BIRMINGHAM, Alabama (AP) – With its dozen intensive care beds already full, Cullman Regional Medical Center began desperately looking for options as more patients with COVID-19 appeared.
Ten beds normally used for less severe cases were transformed into intensive care rooms, with additional intravenous machines. Video monitors were set up to allow staff to monitor patients whenever a nurse had to flee to care for another person.
The patch did the job, for now, at least.
“We’re kind of a bathtub that fills with water and the drain is blocked,” the hospital’s chief medical officer, Dr. William Smith, said last week.
Alabama, one of the worst and impoverished states in America, has become one of the most alarming points of the nation’s coronavirus.
Their hospitals are in crisis as the virus gets out of control in a region with high rates of obesity, high blood pressure and other conditions that can make COVID-19 even more dangerous, where access to health care was limited. even before the outbreak, and where public resistance to masks and other precautions is stubborn.
The virus has killed more than 335,000 people across the U.S., including more than 4,700 in Alabama. Places like California and Tennessee have also been particularly affected in recent weeks.
At Cullman Regional, a medium-sized hospital serving an agricultural area 55 miles north of Birmingham, last week’s intensive care unit had 180% capacity, the highest in the state. Other hospitals are also struggling to keep up with falling in love with people sick with the virus.
Although a typical patient may need ICU treatment for two to three days, Smith said patients with COVID-19 often stay two to three weeks, which causes the load of cases to build up.
Alabama ranks sixth on the list of states with the most new cases per capita over the past week, according to Johns Hopkins University. Alabama’s latest average positivity rate (the percentage of tests that turn positive for the virus) is nearly 40%, one of the highest figures in the country. And the state sees an average of 46 deaths a day, compared to 30 on Dec. 14
Although ICUs nationwide had a capacity of 78% during the week of Dec. 18-24, those in Alabama were 91% full, according to the U.S. Department of Human Services and Health. Last week, 15 Alabama hospitals had intensive care units that had a higher or higher capacity and the ICUs of six more hospitals were at least 96% full.
On Monday, there were 2,800 people in Alabama hospitals with COVID-19, the highest total since the pandemic began.
Experts worry that stress will only increase after the holidays due to new infections related to travel and reunions of family and friends.
“It simply came to our notice then. I really do, ”said Dr. Don Williamson, head of the Alabama Hospital Association. “I’m afraid our Christmas wave is going to be a lot worse than Thanksgiving.”
Alabama Gov. Kay Ivey, breaking up at the time with some of her southern counterparts, imposed a state mask warrant that had been in effect since July, but health officials have struggled to get people to comply. The Republican governor also issued a stay-at-home order at the start of the pandemic, but has strongly opposed doing so again, saying, “You can’t have a life without means of subsistence.”
California, on the other hand, has issued strict home stay orders in recent weeks in areas where ICU employment has reached 85%.
“Unfortunately, we have people who still get together in groups, travel on vacation, and do things that aren’t safe,” said Dr. Scott Harris, an Alabama state health officer.
The deep southern state has some of the highest rates of certain chronic health conditions that increase the risk of coronavirus-related death or serious illness. Alabama has the sixth highest adult obesity rate in the United States and ranks third in the percentage of adults with diabetes.
Alabama is also one of twelve states that did not expand Medicaid under the Accessible Assistance Act and therefore have a large number of policyholders. About 15 percent of 19- to 64-year-olds have no coverage, the 13th highest percentage in the country, according to the Henry J. Kaiser Family Foundation.
The state has seen the closure of 17 hospitals, mostly small in rural areas, in the last decade, a trend that left regional facilities to catch up.
At Decatur Morgan Hospital, deaths from COVID-19 have tripled since September and the intensive care unit is full, Dr. James Boyle said. The pulmonologist struggled to stay calm, pausing and grabbing his lips as he discussed the possibility of having to take care of the ration in the new year.
“I’ve been practicing in this county since ’98. I’ve never had more than two or three people with flu fans in the last 20 years,” he said. “We always have a lot of patients in the ICU in the winter. Having 16 patients with ventilators with a disease that we don’t usually have is unprecedented. ”
UAB Hospital, which is affiliated with the University of Alabama at Birmingham, has hosted retired nurses and dozens of professors and students from its nursing school to help them.
Alabama hospitals receive calls from neighboring states like Mississippi and Tennessee, as doctors are looking for extra space for patients with COVID-19, but are unable to help them as often as they did in the past. The same goes for the state, with hospitals that can help care for patients after a disaster like a tornado that now can’t help.
With thousands of people already vaccinated with the first of two doses needed to protect themselves from COVID-19, the end of the pandemic is in sight. Meanwhile, the toll on medical workers is rising.
“It simply came to our notice then. This is part of what we do; it’s part of our training, “Boyle said.” This year’s difficulty is just the big number. We can’t regret one patient before we have to go and take care of another. “
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Associated Press writer Kim Chandler contributed to this story from Montgomery, Alabama.