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Keely Connolly thought she would be safe once the ambulance arrived at the Hutchinson Regional Medical Center in Kansas.
She had difficulty breathing because she had had to miss kidney dialysis treatment a few days earlier due to lack of child care. Her potassium was dangerously high, putting her at risk for a heart attack. But she hoped she would be fine once she was admitted and dialysis started.
She panicked when a nurse told her there were no beds available and that she would have to be transferred – perhaps over 450 miles from Denver. She had heard a rumor about a dialysis patient who died while waiting for a bed in a Wichita hospital, about an hour later.
“’I don’t want to die in the ER,” Connolly, 32, remembers thinking. “I just wanted them to fix me, but the woman came in and said, ‘There are no beds.’ I was really scared and didn’t know if they had time to take me somewhere else. “
When a bed was finally located 65 miles away in Salina, Connolly, who suffers from kidney failure, was relieved but worried: how long would she be gone? Who would take care of his young daughter? How would she get home? How much would it cost?
Connolly has been caught in a situation experts have warned since the onset of the coronavirus pandemic: Covid-19 patients are overwhelming hospitals, squeezing the space and staff needed to deal with emergencies like Connolly’s .
Although this has been happening across the country since the spring, the pressure on hospitals is now widespread – reaching urban and rural communities at an alarming rate, even as local officials and citizens continue to criticize health services policy and pandemic guidelines. Itinerant nurses are hard to find as their services are in high demand across the country and their salaries have increased beyond the reach of some small hospitals.
“This is the first time since I’ve been here that we’ve had a scenario where several hospitals, for longer periods of time, are experiencing some kind of shortage,” said Cindy Samuelson, senior vice president of the Kansas Hospital Association.
And it got worse after Connolly’s emergency in mid-November. The 14-day moving average rate of positive tests in Reno County, where Hutchinson is the county seat, reached 46% on December 22, although it has fallen to 24% since January 4, DJ Gering said. , data analyst for the Reno County Department of Health. The results did not include inmates at Hutchinson Correctional Center, the local state prison.
As of October 1, four deaths from covid had been recorded in the county of about 62,000 residents. As of Jan.4, the death toll since the start of the pandemic had risen to 105. For comparison, Gering said, Reno County had 19 deaths attributed to pneumonia and flu combined in 2019.
Hospitalizations at the 190-bed Hutchinson Regional Medical Center increased 800% between mid-October and mid-December, then began to subside at the end of the month, said Chuck Welch, vice president of regional medical system by Hutchinson.
“I hate to be too optimistic until we are far past the possible wave of Christmas and New Year holidays,” he said in an email.
Operating between 90% and 95% of its capacity, the hospital provides care to patients with a multitude of needs and still has room to grow. The problem, Welch said, has been staffing.
Competition for mobile nurses and specialists against larger hospitals to fill positions opened by sick or quarantined staff has been tough. When the hospital was faced with a growing number of covid patients seeking emergency care, managing “normal” emergencies like Connolly’s was much more difficult, Welch said.
As staff members strive to transfer patients as close to home as possible, with so many hospitals in Kansas beyond their capacity, it has become more common than ever to transfer as far as Colorado. and Nebraska. Such transfers require medical flights, which are typically not covered by insurance and can cost patients more than $ 50,000, Welch said.
“It is collateral damage,” he said. “It’s something that has kind of been lost in the story of these people where everyone is relieved when they are found a bed. Everyone is forgetting the downstream impact of the cost of these transports.”
Connolly recovered after three days at Salina Hospital. But the question still arises about the costs of his emergency care. Connolly had quit her job as a correctional officer at the prison in September because coronavirus cases had started to climb inside. Without her employer-sponsored health insurance, Connolly now relies on Medicaid and Medicare Part A, which means she is responsible for more charges for things like pharmaceuticals and ambulance services.
Connolly is so worried about her finances that she is too afraid to look at her recent ambulance bills. Being a single mother, living with kidney failure and having dialysis during a pandemic are her main concerns.
As with many underlying conditions, covid-19 appears to pose an additional risk for people with kidney disease and patients on dialysis, said Dr Alan Kliger, nephrologist at Yale University and co-chair of the American Society of Nephrology COVID-19 response. Team.
Data from New York and Europe at the start of the pandemic showed about 1 in 5 dialysis patients who contracted covid died, he said. However, complication and death rates have come down in recent months, according to unpublished survey data from members of the Nephrology Society, Kliger said.
“It’s still a high risk,” he says.
For Connolly, the pandemic has also complicated his dialysis schedule three times a week, three and a half hours. For example, when her daughter’s kindergarten class was ordered to quarantine for 14 days after exposure to the virus in the classroom, she had to scramble to find babysitters so she could attend dialysis.
“I don’t want too many people watching her because of covid,” Connolly said of her daughter, adding that she is lucky the girl’s father is supporting her. But he can’t always intervene, which means if Connolly can’t find a babysitter, she may have to skip or postpone dialysis.
Connolly wants to find another job. But living in a county where so many refuse to wear masks and where some elected leaders accuse the health department of providing false information about covid testing rates and statistics scares her more than being in public. necessary.
“I want to work,” she says. “I had a good job. I have served my community. The reality of how bad it is in the hospital – I saw it with my own eyes. And now I’m outside and I see people without masks and I’m like, ‘If I understand and I have to go back, I might not be leaving the hospital next time.
The reality, said Kliger, Welch and others, is that if the virus is rampant, hospitals will have a hard time keeping up, potentially putting medical staff and anyone in need of hospital care at risk – and the virus will continue. to spread as long as people refuse to wear. masks and failing to adhere to scientifically valid guidelines.
Connolly said she would like to see more empathy for people with underlying health issues like her from those who resist safety measures such as masks.
“Even if they think it doesn’t work, what if it does? What if it could? I don’t really understand how wearing a mask is going to take you so long, compared to someone who is immunocompromised and gets sick, ”Connolly said.“ Or you lose your grandmother, or your parents. It will affect your life much longer than wearing a mask for a little while. “
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