Some U.S. hospitals forced to ration care amid staffing shortages, COVID-19 surge

[September 18, 2021]  By Julia Harte and Sharon Bernstein

(Reuters) - Surges in coronavirus cases in several U.S. states this week, along with staffing and equipment shortages, are exacting a mounting toll on hospitals and their workers even as the number of new admissions nationwide ebbs, leading to warnings at some facilities that care would be rationed.

Montana, Alaska, Ohio, Wisconsin, and Kentucky experienced the biggest rises in new COVID-19 hospitalizations during the week ending Sept. 10 compared with the previous week, with Montana's new hospitalizations rising by 26%, according to the latest report by the U.S. Centers for Disease Control and Prevention (CDC) on Sept. 14.

In Alaska, the influx is so heavy that the state's largest hospital is no longer able to provide life-saving care to every patient who needs it due to the influx of COVID-19 hospitalizations, according to an open letter from the medical executive committee of Providence Alaska Medical Center this week.
 

"If you or your loved one need specialty care at Providence, such as a cardiologist, trauma surgeon, or a neurosurgeon, we sadly may not have room now," the letter read. "There are no more staffed beds left."

Some hospital workers have become so overwhelmed by the fresh wave of COVID-19 cases -- a year and half after the pandemic first reached the United States -- that they have left for jobs at retailing and other non-medical fields, Nancy Foster, vice president of quality and patient safety the American Hospital Association, told Reuters.

At the same time, distribution and other issues are leaving some hospitals short of oxygen supplies desperately needed to help patients struggling to breathe, Foster said.

On Friday, the hospital association held a webinar for its members on how to conserve oxygen, an effort to address a 200% jump in demand at many hospitals, she said.
 

"There is a shortage of drivers with the qualifications to transport oxygen, and a shortage of the tanks needed to transport it," Foster added.

While there are some breakthrough cases among the vaccinated, Foster said most of the hospitalizations were among the unvaccinated.

A SURGE 'LIKE NEVER BEFORE'

On Sept. 16, 1,855 Americans died of COVID-19 and 144,844 new cases were reported, according to a Reuters analysis of state and county data. Both trendlines have been increasing in the United States overall since hitting their lows this summer in July and June, respectively.

New hospital admissions are still surging in several mostly rural and Midwestern states, even as the number of COVID-19 patients admitted to hospitals daily in the entire United States slipped to about 10,685 on Sept. 14 after cresting around 13,028 in late August, according to the latest data from the U.S. Centers for Disease Control.

A nurse works in a COVID-19 patient's room during a tour of SSM Health St. Anthony Hospital's intensive care unit (ICU) amid the coronavirus disease (COVID-19) pandemic in Oklahoma City, Oklahoma, U.S., August 24, 2021. REUTERS/Nick Oxford

“Despite our hospital being ground zero in Kentucky for the onset of the pandemic 18 months ago, this week we are being hit with a COVID surge like never before since the onset of the pandemic,” said Dr. Stephen Toadvine, chief executive officer at Harrison Memorial Hospital, in a statement posted on the Kentucky state website. He added that patients seeking emergency care in Kentucky hospitals and being treated for COVID-19 are at an all-time highs.

Kentucky Governor Andy Beshear said on Thursday that the commonwealth would soon run out of a key treatment for COVID-19 - the use of monoclonal antibodies - and the federal government also recently announced a national shortage.

Since May, the number of COVID-19 cases at hospitals run by the University of Wisconsin's UW Health system has quadrupled, Dr. Jeff Pothof said in an interview.

Emergency rooms are so full that doctors are having to seek rooms for their patients in other facilities, he said, a trend seen in other states, including Florida.
 

"For the first time in my career we're at the point where not every patient in need will get the care we might wish we could give," Dr Shelly Harkins, chief medical officer and president of St. Peter's Health in Helena, Montana said in a video announcement Thursday.

In West Virginia, COVID-19 hospitalizations this week have far outstripped their previous peak of 815, rising from 852 on Monday to 922 on Friday, said Jim Kaufman, the president and CEO of the West Virginia Hospital Association.

The state's hospitals are also facing severe staffing shortages, resulting in fewer patients treated and delays in non-emergency care.

Smaller hospitals are sending patients to larger ones that can accommodate them, Kaufman said. In Oklahoma, new hospitalizations declined by 11% during the week ending Sept. 10 compared with the previous week, but 35% of hospitals in the state report staffing shortages, according to the CDC.

(Reporting by Julia Harte in New York, Sharon Bernstein in Sacramento, Calif., Maria Caspani in New York and Deena Beasley in Los Angeles. Additional reporting by Barbara Goldberg in New Jersey and Anurag Maan in Bengaluru; Editing by Aurora Ellis)

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