"We're full": Ardmore hospital president says area health care impacted as pandemic rages

Michael D. Smith
msmith@ardmoreite.com

Mercy Hospital Ardmore has been operating at capacity this week as the surge in COVID-19 nationwide begins to take its toll on southern Oklahoma health care. Hospital president Daryle Voss said on Friday that expanded staffing and capacity was a planned cushion for the growing number of patients but warned that longer waits for emergency care are becoming a local reality.

By Friday afternoon, no open beds were available at the Ardmore hospital and Voss said transfers to other regional hospitals are becoming more difficult. Patients seeking care in the emergency department are often held until beds become available elsewhere, and other services across the hospital have been reduced to supplement acute medical care.

“At the end of the day we were able to add close to 20 extra beds — 18 to 20 beds on any given day — more than we had three weeks ago. Now that sounds great and all, but we’re full,” Voss said by phone.

Mercy Hospital Ardmore on Saturday, Nov. 21, 2020. Hospital president Daryle Voss said Friday that wait times for emergency care will grow since inpatient capacity has reached a limit, even after retaining agency nurses and reducing some services to redeploy existing staff.

News of Mercy Hospital Ardmore reaching inpatient capacity comes the same week COVID-19 hospitalizations in a single day surpassed 1,700 in Oklahoma, ahead of the Christmas holiday that health experts fear will further spread the virus as some people disregard recommendations and gather for the holidays.

FINDING SPACE FOR A GROWING NEED

Daily hospital capacity can be a moving target on any given day, even outside of pandemic surge plan protocols currently in place, but Voss estimated between 40% and 50% of available capacity for acute care has been occupied by COVID-19 illnesses this week. 

“Accidents are still happening. Heart attacks are still happening. Strokes are still happening. People get other illnesses and need access to care. What we’re all going to find and probably have to get used to is longer waits in our emergency department,” Voss said.

The Ardmore facility has seen a steadily growing number of COVID-19 patients since the summer, when only a handful were admitted for inpatient care on any given day through July. Even though those numbers nearly doubled by September, the hospital could handle less than a dozen COVID-19 patients per day.

Through November, however, numbers kept doubling.

“We got to 10 [patients per day with COVID-19] and we thought we had a lot. Then we were in the teens, then we were in the 20s. This week I think we peaked at 41 COVID-positive patients and as we sit right now I think we have 36 in the building,” Voss said on Friday afternoon.

REDEPLOYING, RECRUITING MEDICAL STAFF

While the hospital has well over 100 actual beds, the level of care each can provide and the staff of nurses, doctors, technicians, and other support staff available to manage that care can vary from day to day. Considering some beds are reserved for delivering newborn babies, emergency care and other specialized needs, the hospital traditionally utilizes about five dozen beds for managed inpatient and intensive care.

A hospital plan announced last month said adult behavioral health services on campus would be reduced to redeploy staff, and Voss said many of those nurses were retrained and shifted from psychiatric to medical care about two weeks ago. He added that a partial closure of inpatient rehabilitation has provided some staffing relief while recruitment of agency nurses continued this week.

As a result of redeployment of existing staff and recruitment of traveling staff, Voss estimates the number of inpatient beds has climbed to about 75.

“The biggest thing for us all along has been trying to increase capacity,” said Voss.

But the efforts to expand capacity can only go so far, and the increased number of local hospitalizations for COVID-19 has put a bottleneck on treating so many other patients.

"Hospitals are utilizing hall beds — we are here because there’s just not enough exam rooms in the ER — and if there’s not enough beds then we’re having to wait for beds to become available through discharges,” said Voss.

GRIM STATE, NATIONAL TREND

Even though local health care resources are already stretched thin, Voss said another surge in COVID-19 case numbers is expected next month. Hospitals across Oklahoma and neighboring states are feeling similar pressure from the pandemic, which means it is becoming increasingly difficult to transfer patients from Ardmore to another hospital if necessary. 

ICU availability in Oklahoma dropped dangerously low this week with about 4% of beds open, according to Oklahoma State Department of Health executive order reports. Voss said at least one patient this week had to be transferred as far away as Enid for further care and expected that trend to continue.

According to the OSDH daily situation report on Friday, 1,733 people were hospitalized with the disease the day prior. Nearly 15,000 total hospitalizations linked to the pandemic have been recorded in Oklahoma and almost 40% of those have been recorded since Nov. 1, according to OSDH data compiled by The Ardmoreite.

Elsewhere in the U.S., hospitals have become inundated with COVID-19 hospitalizations and resources have reached their limits. ICU beds in New Mexico reached 101% of capacity earlier this month as the number of Americans actively hospitalized with the disease on any given day this month has climbed past 100,000, according to USA Today.

“We’re kind of in this little bit of ‘wash-rinse-repeat’ cycle, but this week was a little bit of a week of optimism with the vaccination,” said Voss, referring to the first Mercy Hospital Ardmore staff to receive Pfizer’s COVID-19 vaccination on Wednesday.

LIGHT AND DARK MOVING FORWARD

Despite the first vaccine rollouts locally and emergency federal approval of a second happening this week, a growing number of infections statewide ahead of the holidays has caused concern of an even worse situation in coming weeks.

A nurse at Mercy Hospital Ardmore prepare to administer the first COVID-19 vaccinations Wednesday, Dec. 16, 2020. Vaccines were distributed to front line workers in Oklahoma this week ahead of an expected surge of virus cases over the holidays.

Personal protective equipment and other resources needed by doctors and nurses to care for patients — whether or not a patient is hospitalized with COVID-19 — remain much more accessible than the first months of the pandemic.

Voss said PPE production has caught up with health care demands and he praised the larger Mercy hospital network for acquiring and distributing equipment. OSDH reports also indicate Carter County and most of Oklahoma has a manageable amount of PPE and other equipment like gloves, gowns, masks, and even ventilators.

The vaccinations and PPE will be needed by health care workers more than ever considering Christmas will likely be the spark of a new wave of infections. Despite emergency approval of two vaccines, availability to the general population is still not expected for several months.

The Centers for Disease Control and Prevention has issued guidance for holiday gatherings which suggests reduced travel and proper behavior from expected guests before and during gatherings to include social distancing and face coverings. 

A consensus among those in the health care industry, following health recommendations like mask usage, hand washing, social distancing and other actions are important to reduce the spread of COVID-19. But in order to see the other side of the pandemic's finish line, Voss believes even more action must be taken.

“Let’s all show each other some kindness and grace and we’ll get through this,” he said.