The Intensive Care Unit of Good Samaritan Regional Medical Center is packed with patients. Some of them have serious cases of COVID-19 and are breathing through ventilators.
They occupy rooms that have their own air flow, with negative pressure and latched glass doors that keep their contagious breath contained and filtered out through a vent that blows out of the building where it’s of no harm.
Doctors and nurses have to suit up in paper gowns, gloves, protective eyewear and something called a PAPR (powered air purifying respirator), in order to provide care when they have to go into those rooms. It’s the most protective form of personal protective equipment available to healthcare workers.
Oregon is experiencing the highest level of COVID-19 hospitalizations ever.
As of Friday afternoon, there were 56 COVID patients hospitalized across Samaritan’s five hospitals. At Good Samaritan in Corvallis, there are 26. At Albany General, there are 14, and at Samaritan Lebanon Community hospital there are eight. This is just shy of the highest number of hospitalizations, 57, which was reported on Thursday.
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Experiencing this day in and day out, doctors and nurses called it a “slap in the face” to see the issue of COVID-19 becoming so politicized. You can’t convince them this pandemic isn’t a big deal. They see the reality.
“Everybody’s drowning,” said Dr. James Knight, who spends all day in the ICU. “COVID has put a tax on medical systems like no other disease I’ve seen.”
Mid-valley hospitals are overwhelmed and healthcare providers are tired of it. ICU wards are full or close to it, some hospital wards aren’t able to accept outside patients from other hospitals, and nurses and other providers are experiencing severe trauma and burn-out. Some have left their jobs.
It’s this stark reality that has been exacerbated by COVID-19, and which continues to make the medical response to the pandemic more difficult.
Many of these problems already existed in the healthcare industry before the pandemic. The high demand for hospital beds has highlighted just how understaffed and prone to backlogs our medical infrastructure already was.
Unlike other states, Oregon doesn’t have many long-term acute care facilities — places where patients go to rehabilitate after surgeries or stints in the ICU. Instead, people have to do their recovery in the already full hospital beds. Knight said that getting a COVID patient out of the ICU in 5 to 7 days would be ideal, but they prepare for 10 to 30.
“I would take almost any other diagnosis than COVID in terms of getting people in and out of here quickly,” he said.
While hospital managers say that no one in dire need is being turned away, ICU wards have been “on divert” for weeks, meaning they can’t take in patients from other hospitals or clinics. Some folks who have scheduled surgeries, things for which there is no immediate health crisis, are having to be rescheduled.
“Hospitals can go on divert for two reasons,” explained Samaritan Regional Medical Center CEO Laura Hennum. “One is all your beds are unavailable. While our entire hospital is not on divert … we are on divert for our ICU and Progressive Care Unit. (The other reason) is that we don’t have enough available staff.”
While the fullness of ICU beds is a large factor in hospitals being on divert, the lack of staffing is also critical. Folks who have been working far more than 40 hours per week for months are just now able to take time off this summer, as parts of the country have begun to open up. The seven-week spike we’re currently experiencing coincided with a lot of this time off.
Taking a toll
The other component is “clinician burnout,” or people quitting or changing jobs because healthcare fields have just become too draining. Or because other hospital networks can offer better pay/working conditions.
“Clinician burnout was a challenge for us pre-pandemic as well,” said Hennum. “COVID-19 has only served to magnify and intensify the challenge … we’re all competing for a limited pool of healthcare professionals.”
A nursing shortage was ongoing before the pandemic started, fueled by a lot of factors. One of the biggest is that the Baby Boomer generation is aging into retirement, leaving the largest hole in the healthcare workforce in decades. That aging population also leads to more patients in hospitals.
“As baby boomers age and retire, not only has it led to a greater number of aging patients … but also the number of healthcare workers aging towards retirement,” said Hennum. “Now, with COVID, you could even argue that it manufactured an early wave of retirement.”
It can seem strange for the outside observer to think that nurses and doctors can be affected by the death they see in this line of work. They must get used to it, right? Never, say healthcare professionals.
“One thing people don’t talk about is the trauma nurses go through in treating people with this, especially early on,” said Knight. “These nurses are watching people die every day. That takes a toll on a person. How could you blame them for being like, ‘Hey, I’m done with this.’?”
Politics vs. medicine
The political pressures that healthcare providers face in today’s world don’t help, either. Doctors say they’ve been berated by patients for suggesting they get vaccinated. They point out the hypocrisy of certain patients’ doubts about the vaccine, but complete willingness for experimental treatments like Ivermectin, a medicine used to de-worm livestock, or a host of other experimental treatments like Hydroxichloroquine, Tocilizumab, and Leronlimab.
Doctors say the efficacy of these treatments is up for debate, and the FDA cautions against their use.
“There’s no treatment (for COVID-19) that we can say, with confidence, that this works,” said Dr. Aaron Whitten, Good Samaritan’s ICU pharmacist.
The one medical procedure they can say, with confidence, does work to protect against COVID are the vaccines available from Pfizer, Moderna and Johnson & Johnson. Despite this, their use has become a political statement rather than a piece of medical advice with millions of data points to support it.
“I just pumped five different kinds of antibiotics into you and you didn’t ask what was in any of them,” Knight recalls thinking of some of these patients. “It’s, unfortunately, become so politicized.”
Data released by the Oregon Health Authority as well as comments from doctors, show that the overwhelming majority of patients in the hospital with COVID are unvaccinated, especially in the ICU. And there are no persons in any local ICU because of adverse reactions to a COVID vaccine. It’s a relatively simple reality that healthcare professionals say is being overlooked.
“From the people who don’t do what I do … I see a gigantic disconnect between the reality we see and what people think the reality is politically,” said Knight. “It’s kind of a slap in the face. We know what we’re seeing. You can’t try to gaslight us into believing otherwise.”
Troy Shinn covers healthcare, natural resources and Linn County government. He can be reached at 541-812-6114 or firstname.lastname@example.org. He can be found on Twitter at @troydshinn.