Friday, December 11, 2020

Hospitals Plead with Public as ICU Space Runs Out, COVID-19 Cases Surge: 'We Are at a Breaking Point'

Posted By on Fri, Dec 11, 2020 at 4:16 PM

click to enlarge After dropping sharply from a decade ago, the number of people without health insurance continued to inch back up last year, when more than 800, 000 Arizonans were without coverage, according to Census Bureau data. - PHOTO BY ALEX PROIMOS, CREATIVE COMMONS
Photo by Alex Proimos, Creative Commons
After dropping sharply from a decade ago, the number of people without health insurance continued to inch back up last year, when more than 800, 000 Arizonans were without coverage, according to Census Bureau data.

The Pima County Health Department discussed the critical nature of COVID-19 throughout the county at a press conference today after it issued a joint letter signed by 26 representatives from the health department, hospitals and fire districts warning residents of disastrous consequences if the spread of the virus continues at its current rate.

Hospitals across the county have less than 2% of their ICU beds available. Today, they had only seven open ICU beds, Pima County Health Director Dr. Theresa Cullen shared at the press conference.

click to enlarge ICU beds in use in Pima County from Dec. 6-Dec. 11. According to Pima County Health Director Dr. Theresa Cullen, less than 2% of ICU beds are available. - THE PIMA COUNTY HEALTH DEPARTMENT
The Pima County Health Department
ICU beds in use in Pima County from Dec. 6-Dec. 11. According to Pima County Health Director Dr. Theresa Cullen, less than 2% of ICU beds are available.

Pima County Chief Medical Officer Dr. Francisco Garcia said the county’s experiencing “very significant” numbers of deaths similar to those seen in the July surge in cases. In terms of hospitalizations, numbers have far surpassed levels seen in the summer peak. 

Judy Rich, the president and CEO of Tucson Medical Center, said on the outside, the hospital shows serene Christmas lights and often barren parking lots. The parked cars are diminishing as visitors aren’t allowed to visit their sick loved ones, and behind the glowing lights, the hospital’s staff is fighting an unprecedented number of cases while facing high levels of burnout.

“The staff are tired, and they are giving everything that they have. It is imperative that we take this seriously. This is a serious disaster that is invisible to many,” Rich said. “But when it hits you, when it becomes personal, you'll understand it differently. I would just ask you to project to that and take the steps that you need to to stay safe and help our community get through this.”

The Chief Medical Officer of Banner University Medicine, Dr. Gordon Carr, said although the hospitals he oversees are using all available resources to handle the influx of cases, they are also struggling.

“We are bringing in more staff and expanding our physical capacity. We are redeploying planning staff to assist in the hardest-hit areas. We are doing everything we can to provide essential medical services,” Carr said. “Unfortunately, however, we are facing ongoing, uncontrolled spread of the virus in our community. If we are not able to slow the spread soon, the strain on the healthcare system could become too great. At this critical moment, public health interventions have never been more important.”

With a dramatic decrease in hospitals' capacities, they’re already having to deny elective surgeries to patients and face the troubling reality of having to triage care for patients in more critical conditions.

“We are perilously close to a point where we would not be able to deliver a normal standard of care, and we would only be able to meet the most life-threatening needs under conditions of crisis,” Carr said.

The current delay of elective surgeries is causing hardships for patients who depend on them.

“A lot of time when people talk about elective surgeries, it sounds like it is a facelift or something that is purely cosmetic in nature. These are not cosmetic procedures that we're talking about. These are life-saving procedures. This is cardiac interventions and other types of surgeries that have real-world implications for those individuals who are having to postpone it,” Garcia said. “I want you to understand that's what we mean when we're saying that we are at a breaking point. Our healthcare partners are having to make very, very tough choices.”

At TMC, Rich has firsthand experience dealing with those tough choices.

“The most difficult thing at TMC for us this past couple of weeks has been a day where we get 14 requests to transfer patients from someplace else and we have to say no, or we can only take half of the patients that are being requested,” Rich said. “These are places that do not have the higher level of care that we have at TMC, and so they're unable to meet the needs of somebody, for instance, who's experiencing a lack of circulation to their foot, and needs to go to the operating room to open up the vasculature so that their foot will not suffer a loss.”

Healthcare officials are joining the health department to implore the public to practice safety mitigation tactics including mask-wearing and social distancing.

“This is really a plead from the bottom of our hearts, we need every single person in our community to please listen,” said Dr. Jenitza Serrano-Feliciano, the chief medical officer of MHC Healthcare. “In moments of great difficulty we want to be able to be sure that we can treat you. The hospitals want to be able to provide the care, but it's impossible unless we get your help and your compliance.”

Even as Christmas and New Years' approach, the health department is asking everyone to stay home and avoid gatherings.

"We know that’s a lot to ask this time of year, but the holidays will come again; sit this one out. Use the internet and telephones to communicate with family and friends," the joint letter from the health department and healthcare officials said.

Garcia said although more stringent mitigation protocols have been placed on the county to slow the spread, it’s up to the public to adhere to them.

“The honest truth is that we are running out of the tools in our toolbox. The honest truth is also that we are limited legally in terms of the kinds of interventions that we can and cannot do, the state and the federal government have substantially more flexibility in this space than we do,” he said. “That’s part of the reason why we are making this appeal very directly to the folks in this county, in this community, to please triple down on what they've been doing and continue to help us to try to mitigate this.”

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