewhat eclipsed in hospitals overburdened by flare-ups,” said Sameer Kadri, chief of critical care clinical epidemiology for the National Institutes of Health Clinical Research Hospital and senior author of the study published in July by the Annals of Internal Medicine.

When hospitals reached or exceeded capacity last winter, they delayed transfers and limited admissions, including to intensive care units. “Your thresholds are changing,” said Paul Biddinger, medical director of emergency preparedness at the Mass General Brigham Hospital System in Boston.

Some hospitals affected by the latest wave are transferring patients with other conditions to free up capacity for more Covid-19 patients and to ensure access to care. In Missouri, Lake Regional Health System chief executive Dane Henry said doctors transferred an open-heart patient to another hospital because the hospital lacked the intensive care capacity to support the patient after surgery.

The hospital’s average weekly inpatient occupancy rate reached 99% in early July as Covid-19 patients began to fill beds, according to federal data. About a third of hospital beds at one point last week contained Covid-19 patients, matching its previous pandemic peak of 30 coronavirus patients in mid-November, Henry said.

CoxHealth, a private, non-profit health care system operating six hospitals and more than 85 clinics in Missouri, treated 187 Covid-19 hospital patients on Sunday, more than a previous peak around 170 last winter. The total number of patients admitted overall is at an all time high, with more people also coming for deferred procedures and treatments.

“My advice to other hospitals is this: plan to be at the same high water point that you were in the winter, unless you are in a community where the vaccination rate is very high,” said Steve Edwards , President and CEO of CoxHealth.

Some 41% of Missouri residents are fully immunized, according to federal data, compared to a national average of 50%. Many counties served by the hospital have vaccination rates below 20%.

Hospitals beyond current hot spots are also feeling the pressure.

The University of Illinois at Chicago hospital treated around 3,000 patients per month last year, many of them for Covid-19, said Terry Vanden Hoek, president of the emergency medicine department. Today, the hospital treats about 4,000 patients per month, some with advanced cancer, worsening heart disease and other conditions.

“The hospital is full. There are no beds to be had. We are trying to do our best to get the patients discharged, ”he said.

About 3% of hospital beds are currently occupied by Covid-19 patients, up from 40% during the peak of the pandemic, he said, making frightening the prospect of an increase like those in ‘other hospitals.

“I never want to go through another wave of the pandemic again, and we have very little room to flex right now,” he said.

Write to Melanie Evans at [email protected] and Julie Wernau at [email protected]