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News / Clark County News

Hospitals brace for surge in virus cases as Public Health struggles

Medical professionals fear ‘significant increase’ ahead

By Wyatt Stayner, Columbian staff writer
Published: December 2, 2020, 6:04am

With Thanksgiving over, PeaceHealth Southwest Medical Center is preparing for the possibility of a 20 to 40 percent increase in its number of COVID-19 patients over the next month.

On Tuesday, Dr. Lawrence Neville, chief medical officer at PeaceHealth Southwest, said his hospital has surge planning in place to create more space for patients and the ability to backfill staff if necessary.

“We are concerned that we may see a pretty significant increase in the amount of COVID patients in our communities in the next two to four weeks, in particular,” Neville said during a press briefing.

PeaceHealth had 42 patients hospitalized for COVID-19 as of Tuesday. Neville said the hospital wants to keep that number below 54 COVID-19 patients.

Clark County has a total of 77 people hospitalized for COVID-19, with another four hospitalized people awaiting coronavirus test results. Nine new COVID-19 deaths were reported Tuesday, which brings Clark County to 100 total COVID-19 deaths to date.

Another 67 new cases were reported, too. Clark County has 8,908 total cases, and 376 cases currently in an isolation period.

Neville, who is also the chief medical officer at PeaceHealth St. John Medical Center in Longview, said the Longview hospital has created space for 10 COVID-19 patients. In recent months, Cowlitz County coronavirus patients were being sent to PeaceHealth’s main Vancouver campus if they needed longer-term treatment.

Neville said the overall hospital capacity is about 10 percent higher than usual at this time of year, but that overall capacity is “in reasonable shape.”

The hospital should not encounter personal protection equipment shortages this winter, Neville said, and PeaceHealth Southwest will likely receive COVID-19 vaccines this month to give to hospital front-line staff.

The hospital recently saw its first patient with both COVID-19 and influenza, Neville said. While that’s likely to be a rare occurrence this winter, Neville said it underscores the need to get vaccinated against the flu.

If hospitals have the added burden of treating an active flu season, it could present too much strain. Neville feels confident PeaceHealth Southwest has the right surge planning in place, but did admit he’s worried about the stress on hospital staff if things worsen.

“We are going to make it through this, but it would be an uncomfortable couple of months,” he said.

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In an interview with The Columbian last week, Kelly Espinoza, vice president and chief nursing officer at Legacy Salmon Creek Medical Center, said the hospital is mostly in line with its normal overall capacity during the late fall.

Typically, hospitals are most full in the winter because of flu patients and surgeries.

Espinoza said overall capacity isn’t her main concern. She’s worried about the stress of staff who take care of COVID-19 patients. People hospitalized for coronavirus generally require a much higher level of care than other patients, and staff must wear lots of protective equipment throughout the day to treat those patients.

“The staff are tired. We are all experiencing fatigue,” Espinoza said.

‘Really harrowing experience’

Clark County Public Health Officer Dr. Alan Melnick said the number of new cases and hospitalizations is “scaring the crap out of me.”

His staff has been strained by the amount of new cases.

“When you’re faced with a situation that is overwhelming, you’re continuously behind in trying to catch up,” Melnick said.

That feeling metastasized in November as confirmed cases, hospitalizations and deaths broke county records. One demoralizing moment arrived Nov. 17, when Public Health announced it had to scale back contact notification efforts.

In previous months, Public Health was able to reach out to all confirmed COVID-19 cases to go over isolation protocols, and also do the same with close contacts.

Public Health no longer identifies, notifies and monitors close contacts, just confirmed cases. Melnick said the number of cases has overwhelmed Public Health’s ability to do that work, and also made contact notification less effective.

“It’s not a good use of resources anymore,” Melnick said.

Instead, Public Health is asking confirmed cases to reach out to close contacts on their own. Multnomah County, which is home to Portland, recently took a similar approach.

In statement from Nov. 17, Melnick said that on many occasions cases are already notifying their close contacts quicker than Public Health is able to.

“We believe these changes will allow us to more quickly interview cases, ensure they are isolated while contagious, and identify priority locations that may need our help to prevent or mitigate an outbreak,” Melnick said in the statement.

The large number of new cases makes it more difficult to cull exposure data, or find out where people are being exposed to the virus.

“Once you get to this number of cases you’ve got broad community transmission,” Melnick said.

There’s still three major holidays that haven’t been factored into the newest numbers yet. Melnick said this pace of infections is not sustainable.

His staff has felt the impact. Public health agencies already operate with budgets and workforces that have been cut dramatically since the 2008 recession. Melnick said one manager at Public Health recently turned in a time card that had 140 hours worked over two weeks.

“We’re not immune to some of the morbidity and mortality around us,” Melnick said. “It is really a harrowing experience. It can be almost demoralizing at times.”

Columbian staff writer