If you live in southwest Missouri, hospital officials say acquiring a severe case of COVID-19 could now mean a stay in St. Louis or Kansas City, as a global pandemic who has killed 3.9 million people continues to stretch Missouri hospital staff towards what a statewide association recently called a “tipping point” in its actual report 2021.
A handful of Springfield-area patients are already being treated hundreds of miles away in the state’s two largest cities, the CoxHealth chief confirmed Tuesday morning.
Springfield-area COVID cases increased 44% in two weeks
The news comes as Delta variant COVID-19 infections rise in southwest Missouri, even as large swathes of residents have chosen not to benefit from vaccines shown to prevent or reduce the impact of disease by ensuring immunity.
Data collected by The New York Times showed Tuesday that infections in the Springfield metro area have increased 44% in the past two weeks, a period in which the United States as a whole has seen a 15% drop.
The infection rate per 100,000 people for the Springfield area, 38 new cases per day, is nearly 10 times the national rate, the Times reported.
Mercy Springfield announced that it hospitalized 104 COVID-19 patients on Tuesday, said Mercy Springfield President Craig McCoy; Cox brought in around 100 for the day, said System Chairman Steve Edwards.
The numbers are just one part of a tapestry of facts that show how the pandemic has evolved since its winter peak, when the COVID-19 patient census figures sometimes reaches 170. On January 20, Edwards noted on Twitter that Cox had accepted a patient transfer from Louisiana. About a month later, he said Cox was able to leave his COVID-19 emergency intensive care unit.
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But now things have changed.
“For the first time, we’ve been on COVID hijacking,” Edwards said on Tuesday.
“Bypassed,” he explained, is a status that can quickly switch from on to off and back. This means that at some point a hospital “feels that its capacity to deal with a particular type of patient is limited in that it tells referral hospitals and ambulances not to send them patients of that type. “.
In recent times, four Cox patients have been transferred to the BJC HealthCare healthcare system in the St. Louis area with 14 hospitals, including Barnes-Jewish, a large teaching hospital linked to the University of Medicine School of Medicine. Washington. A spokesperson for the BJC confirmed the number of patients on Tuesday.
Four other Cox patients have been transferred to the St. Luke Health System in Kansas City, Edwards said. (After two attempts, the News-Leader was unable to reach St. Luke officials for comment before Tuesday’s deadline.)
Edwards cited internal data from Cox showing that 47 COVID patients were transferred to facilities in Cox from June 1 to 21, including many hospitals in small communities such as Lebanon and Mountain View, while 23 were transferred.
Transfers of patients from the Springfield area to other hospital systems in major cities appeared limited at the start of this week. A spokesperson for SSM Health in St. Louis, which operates Saint Louis University Hospital and seven other facilities, said Monday evening that it had recently accepted three patients from Ozark County for non-COVID care, but no other patient from southwestern Missouri.
Cox had recently warned that resource issues could force patients to be diverted outside of the Springfield area, Edwards added.
“It’s really just that rushing capacity every moment that Cox and Mercy have to manage,” said Edwards.
Ethical dilemmas: whether or not to transfer COVID patients?
Hospitals face an ethical dilemma, Edwards said: Rising patient numbers are good for hospital outcomes, but New York City’s first experience with COVID-19 in 2020 showed that As the number of COVID-19 patients increases, the quality of care decreases.
“Do you take a patient to the ER for 24 hours, how long can it take to get into a bed in the tower?” Edwards asked, pointing to the choices hospitals need to make right now. “Or are you transferring this patient who requires hospitalization, who will become more seriously ill, but is in a better position to transfer him now, to another hospital that may have a COVID count of 10 (patients)?” “
Meanwhile, Edwards said hospital workers recognize the burden that remote treatment options place on the families of those who are ill.
Mercy Springfield chairman Craig McCoy said he hasn’t sent patients to major cities yet, even though the system is headquartered in suburban St. Louis. He moved patients within his four-state system and tried to keep them as close to home as possible, he said.
“We will do everything in our power to make sure we don’t have to transfer anyone else out of the community because we believe the best care is where you have your local support,” McCoy said. .
Hospital staff issues
Local hospitals are well equipped in some ways, and less so in others, the executives said.
“We literally have years of supplies,” Edwards said. “We have built up a large reserve, we have enough equipment, we have added more than 150 beds.”
The problem now is the staffing associated with high infection rates in southwest Missouri, Edwards added. Staffing for positions like nurses and respiratory therapists is a major challenge.
Many traveling nurses appear to be taking their summer leave after working hard and being paid high rates in previous COVID-19 outbreaks, he said.
Dave Dillon, spokesperson for the Missouri Hospital Association, said at the time that “hospitals are not as well staffed as they were during the outbreak” of COVID-19 infections last winter.
“Many have cut back on the expensive agency staff who then helped get through the months of high hospitalization,” Dillon told the News-Leader by email on Tuesday. Many pandemic contracts between hospitals and temporary workers such as mobile nurses have expired, including a big state contract between Missouri and Texas-based healthcare staffing company Vizient Inc.
“These staff members are probably gone for their next internships,” said Dillon.
Another issue cited by health officials is the return of patients who need hospital care for non-COVID treatments.
“It’s fair to say that hospitals are already overburdened to meet pent-up demand for health services that were cut back last year and into the spring,” Dillon said.
McCoy, along with Mercy, said: “Obviously we’re being pushed. We’ve got a high count in intensive care… COVID is doped (and) at the same time, we’ve got a lot of other non-COVID stuff going on.”
Mercy is able to draw “virtual resources” from its headquarters in Chesterfield to help share the load in Springfield, he said.
President of Mercy: “I don’t understand why people don’t get vaccinated”
The transfers of patients occur despite the fact that vaccines are available free of charge within a five-mile radius of their homes for more than 80% of Missourians, according to Governor Mike Parson. said on twitter Last week.
The News-Leader asked Acting Missouri Department of Health and Seniors’ Services Director Robert Knodell to comment on patient transfers from southwest Missouri to major cities. He responded with a prepared statement relayed by a spokesperson:
“The department continues to work with our CDC partners, local public health agencies and statewide health systems to provide all available resources and analysis. We continue to promote and encourage vaccination as the most effective mitigation measure the public can take to stop this virus in its tracks. “
Dillon, with the state hospital association, said Missouri is a “mixed bag” when it comes to vaccination rates: some communities are nearing 60%, others are below 20%.
He explained, “The virus does not respect the boundaries of political subdivisions like counties, states or regions, and with the greatest chance of transmission with the Delta variant, hot spots will be inundated with patients.”
Dillon added that as effective vaccines are now available, hospitalizations related to COVID-19 are “largely unnecessary.”
Hospital officials agreed.
“I don’t understand why people won’t get vaccinated,” said McCoy, president of Mercy Springfield. “I haven’t heard for a good reason yet.”
Mercy expects the pandemic to continue, although McCoy said “we certainly hope to get a respite.”
Cox’s Edwards called on a skeptical public to consider whether to vaccinate not in terms of political discourse, social media misinformation or judgmental attitudes, but in terms of personal trust between an individual and their attending physician.
He said he was in favor of “the idea of trying to remove all those feelings of anger and rivalry and go to that person who really cares about your health care, who doesn’t judge you, is your doctor – not Dr Fauci, you know, but your doctor. I think that’s a message we’re learning in our community. “
Edwards pointed out that the rate of unvaccinated people in the region is much higher than the rate of people without health insurance who may not have easy access to a primary care doctor.
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