Local health care again pressured by COVID-19 surge
Doctors and nurses at Mercy Hospital Ardmore in January were torn between hope from a new COVID-19 vaccine and distress over a record number of hospitalizations spurred by an ongoing pandemic. As hospital beds overflowed into emergency department hallways and waiting rooms early this year, Oklahoma health care workers were finally receiving their second shot of vaccines and the end of the pandemic felt closer than ever.
But almost seven months later, vaccine rates in Carter County have stalled below one-third of the population and local health care providers worry about another uncontrollable surge in infections. The mixture of hope and despair they felt at the beginning of the year is now joined by frustration as a new variant of COVID-19 continues to ravage the middle of the country despite widespread vaccine availability.
“It is frustrating to see so many severe infections and admissions that could have been avoided,” said Dr. Koby Hunter, an emergency room physician at Mercy Hospital Ardmore.
Hunter is not only concerned about the recent increase in COVID-19 cases but also other respiratory illnesses uncommon for this time of year that are taxing local health care resources. For an emergency department that normally handles about 80 patients each day, COVID-19 and other maladies have led to over 100 patients in a day.
“It’s hard to have a great idea of how things are going to shape up. We can’t tell the future but it is worrisome,” he said.
A FAMILIAR SURGE
Hospital staff and administration are watching the spread of COVID-19 and anticipating increased pressure on local personnel and resources in the coming weeks and months. According to the Oklahoma State Department of Health on Thursday, the state recorded about 20,000 new cases of COVID-19 since June 30. In those four weeks, the three-day average of hospitalizations statewide has surged from 116 to 620 on Thursday.
For comparison, the number of COVID-19 hospitalizations in Oklahoma between June 30 and July 29 of last year jumped from 315 to 663, according to OSDH data compiled by The Ardmoreite. In that same four-week period last year, Oklahoma recorded 20,866 new cases of COVID-19.
Mercy Hospital Ardmore President Daryle Voss said the administration is carefully watching epidemiological patterns and using lessons learned from the previous surge to prepare for an inevitable surge in southern Oklahoma. Of particular concern is a cluster of the new Delta variant creeping into northeast Oklahoma in recent weeks.
“The thinking is that ultimately it’s going to make its way to Oklahoma City and down I-35, and the only thing that stands between us and the variant is the vaccine or hand hygiene and masking and all the things we’ve been preaching since the pandemic started,” Voss said.
“What we believe is that eventually the variant will hit here hard. Will it hit like it did last January when we had 63 COVID patients in the hospital? I hope not,” he said on Wednesday. “In March and April, we were running single digits less than five (hospitalized COVID-19 patients). We’ve been over the 10 mark for several days now and I pray that we don’t go past 20.”
The current surge of infections and hospitalizations for COVID-19 has hit northeast Oklahoma the hardest and is already having an impact on the southern part of the state. Mercy Hospital Ardmore on Wednesday morning was caring for 15 patients with COVID-19. That number had risen to 17 by Thursday morning.
TRYING TO FIND BEDS
It’s not uncommon for patients treated in the Ardmore emergency room to be stabilized and transferred to other hospitals in the region. When inpatient beds become scarce, hospital emergency departments must hold these patients until a proper bed and necessary staffing become available.
This situation often leads to lengthy wait times in emergency departments.
In early January, when Mercy Hospital Ardmore was treating dozens of people with COVID-19, all 17 exam rooms in the emergency department were filled with patients waiting for an inpatient bed. Nurses and doctors were having to care for other patients behind curtains in hallways and waiting rooms.
“My last couple of shifts last week we were holding up to six in the ER, which is not where we were before,” said Hunter on Wednesday. “When we’re trying to transfer patients that we can't keep at our facility due to lack of beds or lack of specialty, we’re seeing other facilities don’t have any beds either.”
Voss said that some facilities in the Mercy hospital network are already seeing this most recent surge putting more pressure on their resources than the previous surge. The shrinking availability of hospital beds in Oklahoma is also having an impact on wait times for emergency room visitors.
“If you’ve been to our ER in the last couple of weeks, you’ve probably felt that we’ve been getting hit hard,” he said.
VACCINES AND THE PANDEMIC
Earlier this month, Centers for Disease Control and Prevention Director Dr. Rochelle Walensky told reporters that the most recent surge “is becoming a pandemic of the unvaccinated.” While official data recording the vaccination status of hospitalized patients is incomplete and difficult to verify, local anecdotal evidence corroborates the claims that a vast majority of severe COVID-19 illness is among those who remain unvaccinated.
“In our electronic medical records, there’s not a box that says ‘have you been vaccinated, yes or no,’ but we have asked them (physicians) to start trying to document that so we can go back and manually start pulling that data,” said Voss.
Wilson said that she has been asking patients about their vaccination status regardless of why they’re in her emergency room.
“I ask every single person I see in the ER if they’re vaccinated or unvaccinated simply to address concerns and fears,” she said. “I have yet, personally myself, to see one COVID patient that is vaccinated.”
Hunter said his experience in recent months has also shown that patients with COVID-19 needing emergency room treatment are overwhelmingly unvaccinated. While some who have received one of three vaccines approved for emergency use in the United States have still developed COVID-19, the outcome for them has been much better.
“I think we have seen overwhelmingly the sicker patients that come in with COVID are unvaccinated. We have seen some breakthrough COVID infections in vaccinated patients, but those breakthrough infections almost invariably lead to a discharge from the ER instead of being admitted or transferred,” said Hunter.
“WE NEED THEM HERE...FOR THE FIGHT THAT’S COMING”
According to OSDH data, nearly 100 workers of hospitals and long-term care facilities in Oklahoma have already been killed by the disease. The risks and associated burnout with health care jobs were already having an impact on staffing, but now hospital systems must consider how vaccine mandates will impact their workforce.
Early this month, Mercy Hospital joined at least two dozen other health care systems when it announced that all coworkers would need to be fully vaccinated by Sept. 30. A group of Ardmore health care workers have started a petition asking Gov. Kevin Stitt to intervene and claim that “almost half of the employees at Mercy Hospital in Ardmore, Oklahoma will lose their jobs.”
“It’s not half, that’s an overstatement,” Voss said.
He declined to say how many or what percentage of employees have yet to be vaccinated but said he knows every individual who has not received their shot. With staffing levels already below what he would like, Voss still agrees with the vaccine mandate for employees to help protect coworkers and patients.
“It will impact us if we have even a small percentage decide not to get vaccinated. It will impact our ability to deliver care,” Voss said.
“We need them here to be alongside us for the fight that’s coming with the variant, but at the end of the day I also respect each and every one of them. If they choose a different path, I can be okay with that.”