While recent state data is still preliminary, early reports show COVID-19 hospitalizations throughout the state are up after the Labor Day weekend, pushing hospital leaders to continue their plea for residents to mask up, get vaccinated and be wary of mass gatherings.
At a news briefing Tuesday morning, Washington State Hospital Association CEO Cassie Sauer said that after the weekend, hospital officials counted 1,674 Washingtonians hospitalized with the virus, a 7% increase from last week. “Even more shocking,” she said, 251 of those patients are on ventilators, reflecting a 34% increase from last week.
“To be clear, a lot of these people are not going to make it,” Sauer said. The patients are “almost exclusively” unvaccinated individuals, or people who are immunocompromised, she said.
Julie Petersen, CEO of Kittitas Valley Healthcare, said during the news conference that her hospital in Ellensburg was full. While the hospital is not yet out of beds or supplies, Petersen said it is classified as full because its staffing shortage has worsened recently, exacerbated by the spike in delta variant cases.
She’s particularly concerned about the thousands of people who visited the area this past weekend for the Ellensburg Rodeo and parade, the Kittitas County Fair and the High Country Log Show in Roslyn. One county over, the Gorge Amphitheatre also hosted a Dave Matthews Band concert over the weekend, she said.
“I don’t believe there was a lot of masking going on, and our vaccination rate is about 50%,” Petersen said. More patients are expected as the week continues, she said.
Because of the large gatherings, Petersen added Kittitas County’s public health department will on Tuesday issue a statement encouraging anyone who attended those events to get tested for the virus this week.
About 20 new deaths were also reported throughout the state in the last week, Sauer said, adding that data is still preliminary due to a lag in reporting during the holiday weekend. In late August, the state was seeing a seven-day hospitalization rate of about 17.7 admissions per 100,000, compared to about 2.8 near the end of June and beginning of July, according to the state Department of Health’s COVID-19 dashboard.
There are some signs, however, help could be on the way for hospitals strained with staffing crunches.
Sauer noted a renewed push to expand the federal government’s emergency approval of monoclonal antibody treatment for mild to moderate COVID-19, which would be administered through a subcutaneous, rather than an infusion, route. The treatment would open up possibilities of a series of four shots, which is “easier to do and allows for more treatment centers to do it,” she said.
Monoclonal antibodies are laboratory-made proteins that mimic the immune system’s ability to fight off harmful antigens such as viruses, according to the Food and Drug Administration. The safety and efficacy of the treatment “continues to be evaluated for treatment for COVID-19,” the FDA said.
The treatment is the same one then-President Donald Trump received after testing positive for the coronavirus last fall. In addition to a dose of the antiviral drug remdesivir, Trump’s doctors gave him an eight-gram dose of two monoclonal antibodies through an intravenous tube. The experimental treatment required the FDA’s signoff at the time.
Now, Washington’s hospital association is urging the state to expand the kinds of providers that could give the monoclonal antibody treatment — potentially including pharmacies, clinics, ambulatory surgery centers and outpatient facilities — to take some pressure off hospital emergency rooms.
“We would like that treatment to be happening someplace else since the hospitals are so full,” she said. “We would also like to keep COVID patients who don’t need hospitalization out of the hospital so they’re not potentially spreading COVID throughout the hospital.”
In last week’s briefing, Sauer and other hospital leaders also mentioned the struggle to discharge patients who no longer need hospitalization. Nursing homes, assisted living centers and other care facilities are also short staffed, and have been largely unable to take patients in.
On Tuesday, however, Sauer said the hospital association is “very pleased” with the state’s efforts to move patients out of hospitals, including those on Medicaid. She added that there needs to be “continued work” on the issue, including potentially opening up alternative-care sites and using coronavirus-positive nursing home units.
About 10% of hospital beds throughout the state are being occupied by those who don’t have medical needs, she said.
“We need that capacity for people who have acute care needs,” Sauer said.
Pregnant patients with COVID-19 also continue to worry doctors as more and more data emerges about the infection’s risk to pregnancies, said Dr. Linda O’Neal Eckert, a specialist in infectious diseases in obstetrics at Harborview Medical Center.
She mentioned one particular study published in August that looked at more than 800,000 pregnant patients from nearly 500 hospitals across the country, comparing coronavirus-positive pregnant patients to coronavirus-negative pregnant patients.
“I am seeing risks for the pregnant individuals that I’ve never seen with any other event in pregnancy,” Eckert said, adding that the study reported pregnant patients with COVID-19 are 15 times more likely to die than pregnant patients not infected with the virus. The study also showed coronavirus-positive pregnant patients are 14 times more likely to be intubated and 22 times more likely to be pushed into early labor.
In Eastern Washington and in rural communities, hospitalizations remain on the rise, hospital leaders also noted. As of Tuesday morning, about 305 patients in the Spokane metro area are hospitalized with COVID-19, Peg Currie, chief operating officer of Providence Health Care, said during the news conference.
“Health care is not an unlimited resource,” Currie said.
Providence has stopped elective surgeries, including children’s surgeries, because the health care system is unable to staff them or doesn’t have the appropriate outpatient beds.
Statewide, certain non-urgent procedures continue to be canceled, including colostomy reversals and other “very serious care that people need,” Sauer added.
Across the Washington border, Currie said, Kootenai Health — a health care system in Coeur d’Alene, Idaho — has declared crisis standards of care. The hospital is 50% full of coronavirus-positive patients, mostly those ages 40 to 50 years old, she said.
The increased hospitalization trend means more and more local officials are going to be requiring proof of vaccination for nonessential public gatherings, Sauer said.
In King County, Executive Dow Constantine announced Tuesday that Public Health — Seattle & King County is working to develop a vaccine verification policy for some nonessential indoor business activities and other venues. Further details about the policy are not yet clear, but Constantine said in a Tuesday statement that it would go into effect sometime in October.
Clallam and Jefferson counties have already adopted some form of vaccine verification policies.
“We’re at a critical point in the pandemic,” Constantine said in the statement. “In a County where more than 4 out of 5 eligible residents have taken advantage of the opportunity to be vaccinated against COVID, vaccine verification is the best way for businesses and gatherings to remain open, vibrant, and at full capacity.”