Already at capacity for months, the Cincinnati area's hospitals and their exhausted workers are bracing for what could be the highest surge in demand of the 21-month pandemic. The tide approaches with the year-end holidays, the seasonal spike of flu and a new variant of the new coronavirus.
Local health officials are concerned for the future here when they see what's happened in northern Ohio, with every one of the Cleveland Clinic's 43 intensive care beds are filled with a patient with COVID-19 and an Akron hospital bringing in a refrigerator truck for extra morgue capacity.
“It’s calm on the outside looking in,” said Tiffany Mattingly, vice president of clinical strategies at the Health Collaborative, the conference board of the regional health care industry. “The hospitals have become fantastic at managing this and taking the brunt of the pain internally to make sure our community receives quality care. But at this point in this surge, all signals are that it will and could be the worse we’ve seen so far. It’s a dire situation.”
Elective surgeries are still being done in the Cincinnati region, but Mattingly said hospitals may defer some procedures to save beds. While she did not have access to numbers of staff, Mattingly said that so far, the hospitals report that as many staff have taken sick leave so far in December than in all of November.
The daily regional report of pandemic conditions said Thursday that 98% of the roughly 2,500 medical-surgical beds in the 40 hospitals in the 14-county region were full. The region’s 513 intensive care beds were at 102% of capacity; that means another 10 patients were in ICU. A quarter of the ICU patients suffered from COVID-19, and 70% of them were on breathing ventilators.
On Wednesday, an alarm came from Dr. Richard Lofgren, president and chief executive officer of UC Health. He said hospital staffing was less than a year ago due largely to the punishing pace of tending to COVID-19 patients, who need 12 hours of one-to-one care from a nurse.
Lofgren said the Cleveland area hospitals are even more stressed, and he fears the same conditions were headed for southwest Ohio, Northern Kentucky and southeast Indiana. Lofgren said about 90% of COVID-19 patients now hospitalized locally are unvaccinated.
The U.S. Centers for Disease Control and Prevention, the Ohio Department of Health and local public health departments have issued repeated appeals for vaccination to stop the spread of SARS-CoV-2, the coronavirus that causes COVID-19. As of Thursday, 69% of the population 12 and older in the 14-county region had been vaccinated.
The omicron variant, believed to be even more infectious than the delta variant currently sickening people, has been detected in Ohio.
Even without the new strain being dominant in Ohio, the situation in the state is grave enough that Dr. Bruce Vanderhoff, director of the state Health Department, on Thursday asked residents to avoid visiting emergency departments simply to confirm a case of coronavirus, the Columbus Dispatch reported.
On the outside, the situation at local hospitals does look calm. A new emergency department is going up at the University of Cincinnati Medical Center. People are slowly returning to medical practices for checkups and screenings.
On the inside, hospital representatives said, the situation is critical. But they want people to know that if they need emergency medical care, a hospital can receive them. The patient might not go to the nearest hospital, which could be on “diversion status” due to overcapacity, but to one farther away that can take more patients.
In addition, the representatives said, the hospitals have learned in 21 months to manage the ebb and flow of the pandemic patient load.
“Our hospitals are very busy, but we currently have the capacity to care for all of our patients,” said Nanette Bentley, spokeswoman for Mercy Health. “We are monitoring COVID-19 and flu cases closely. We continue to schedule elective cases at this time.
“Our scheduling decisions are based on safeguarding the health of our patients, associates and the communities we serve. We make adjustments to operations as needed to be able to continue to care for our community. The community can help us lessen the strain on area health systems by getting vaccinated and receiving the booster shot and following the well-established protocols of avoiding large gatherings, masking and frequent hand washing.”
At the Christ Hospital Health Network, spokesman James Buechele said the hospitals “have seen an alarming increase in unvaccinated COVID-19 patients over the past few weeks, and we continue to encourage the community to do everything to stop the spread of this virus, such as getting vaccinated, which is both a safe and effective way of protecting against severe disease and hospitalization ahead of the holiday season.”
Hospitals have been paying extra time off and offering resilience training for teams to better support each other. Jennifer Skinner, senior vice president and chief nursing executive at TriHealth, said Wednesday that leaders “are staying very close to our team, listening to them, understanding what they need and know that people don’t like asking for help. So we’re going to them and asking them what they need.”
Across the Ohio River, spokesman Guy Karrick at St. Elizabeth Healthcare said by email, “This surge is no different than any other surge. The census (number of patients) has been moving up since Thanksgiving but not as high as this past fall and certainly nowhere near peak this last winter.”
Karrick said St. E is not considering a cutback to nonessential services, but, “That has always been on the table if it becomes necessary. We are just not there yet, but I did see the situation at Cleveland Clinic.”
"I know people are more than tired of hearing this,” Karrick added, “but masking in public and vaccination is still the best pro-action we can take against COVID.”
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