Hospital officials, on front line of COVID, issue dire warnings about WA’s medical system
Hospital officials from across Washington state sounded the alarm again Monday on COVID hospitalizations reaching crisis points in several areas of the state.
Statewide, there are 1,570 patients hospitalized with COVID, according to details released at Monday’s Washington State Hospital Association briefing.
“This is enormous stress on the health care system,” said Cassie Sauer, Washington State Hospital Association CEO. “To have this many patients with a single diagnosis, this doesn’t happen, like you don’t have this many people out of nowhere .... with a single diagnosis coming in and really filling up your hospitals.
“There are 188 of those patients on ventilators, and we’re starting to see the deaths go up.”
“Oregon has brought in refrigerated trucks to handle the number of deaths. I think their surge is a little ahead of ours and so that’s just super alarming for us,” she added.
Dr. Mark Johnson, infectious disease specialist with Confluence Health in Wenatchee, said their respite from COVID was brief.
“There was a brief moment, on the 16th of June, where we had zero COVID patients hospitalized in isolation. That lasted for two hours,” Johnson said.
The good news is that area has seen a three-fold increase in people seeking vaccinations, he said.
The bad news is the wave of new cases spurred there and statewide by the Delta variant, affecting a wide range of ages.
“Previously, about four weeks ago, we were doing about 140 tests per day. And now we’re back to 400 tests per day,” Johnson said. “So, as of the 23rd of last week, we had 37 patients with severe COVID admitted to hospital; 14 were considered in critical condition. None of our critically ill patients were vaccinated.
“This is untenable.”
He continued: “We are seeing very sick, unvaccinated persons, but what’s also interesting is that the age range was anywhere at that point between 23 and 86 ...
“But among those 14 critically ill patients, 40% of them were age 40 or younger. And in the last week, we have had two third trimester, unvaccinated, pregnant persons admitted to hospital with severe COVID, who had to undergo emergency C-section.”
The worries about treating pregnant women ill with COVID were underscored at Monday’s briefing.
“When our patients get really sick, it’s pretty common to need to deliver them,” said Dr. Tanya Sorensen, maternal fetal medicine physician at Swedish Health. “And it’s usually by an emergency C-section and sometimes even in the intensive care unit.”
She added the reason was “either the babies are are getting distressed because their mothers are so ill, or that we need to deliver the baby to help improve the mother’s breathing, because having a fetus pushing up on the diaphragm does not help.”
Mike Glenn, CEO of Jefferson Health Care in Port Townsend, said his smaller facility was struggling with the strain of new patients.
“We have suspended all inpatient elective procedures. We had five cases scheduled for today, tomorrow, that we cancelled on Friday,” Glenn said.
Testing of patients now, he noted, also is turning up more cases.
“We’re also beginning to see more patients where their code positive status is secondary and incidental to what brings them in an acute condition ... like we had a case of acute appendicitis, and while we were working the patient up for surgery, indicated that that she was positive,” Glenn said.
“We’re beginning to see this more and more now and have just concluded that it’s a thing related to just higher community prevalence rates of COVID.”
Pierce County and the fair
The tsunami of new COVID-19 cases has now overflowed outside of hospital walls and into parking lots for at least two Pierce County hospitals.
Dr. David Carlson, senior vice president, provider enterprise and chief physician officer for Tacoma-based MultiCare, on Monday said tents were being added outside of Tacoma General and Good Samaritan Hospital in Puyallup “because we need to keep people out of our emergency room waiting rooms because we’re starting to have people that are kind of in a window of treatment that are having to be in those rooms and we need to keep them safe.”
Carlson, participating in Monday’s statewide hospital update provided by the Washington State Hospital Association, noted that on Monday Good Sam alone had about 100 COVID patients.
“The hospital is full,” he said.
Surgery cancellations are now common to devote as much staff as possible to the overflow, Carlson said.
“We have surgeons that are helping out our hospitals because we’ve canceled surgeries. Our surgical staff is being deployed wherever we can, to help out our medical surge and our clinical care staff.”
Volunteers are also being redeployed for meal service and other patient care services.
Given the current case numbers, the Washington State Fair looms as a potential superspreader event and had the hospital officials, particularly Carlson, concerned.
“We are, over the course the next three weeks likely going to bring in an additional million people to that community,” Carlson said, “and I am very, very concerned about the stress that will put on our emergency room, and the stress it will put on our systems because undoubtedly a number of those people are going to need care for routine stuff — cuts and bumps and broken arms, legs. Likely somebody is going to think that they are having a heart attack or chest pain or a stroke or a seizure or something else.”
“God forbid there’s a mass event,” he added.
“Our state doesn’t have the capacity to manage a mass event at this point,” Carlson said. “And ... I would look no further than other news, and what’s happening in New Orleans right now on the Gulf Coast with the hurricane.”
Echoing concerns raised by hospital officials at the last WSHA briefing, Carlson said MultiCare is struggling not just with finding space for those that need treatment, but also finding places for those already treated.
“We have well over 100 patients that are waiting for a placement, out of our hospitals to get into a skilled nursing facility or an adult day home,” he said.
He noted that the system’s urgent care clinics also were feeling the strain.
“So, a facility that was designed to deliver care within 30 minutes is taking hours, and by and large nearly all of that care is for people seeking care for respiratory disease seeking COVID treatments, etc.,” he said.
The officials reiterated that vaccines were the key to ending the crisis facing health care systems statewide, and for now, event cancellations may need to extend beyond surgeries.
Glenn cited the recent cancellation of the Wooden Boat Festival in Port Townsend, an event that normally draws up to 30,000 people to that community.
“Just last week, the director of the of the maritime center canceled the event, which was not an easy decision to make. But it was the right one,” Glenn said.
“Given what we are facing and what I think the entire state is facing, I would just encourage that level of support ... it’s quite a bit more meaningful than you know maybe banging on a pot to recognize the good work of other nurses and technicians,” Glenn said.
This story was originally published August 30, 2021 at 12:57 PM.
