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Rogue Valley hospitals overflowing with patients

Photo courtesy of Asante Kristina Lawson, Vicky McGuffee and Kirsten McNaught work Wednesday in the Rogue Regional Medical Center Emergency Department.
COVID-19 surge straining local capacity

Heart attack and stroke victims, people needing brain and heart surgery, and cancer patients are in hospital hallways and waiting rooms as Asante struggles to provide enough beds for them.

"You put yourself in the shoes of a person who's having a heart attack or a stroke and having to be in a hallway in the emergency department, you can imagine how terrifying that is," said Amanda Kotler, vice president of nursing at Ashland Community Hospital and Rogue Regional Medical Center in Medford.

She said health care providers are working as hard as they can to give patients the best care possible, wherever they are in a hospital.

Hospitals in Jackson and Josephine counties had 92 COVID-19-positive patients Wednesday ― the most since the pandemic began. Of those, 30 were in intensive care units.

More than 90% of the hospitalized people are not vaccinated against the virus, Asante officials said.

More people are hospitalized with COVID-19 now than during the winter, before vaccines were widely available. After cases dropped in the spring and early summer, a July and August spike is pushing local hospitals to the edge.

“It’s our high-water mark,” Dr. Jamie Grebosky, chief medical officer for Asante, said of the record number of patients. “Even during our darkest days in January, we didn’t see that many patients. And those numbers are only going to increase over the next two to three weeks.”

Spikes in hospitalization tend to follow spikes in cases.

Jackson County Public Health reported 149 cases Wednesday and a record 253 cases Tuesday, shattering a daily record of 188 cases that had been set last Friday.

Oregon reported 1,213 COVID-19 cases Wednesday and the deaths of five people, including a 74-year-old Jackson County woman.

As it has several times in recent days, Jackson County logged the most COVID-19 cases among Oregon’s 36 counties Wednesday.

"Oregon is the fifth-worst state in the nation in terms of acceleration of COVID cases, and we are one of the hottest spots in Oregon. We know we are looking at really challenging times in the next few weeks," Grebosky said.

The delta variant of the COVID-19 virus is spreading. The variant is more contagious and patients often have higher levels of virus in their bodies.

Current vaccinations are effective against the delta variant. Rarely, vaccinated people can still get sick, although their symptoms tend to be more mild.

The phrase “younger, sicker, quicker” is spreading among health care providers locally and nationally to describe the current situation with COVID-19 patients.

“That’s the trend we’re seeing. There’s been a drift to younger patients. They get sicker, requiring more interventions, and they deteriorate more quickly,” Grebosky said.

More patients need to be transferred into critical care, but beds aren’t always immediately available, Kotler said.

"You can imagine being unable to breathe, being ventilated ― and waiting for that bed to become available is extremely scary as a patient and for our staff. The patients are younger, which is jarring for all of us to see our community going through this," she said.

Asante, long a hub for advanced medical care in Southern Oregon and Northern California, has had to limit transfers of patients from outlying areas. Even some people on ventilators are having to wait in rural hospitals.

“Last month, we denied care — because we did not have capacity — to 177 patients. We couldn’t accept 177 regional referrals because of that,” Grebosky said.

Hospitals in more rural areas are having to keep those patients and work to keep them stable, he said.

While local and regional patients are desperate for beds, dozens of people remain in Rogue Valley hospitals who’ve improved enough that they no longer need hospital-level care. They aren’t well enough to live on their own, but no nursing homes will take them.

On Wednesday, Asante officials said they were boarding 63 such patients who no longer need to be in the hospital. The patients are in Asante hospitals in Medford, Ashland and Grants Pass.

Since the beginning of the pandemic, hospitals locally and nationwide have struggled to get nursing facilities to accept patients who need follow-up care after hospitalization ― whether patients had COVID-19 or not. Patients are spending days, weeks and even months in hospital beds.

“We’ve had some patients who’ve been in our hospital since February,” Kotler said.

Asante officials are begging the state, the Federal Emergency Management Agency and even the National Guard to help solve the discharge problem.

FEMA helped by providing staffing and money for 30 nursing home beds at the local Hearthstone Nursing & Rehabilitation Center.

Hospitals filled those beds in two weeks and continue to accumulate patients who can’t be discharged into community nursing facilities, Kotler said.

Grebosky said the state could help by providing money to boost staffing at skilled nursing facilities. He would like FEMA to provide more money and the National Guard to help with staffing.

“This is dangerous. We need all the help we can get,” Kotler said.

With money and a coordinated effort by the Oregon Health Authority and Oregon Department of Human Services, Grebosky said, the discharge problem can be fixed.

“We don’t have any facilities in Southern Oregon who are now accepting long-term care patients who need placement,” he said. “We don’t have a facility accepting COVID patients. The closest one is Portland.”

Providence Medford Medical Center is also having hospital bed capacity and discharge problems, said Ryan Hutchinson, acting incident commander.

He said the hospital is having problems getting enough staff, as are local nursing homes and urgent care clinics. He’s seen nursing homes limit intakes because of staff shortages and because they want their current patients to follow social distancing.

When people can’t get quick appointments at urgent care clinics, they come to hospital emergency rooms, further straining hospitals, Hutchinson said.

The health care industry is facing a worker shortage, with workers retiring or leaving the field, and new people hesitant to enter. The problem is widespread, impacting nurses, imaging technicians, physicians and other categories of workers, Hutchinson said.

If people do get sick with COVID-19, they should ask their health care providers if they are eligible for an infusion of COVID-19 antibodies, a treatment available through Asante in Ashland, Grebosky said.

“It can be a life-saving intervention. It reduces emergency room visits, hospitalizations and deaths,” he said.

Asante and Providence officials are asking local residents to help in the fight by getting vaccinated against COVID-19.

The community’s health care providers are under enormous pressure as they try to help the growing number of patients, Kotler said.

“We know they are giving everything they can. We are extremely strained,” she said.

For information on getting vaccinated in Jackson County, visit jacksoncountyor.org/hhs/COVID-19/Vaccine-Appointments.

Reach Mail Tribune reporter Vickie Aldous at 541-776-4486 or valdous@rosebudmedia.com. Follow her on Twitter @VickieAldous.