A surge in COVID-19 patients is stretching thin hospital resources from beds to staff and putting local and regional health care systems in a precarious position.
“We are on the verge on what they call crisis standards of care, where the demand is greater than what our resources are able to handle,” Island Hospital CEO Charles Hall said in a community briefing Thursday. “This is true for almost every hospital in Washington state.”
Hospitals in Skagit County are seeing an increase in emergency room visits, with longer wait times in some cases. Patients with COVID and non-COVID issues are filling up emergency departments.
In addition, some hospitals are dealing with staff shortages, while preparing to meet the state’s Oct. 18 deadline to have 100% of their employees fully vaccinated.
As hospitals fill with COVID patients, there are concerns about having the available resources to care for patients with non-COVID medical emergencies, such as heart attacks or strokes.
“Our staff and providers are strained,” Hall said at the briefing. “They have been at this 18 months, caring for the ill and injured.”
Hall reported in his briefing that both COVID-19 cases and hospitalizations are at an all-time high in Skagit County. In the past week, there were 17 new hospitalizations per 100,000 people in Skagit County, well beyond levels from last winter, he said.
Up until August, there had been no COVID-19 deaths at Island Hospital. In August, the hospital recorded four deaths, and another in September, Hall said.
Statewide, about 94% of those hospitalized for COVID-19 between February and mid-August were unvaccinated, according to data from the state Department of Health. About 92% of people who died from COVID-19 in roughly the same time frame were unvaccinated.
About 93% of positive COVID-19 cases are among the unvaccinated, according to the state’s data.
At the Thursday community briefing, Island Hospital Chief Medical Officer Dr. Jason Hogge noted that while some vaccinated people still may become infected, vaccinations strongly protect against severe illness and hospitalizations.
With an influx of patients, some hospitals have had to activate “diversion status” — a scenario in which they turn away incoming ambulances and divert them to other hospitals, Skagit Emergency Medical Services (EMS) Director Josh Pelonio said.
In August, Skagit Valley Hospital and PeaceHealth United General Medical Center had to divert ambulances on eight occasions for a total of nearly 30 hours, according to a report from Skagit County EMS.
According to the report, ambulances were diverted for an average of several hours, but on two occasions, had to be diverted for a period of about six hours.
On Sept. 1, both Skagit Valley Hospital and United General Medical Center went on diversion status at the same time, and at least two patients were sent to Island Hospital, Pelonio said.
Hospitals are trying their best to avoid diversion, which can delay patient care.
“It’s been something we’ve tried not to do, but have needed to do for staffing and space availability a couple of times,” Skagit Valley Hospital Chief Medical Officer Dr. Connie Davis said.
She said the hospital may need to send a patient elsewhere if the patient requires a certain piece of equipment or type of bed.
As of Friday afternoon, the 137-bed Mount Vernon hospital had 135 patients — a nearly 99% occupancy rate, according to a Skagit Valley Hospital spokesperson.
Davis said the hospital has canceled some elective surgeries, but is doing so on a case-by-case basis.
“(Our staff) look at the severity of medical illness,” she said. “You don’t want to put off (treatment for) somebody who has cancer. What we are trying to do is prioritize those people medically, and schedule them accordingly.”
She said the hospital is looking to move more procedures to outpatients facilities, where hospital admission is not required.
In Sedro-Woolley, the 25-bed United General Medical Center is at 94% occupancy, according to PeaceHealth spokesperson Anne Williams. She said the hospital sends COVID-19 patients requiring hospitalization to PeaceHealth St. Joseph Medical Center in Bellingham.
“Should we experience a significant regional surge, (United General Medical Center) could be used as a satellite COVID care facility,” she said in a email. “We have seen a 300% increase in COVID-positive cases in our ER over the past two months.”
Williams said the hospital has also had to go on diversion status because of a crowded emergency department, “but fortunately this happens infrequently and we are able to care for those who seek it with minimal delays.”
As other hospitals throughout the region deal with their own capacity issues, it creates additional burden on local hospitals.
Island Hospital spokesperson Laura Moroney said the hospital has been accepting patients sent from hospitals outside Skagit County.
“It’s really a collaboration of hospitals in the region saying ‘Hey can you take our patients?’ and it’s getting harder and harder to do that,” she said.
Pelonio said if all three Skagit County hospitals were to go on diversion status, EMS personnel would look to transfer patients to out-of-county hospitals. That could not only further delay patient care, but because EMS personnel would need time to return to their service areas, it would delay response on the next emergency call, he said.
He said as patient volumes exceed available resources, it’s frustrating not only for health care workers but for EMS personnel.
“You take them to the hospital and it’s busy and they don’t get their care right away,” he said. “That’s a frustrating situation to be in.”
He said in his 16 years working in EMS, he has never seen the regionwide capacity challenges hospitals are facing now.
Meanwhile, the situation has worsened in neighboring states.
Some hospitals in Idaho have activated crisis standards of care — where health care is rationed and not everyone is guaranteed care — because there are more patients than the system can handle, the Associated Press reported.
Locally, hospitals are asking for the community’s help to avoid that scenario.
“Please get vaccinated, wear a mask, isolate and get tested if you have COVID-like symptoms,” Hall said in an emailed statement to the Skagit Valley Herald.
Davis said staff at Skagit Valley Hospital are continuing to support one another and getting creative in how they care for patients. However, she said staff are also tired and frustrated because the current surge of COVID-19 patients was preventable.
She echoed the request to get vaccinated.
Pelonio said people experiencing a medical emergency should still call 911 and not delay care. For non-emergency medical issues, he encourages people to reach out to their primary care physicians or visit an urgent care or walk-in clinic.