Hospitals search for enough beds and nurses as virus rebounds

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The coronavirus is engulfing big city hospitals in states including Utah, Wisconsin and Indiana that are running low on nurses and beds and are being forced to set up overflow facilities.

With new daily U.S. cases surpassing 62,000 on Thursday, the prospect of swamped intensive care units is prompting some governors who previously resisted public health orders to weigh new restrictions to ease pressure on their health care systems. From the early days of the pandemic, the availability of ICU beds — and hospitals’ ability to treat people who need life-support equipment like ventilators to breathe — has been an important benchmark for whether local health systems can handle outbreaks.

“Our hospitals are getting overwhelmed,” Republican Utah Gov. Gary Herbert said this week. “The dramatic increase in infections has put the integrity of our health care system at risk.“

The University of Utah Health System, one of the largest hospitals in the state, reported its ICU is 95 percent filled, and health systems in other parts of the country have been forced to relocate patients because of bed and staffing shortages.

Herbert said the National Guard is on standby to build a field hospital in a convention center outside Salt Lake City, and on Tuesday he ordered masks be worn at all outdoor events.

The pandemic is spawning new infections at a rate not seen since the end of July. Hot spots began to cluster in parts of Utah, Indiana, Wisconsin, Oklahoma, Wyoming, Missouri, Mississippi and North Dakota as the nationwide average number of daily new cases surged over the past month.

In Indiana, the state is facing “critical ICU bed shortages along with personnel shortages” according to Chief Medical Officer Lindsay Weaver, only three weeks after Republican Gov. Eric Holcomb removed most Covid-related restrictions. Officials have put out a call for volunteers to help fill staffing shortages in hard-hit facilities near the Michigan and Kentucky borders.

Indiana has fewer than one-third of its ICU beds available, according to its health department, and there are more than 1,300 patients in the hospital, the most since May and up 67 percent in three weeks.

“This is especially concerning, because we have not begun to see the typical increase in ICU bed usage from influenza,” Weaver said.

Colder weather pushing more people to gather indoors appears to be driving the latest surge more than school reopenings, according to public health experts. Other areas could soon face similar dilemmas, with U.S. hospitalizations at their highest point since the end of August, according to the COVID Tracking Project.

And the phenomenon isn’t confined to the U.S.: The single-day jump in cases worldwide surpassed 350,000 for the first time on Oct. 9.

Wisconsin, where President Donald Trump plans to hold a rally on Saturday, opened a field hospital on its state fairgrounds in West Allis on Wednesday after officials said the health care system is in crisis.

“Many of our ICUs are strained,” said Julie Willems Van Dijk, a deputy secretary with the state’s health department. “Every region of our state has one or more hospitals reporting current and imminent staff shortages.”

Democratic Gov. Tony Evers’ administration asked the Army Corps of Engineers to review plans for two more field hospitals.

The situation appears similarly dire in parts of Texas, Missouri and Oklahoma.

The area around El Paso, Texas, a city of nearly 700,000, has 10 remaining ICU beds, according to the state health department. On Monday, Republican Gov. Greg Abbott announced he was sending 75 health workers, including nurses and respiratory therapists, to help respond.

Meanwhile, two out of three major hospitals in Albuquerque, N.M., are at, or exceeding, capacity. Democratic Gov. Michelle Lujan Grisham on Thursday announced that restaurants and bars must close at 10 p.m. and gatherings of more than five would be prohibited.

“This is the most serious emergency New Mexico has ever faced,” she said.

A spokesperson for Integris, Oklahoma’s largest health system, reported one available ICU bed on Thursday after having none available on Wednesday. The administration of Republican Gov. Kevin Stitt has had multiple conversations about suspending elective surgeries but hospitals, which rely on the revenue from those procedures, have pleaded for the flexibility to manage caseloads without such restrictions.

“That remains an option if needed, but we would prefer to work in partnership with the hospitals as much as we can without issuing mandates,” said Charlie Hannema, a spokesperson for Stitt.

Hospitals have already been paid more than $100 billion from the federal government’s stimulus packages and there were concerted efforts in the spring to ease the shortage of ventilators and personal protective equipment. Many governors prohibited elective surgeries to save room and supplies. But the facilities are still in perilous positions with the pandemic raging in nearly every corner of the country.

In Missouri, hospitals are reaching capacity in every region of the state.

“ICU beds are very limited in several regions,” said Dave Dillon, a spokesperson for the Missouri Hospital Association. “Hospitals are working collaboratively to manage patient flow, but Missourians still have heart attacks, strokes and automobile accidents, for example, that demand ICU care. This is a finite resource and if Missouri cannot bring down the infection rate, we will meet or exceed our capacity to care for the most critical Covid-19 patients.”

In Fargo, North Dakota’s most populous city, there were 10 ICU beds available on Wednesday, and in Bismarck, the state capital, there was only one, according to the health department. Republican Gov. Doug Burgum on Wednesday recommended that bars, restaurants and other large venues in the state’s most populated counties serve only a quarter of their capacity and no more than 50 people but declined to require them to do so.

The recent spike in infections, the coming winter and the prospect of holiday travel and gatherings have many physicians worried that the hospital numbers are only going to get worse.

“This is not going to go away for the next several months,” said Mark Dowell, an infectious disease doctor at the Wyoming Medical Center in Casper, where on Wednesday morning every room was occupied and 17 patients were holding in the emergency room.

“Our hospital is already stretched, and we are not even seeing the amount of Covid we are going to see,” Dowell said.

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