Wednesday, August 18, 2021

Decreased Hospital Capacity from Both COVID and Non-COVID Patients Troubles Hospitals

Posted By on Wed, Aug 18, 2021 at 5:09 PM

click to enlarge Decreased Hospital Capacity from Both COVID and Non-COVID Patients Troubles Hospitals
The bug continues to spread, testing the capacity limits of Arizona hospitals.

Banner Health is reporting a troubling increase in hospitalizations of COVID-19, coupled with a higher-than-average number of non-COVID patients.

Last week, the number of ICU patients in Arizona, for both COVID and non-COVID patients, reached the peak numbers of those seen in the summer 2020 surge, said Chief Clinical Officer Dr. Marjorie Bessel at a media conference Wednesday morning.

She reported only 30% of those patients are COVID positive, compared to the last surge when 50 to 60% were COVID positive. Bessel believes the high number of non-COVID patients in the ICU is partly due to patients delaying care in 2020 because of the pandemic and are now seeking care for illnesses and medical issues that have become more severe.

“The high number of non-COVID patients that we were caring for coupled with the week over week increase in COVID hospitalizations is troubling,” said Bessel.

During the past week, she said they continue to see an increase in COVID-19 hospitalizations, ICU admissions, and ventilator usage. Banner has also seen exponential growth in pediatric COVID hospitalizations. In the first two weeks of August, Banner had as many pediatric COVID admissions as they did the entire month of June, according to Bessel. She said they are on track to surpass the number of pediatric COVID patients seen during the winter surge.

Due to the rise in cases and decreased hospital capacity, the Pima County Health Department updated its Public Health Advisory on Tuesday.

Similar to Banner, Pima County hospitals are seeing more people coming to the ER for reasons other than COVID-19, such as heart attacks, RSV and sepsis, who require hospital admission. According to the Public Health Advisory, local hospitals are also experiencing abnormally long wait times for EMS to be able to transfer care of their patient to the hospital staff, becoming unable to respond to other emergencies.

The Pima County Health Department said “It is NOT the norm for area hospitals to be experiencing such high hospital admission rates, reduced hospital surge capacity and long EMS offload times at this time of year.”

Alongside decreased hospital capacity, area hospitals face severe nursing workforce shortages due to high rates of turnover and burnout from the pandemic.

Banner Health has several core positions available and is securing external contracted labor for both nurses and therapists. Bessel said they have individuals who are starting each week and expect that to continue throughout the winter. Banner is requiring all employees to receive the COVID-19 vaccine by Nov. 1 and would include vaccination in the onboarding process for new employees. Bessel does not believe this requirement will have a large impact as many other health care systems in the communities they operate have a similar process.

“We do expect that staffing will continue to be our greatest challenge as we continue to face this surge,” said Bessel.

The Pima County Health Department is actively assisting area hospitals to request federal assistance to address the healthcare workforce shortages and alleviate decreased surge capacity.

While Banner is currently available for both COVID and non-COVID patients, Bessel warned of a possible reduction in services based on the experience of previous surges.

“If our COVID patients overwhelm our healthcare systems, there may come a point where we have to reduce or cut back on other services such as ambulatory services or patients that have planned elective surgeries,” said Bessel. “It is our absolute hope and desire to not get to that point and so we ask all of you who are out there listening to please do your part, so that we can be here for you to take care of both COVID and non-COVID illnesses.”

In his latest COVID-19 Update and Forecast published on Saturday, Dr. Joe Gerald, an epidemiologist with UA Zuckerman College of Public Health, predicted that hospitals would experience reductions in services.

“Undoubtedly, some medically necessary procedures will likely be postponed and rescheduled over the coming weeks to make room for critically ill COVID-19 patients,” said Gerald. “Even if you are vaccinated, the COVID-19 surge can impact your health should you become ill and require hospital care. In essence, care will become increasingly more rationed over the coming weeks with only the sickest of the sick being able to access critical care services.”

According to Bessel, 94% of COVID patients hospitalized at a Banner facility last week were unvaccinated and those patients are younger than those treated in prior surges, with most between the ages of 20 and 60.

Gerald noted that this outbreak, like past outbreaks, is being driven by transmission among adolescents and working-age adults in the community, despite the rise in pediatric COVID hospitalizations and an increase of school cases and outbreaks.

“If our goal is to protect children, the most effective way to accomplish it is to slow transmission among adults,” said Gerald.

In the short term, he advised mask mandates, restrictions on indoor gatherings in public settings, and targeted business restrictions would reduce transmission, but in the long-term, vaccination remains the “most important public health priority to reduce viral transmission and severe illness.”

Bessel asked the public to do their part and get vaccinated not only to protect themselves but also to support the health care systems in their communities.

“They sacrificed so much for you and rose to the occasion during the prior two surges when there was no solution as effective as we have now today, which is vaccine to prevent hospitalizations. We now have that solution available to us, and we need everyone to take it,” said Bessel.

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