As COVID patients overcrowd hospitals, those with other medical conditions wait for care

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When Jazz Paz learned that the 93-year-old woman she was caring for had waited 24 hours for a hospital bed, she held back tears.

The woman’s family hired Paz, a retired nurse, to accompany the woman in February. Paz found her absolutely endearing. She laughed at his quick wit, listened intently to her childhood stories about the Great Depression, and was impressed that someone her age was exercising daily.

“Every day I was just amazed at how strong this woman was mentally and physically,” said Paz, 69, of southwest Houston. “She had no indication that she was sick until she contracted this urinary tract infection.”

Considering the woman’s age, her family and doctor took a break before sending her to hospital as the intensive care units were nearly full, Paz said. Initially, they decided to treat her with antibiotics and keep her at home when she fell ill.

The data suggests that the decision of Paz and his client’s family was not unfounded. According to the Southeast Texas Regional Advisory Council, about 98% of intensive care beds in Texas are full and 43% of those full beds are used for patients with COVID-19, which oversees a hospital readiness region of 25 counties, including the Houston area. The majority of hospitalized COVID patients – 86% – are not vaccinated, according to the Peterson Center on Healthcare and the Kaiser Family Foundation. Meanwhile, like hospitals in Texas and the country are filling up and emergency rooms and intensive care units are crowded with COVID patients, those with other medical needs, like Paz’s client, wait.

A “dire situation”

“We are still in a very critical situation, the hospitals are absolutely full, the emergency departments are full,” said Dr David Persse, chief medical officer for the city of Houston, where hospital occupancy closely reflects the state trend. In Harris County, 98% of beds are full, with COVID patients occupying 39% of those beds, according to Friday’s SETRAC data.

“Ambulances have extended delays to unload patients because there is no room in the emergency department and the situation is very bad,” said Persse.

Paz’s client became one of those waiting patients. She did not respond to antibiotics and the infection reached her blood, so she had to be hospitalized a few days after her diagnosis. She returned home in hospice care after four days in the hospital. Paz said it was the right decision to remove her from hospitals, but wonders if she would return home to hospice care if she had been to the doctor sooner.

“There are so many people who haven’t taken their photos, and now they’re overwhelming the system,” Paz said. “I’m just so angry that my friend is coming home to hospice care because she couldn’t get the immediate care she needed.”

Paz and his client are not the only ones.

Daniel Wilkinson, a U.S. Army veteran who got a Purple Heart in Afghanistan, went to Bellville Hospital, west Houston, to be treated for biliary pancreatitis, a treatable condition in in which a gallstone blocks the pancreatic duct and causes inflammation. For nearly seven hours Wilkinson waited. Several hospitals have told his doctor they don’t have a bed for him because they have been caring for so many COVID patients, media reports. By the time a bed in a Houston VA hospital opened its doors, it was too late. Wilkinson died the next day at just 46 years old.

This problem is not unique to Texas. Martin DeMonia of Cullman, Alabama, died of a heart emergency after being unable to find a bed. Hospital staff contacted 43 hospitals in three states looking for a cardiac intensive care bed and eventually found one in Mississippi, according to his obituary.

Crisis management

The effects of the overflow are felt even before patients set foot in a hospital. During COVID spikes, first responders kept patients on stretchers for up to five hours while awaiting transfer of care, Persse said. It has since improved, but wait times remain.

On a Wednesday afternoon in mid-September, about 26 of the city’s 104 ambulances waited in emergency environments across the region – six for over an hour.

“This hospital overcrowding we are facing was and is 100% preventable,” said Persse. “A lot of these people (in the hospital) were exposed by someone who was not vaccinated. So almost all of these COVID admissions could have been avoided if people got vaccinated. “

About 59% of Texans are fully vaccinated, according to data from the Centers for Disease Control and Prevention. In Harris County, 62 percent of the eligible population – those who are 12 years of age or older – are fully immunized, according to the Texas Department of State Health Services.

About 128 patients were awaiting an intensive care bed on Aug. 19 in the SETRAC 25 county area, the highest level this month. In September, the peak was 95; it is currently around 65. While this is an improvement, it is still above pre-pandemic levels when fewer than 20 people were waiting at a time.

The recent decrease in the number of patients waiting is due to the ability of hospitals to adapt, rather than a slowdown in COVID cases, which continue to plague the region, said Darrell Pile, CEO of SETRAC.

Some received additional beds as they hired more nurses. And many hospital administrators tell Pile they have been able to shorten the stays of COVID patients in intensive care with medication to treat symptoms and more beds in the general hospital.

“The hospitals are doing a good job of dealing with this terrible crisis,” Pile said, “but the volume remains extraordinarily high. “

According to the Texas Department of State Health Services, there are 310,411 active cases of COVID in Texas, including 56,985 in Harris County.

Triage and solutions

Anyone who thinks they need urgent medical attention should seek treatment, Pile said. He recommended calling 911 and describing their symptoms to paramedics who can determine if they need hospital treatment.

Other medical experts, like Dr. Jill Weatherhead, assistant professor of pediatrics at Baylor College of Medicine, recommend telemedicine.

“Patients have permanently suspended routine screenings and sought medical attention to limit their exposure,” Weatherhead said. “One thing that is being done is telemedicine. This ensures that patients can be in contact with their provider.

Danielle Rushing, 51, of Hunters Creek, has found telehealth helpful in deciding whether or not to send her 76-year-old mother to hospital.

Her mother remains at Belmont Village Senior Living, which has started using a specialized telehealth platform for emergency care since the start of the pandemic, resulting in an 85 percent drop in emergency room visits to residents.

Rushing said she had used the platform four times and it helped her determine when it was necessary to take her mother to the emergency room. After a bad fall, the doctors determined that it was necessary to go to the emergency room. But screening saved her at least one emergency room visit: When Rushing’s mother had stomach problems and lost her appetite, Rushing worried about having a urinary tract infection and took her to the hospital. ‘hospital.

As the symptoms persisted, she wondered if she should take it back. Together, Rushing and his mother decided to use the telehealth program again. In addition to the standard video chat with a healthcare professional, the telehealth device included machines to capture the patient’s vital signs and other medical equipment.

“They did the test and assured me that she no longer needed to go to the emergency room,” Rushing said, “and that to return her to the emergency room again during COVID when there is (limited) having available hospital beds would be very difficult for her. “

Eventually, COVID cases will be low enough that people like Rushing and Paz don’t have to debate whether or not to send loved ones to the emergency room, Persse said. In the meantime, people need to get vaccinated so the health system is not inundated with COVID cases, he said.

“We have clearly failed because the hospitals are completely overwhelmed,” said Persse. “This has an impact not only on patients with COVID, but on all patients who have other medical conditions for which they would need urgent care.”

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