For several months, Oregon appeared to be a national publisher, avoiding the worst case scenario of COVID-19 infections.
But over the past several weeks, critically ill COVID-19 patients have arrived in emergency rooms from Portland to Metford to Bend, pushing the hospital bed facility to 90% and making the health system difficult in some areas.
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“Over the past four months, we have been oscillating between two and eight patients admitted to the hospital with COVID-19 disease. Today we have 49 patients,” said Dr. Jeff Absalon, chief physician of St. Charles Health Systems, which operates four hospitals in the Bend region.
“We honestly expect the number to be higher than that, and this is the number of patients we have seen in epidemics.”
Statewide, hospitals treated 494 patients with severe COVID-19 disease two weeks ago, the Oregon Health Commission said last week, before that number dropped slightly.
Oregon is somewhat less prone to error in terms of hospital capacity. According to the Kaiser Family Foundation, this is the lowest number of individual hospital beds.
Hospitals developing other projects
In many regions – the Portland metro area, Central Oregon and South Oregon – the percentage of intensive care beds in use is up 85% for most of last week. Non-ICU hospital beds were similarly in high use.
According to CDC data, Oregon’s average hospital bed rate was 60% pre-infection.
In recent days, in the South Oregon region, including Grands Pass, Ashland and Medford, there are only 6 ICU beds out of a total of 57 – about 90% in use.
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“From my conversations with other health executives over the past few weeks, I think we are starting to feel more tense than we have ever been,” said Dr. Courtney Wilson, vice president of medical affairs at Asante. Rogue Regional Medical Center in Medford, South Oregon Regional Resource Hospital.
In response to the visit, the St. Charles Health Network in Bentley has begun implementing parts of its Rise program. Patients with less complex medical needs may be sent back to other hospitals in St. Charles, Redmond and Prinville. Doctors are reviewing a list of more than 800 selected and planned surgeries to see how many can be postponed.
Procedures reviewed by St. Charles include surgeries and joint replacements for cancer and heart disease. The hospital system is looking for something that can be postponed for two weeks without causing a significant decline in health.
“I would say that most of the selected surgeries we have are very important to maintain health or to maintain function,” Absalon said.
Hospitals in Portland and South Oregon also have to make daily decisions about how many planned and selective surgeries can be continued to ensure that intensive care beds are available to all those in need of emergency.
Different than spring
At the onset of the epidemic, Wilson of Asante was concerned about the expulsion of masks, gowns and test items. Now, the main challenge facing his hospital is the staff.
The hospital has ample space to accommodate more patients, and it has applied to the state for an increase in the number of beds licensed for complex care.
This April 9, 2020, when the corona virus erupted, Salem, Ore. A new, larger corona virus outbreak across Oregon has many areas that have been relatively protected from the spring surge that is struggling to continue this fall.
Andrew Chelsky / A.P.
“But those beds would do us no good if we didn’t have staff to care for patients,” Wilson said.
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In the spring, the Rock region was able to hire travel nurses to prepare for the outbreak.
“We really had a surplus of staff, tied ourselves up and were ready to face the waves of COVID, which fortunately never came at that time,” Wilson said.
Now, the hospital is in reverse: the social spread of COVID-19 is in high demand for travel nurses across the country as they are admitted to hospitals everywhere.
Wilson said the planned spike in COVID-19 cases would come this time and it would be difficult to get additional help. “It’s almost impossible for staff to come,” Wilson said.
Meanwhile, the hospital’s ethics committee is finalizing an advance plan, which will determine how patients will receive care in situations where the hospital is overcrowded.
Some good news: The flu is not so bad
A few hours north, the Peace Health Sacred Heart Medical Center in Springfield, the regional resource hospital for the Lane, Goose, Douglas and Curry districts, has not yet canceled selected surgeries or made significant changes to the care available there.
“We are managing our COVID modules and are still able to do everything we normally can,” said Dr. Jim McGovern, COVID-19 incident commander with PeaceHealth’s Oregon network.
One thing that Makeover is helping its region with is a slow start to the flu season, and fewer cases of other respiratory viruses than usual this year.
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“I think we see less this year because of hand washing, hiding, social distance,” he said. “It not only prevents the spread of COVID, it also protects against other respiratory viruses.”
Oregon has not yet reached the point of crisis reached by states such as Texas and Oklahoma. If patients are not in their community hospital, there are still enough beds to get treatment somewhere in their region.
Representatives from the state’s regional resource hospitals have regular calls several times a week, planning to have any hospital or region overcrowded and without beds — and begin redistributing patients to hospitals hundreds of miles away. Treat them.
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The goal of the crisis situation is to “maintain access for all to patient sharing and patient redistribution,” said Dr. James Heilmann, Chief Medical Transfer Officer at the University of Oregon Health and Science, a regional resource hospital for Portland. Area.
“Fortunately, we don’t need to do that yet,” Hailman said.
When several hospitals were evacuated due to the huge wildfire that devastated communities across western and southern Oregon, the team planning for a COVID-19 uprising dried up to see what an overflow situation would be before this fall. .
Vaccines help, but slowly
There may be little relief on the horizon for statewide hospitals. The first shipment of the COVID-19 vaccine is likely to arrive in Oregon this week, with health workers receiving the first dose.
This vaccine will provide doctors and nurses with even more protection and psychological relief from the fear of catching the virus at work and spreading it to family members.
Related: The Governor of Washington announced that the distribution of the COVID-19 vaccine will begin this week
“It’s something that boosts morale,” Hailman said.
But of course, there is not yet enough available for the general public to start vaccinating.
Dr. Jeff Absalon, with St. Charles Health, said vaccinations were not important in getting his hospital system out of bed in the short term.
“We know they won’t be here anytime soon to help us this winter-reduction-breathing season,” he said.
Now the important thing is that each of us, doing what we know from the beginning can stop this virus. Stay home if you are sick and avoid spending time with people outside your home. Wear your mask.
Editor’s note: This story was first aired on December 11, 2020.