August 13, 2021

'Total failure': More hospitals are hitting the breaking point—even in high-vaccination states

Daily Briefing

    Amid the latest surge in Covid-19 cases, hospitals and ICU units are overwhelmed even in high-vaccination states long considered pandemic "success stories"—creating what one hospital leader calls a "heartbreaking" situation.

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    A growing crisis in Texas

    For instance, Texas has recently averaged around 12,400 new Covid-19 cases a day—nearly double the number from just two weeks before. More than 10,000 Texans have been hospitalized this week alone, Edgar Sandoval and Giulia Heyward report for the New York Times.

    According to state officials, most hospitalized Covid-19 patients were not vaccinated.

    This rapid increase in hospitalizations has strained hospitals across the state—a situation similar to what happened during a winter surge in cases in early February, Sandoval and Heyward report. Currently, at least 53 hospitals around the state no longer have rooms available in their ICUs. In Houston, some hospitals have been so overwhelmed with patients that they have had to construct overflow tents.

    "The fact that we're having to construct the tents shows that the system in general is not prepared," said Amanda Callaway, associate administrator for Harris Health System. "There's lots of concern. There's only so much you can do, only so many rooms. We're just trying to respond as fast as we can."

    According to the University of Texas at Austin's Covid-19 model consortium, the number of Covid-19 hospitalizations is expected to increase to more than 15,000 by the end of the month.

    "If this continues, and I have no reason to believe that it will not, there is no way my hospital is going to be able to handle this," Esmaeil Porsa, a top health official in Harris County, said. "There is no way the region is going to be able to handle this."

    "I am one of those people [who] always sees the glass half-full, I always see the silver lining," Porsa said. "But I am frightened by what is coming."

    Increasing hospitalizations among children

    A significant number of children have been affected in the latest Texas surge, Sandoval and Heyward report.

    For instance, according to the Texas Department of State Health Services, almost 240 children were hospitalized with Covid-19 on Tuesday.

    And at the Children's Hospital of San Antonio, an increasing number of children were being admitted to the hospital with severe Covid-19 symptoms, such as high fevers, chills, coughs, and shortness of breath. Moreover, many children coming to the hospital for unrelated illnesses subsequently tested positive for the coronavirus, officials at the hospital said.

    "We are now entering a new phase where our volumes are increasing … just like on the adult side," Norman Christopher, the hospital's CMO, said. "And that's compared to almost nobody just a few months ago."

    Anne Marie Baker, a pediatric nurse at the hospital, noted that children under 12 who are not yet eligible to be vaccinated are the most at risk. "In the last two months, we just had all of these patients," she said. "It's just so sad."

    Mississippi, Louisiana face onslaught of Covid-19 cases

    The situation in Texas comes as several other states with low vaccination rates also face potentially overwhelming surges of Covid-19 patients, AP/Modern Healthcare reports.

    For instance, Mississippi—where only about 35% of residents are vaccinated—is averaging about 2,700 new Covid-19 infections per day. It recently hit a new record with more than 1,500 hospitalized Covid-19 patients, including 400 ICU patients.

    According to state health officials, there were no additional ICU beds available in Mississippi earlier this week.

    To address the surge, state health officials are opening a 50-bed field hospital in the parking garage of the University of Mississippi Medical Center (UMMC). In addition, the federal government will dispatch medical professionals to help state officials treat a spike in Covid-19 patients.

    "Since the pandemic began, I think the thing that hospitals have feared the most is total failure of the hospital system," Alan Jones, associate vice chancellor for clinical affairs at UMMC, said. "And if we track back a week or so when we look at the case positivity rate, the rate of new cases, the rate of hospitalizations … if we continue that trajectory within the next five to seven to 10 days, I think we're going to see failure of the hospital system in Mississippi."

    He added, "Hospitals are full from Memphis to Natchez to Gulfport. Hospitals are full."

    In Louisiana, where just 37% of residents are vaccinated, nearly 2,900 Covid-19 patients are currently hospitalized—a record number for the state, AP/Modern Healthcare reports. At Ochsner Medical Center, frontline providers are fulfilling multiple roles, juggling an overwhelming caseload, and trying to quickly train health care contractors from other facilities.

    "We're trying to provide the most consistent care we can, but to do that we need more hands," said Robin Davis, a neurologist at Ochsner who said she's also doing the work of nurses, janitors, and orderlies amid the patient crush.

    "One of the biggest issues for our nurses is, the volume of patients is such that we're having to create beds that didn't previously exist," she added. "We're having to find providers [who] weren't previously put in place."

    Even 'success story' states see challenges

    And states such as Hawaii and Oregon—which both have higher-than-average vaccination rates, and which were once considered "pandemic success stories"—are also being "clobber[ed]" by the latest Covid-19 surge, AP/Modern Healthcare reports.

    For instance, Oregon currently has more people hospitalized with Covid-19 now than at any other point of the pandemic, at 665, and ICU beds across the state are 90% full. And Hawaii is about to mark its own record high in hospitalizations, with experts expecting 300 hospitalized Covid-19 patients by the end of the week.

    "It's heartbreaking. People are exhausted. You can see it in their eyes," said Jason Kuhl, CMO at Oregon's Providence Medford Medical Center.

    Separately, citing the at-capacity ICU at Hilo Medical Center—the biggest hospital on Hawaii's Big Island—Elena Cabatu, the facility's spokesperson, said, "If someone out there has a heart attack or a sepsis or gets into a bad accident that requires intensive care, we will have to hold that person in the emergency department." (Bella, Washington Post, 8/12; AP/Modern Healthcare [1], 8/12; AP/Modern Healthcare [2], 8/12; AP/Modern Healthcare [3], 8/12; Sandoval/Heyward, New York Times, 8/12)

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