The man, who arrived at the emergency room in Childress earlier this month, did not have COVID-19, but he had a severe stomach upset that required surgery, hospital administrators said.
The man waited more than nine hours in the emergency room while doctors called eight major hospitals to see if they could perform the surgery, said Holly Holcomb, executive director of Childress Regional Medical Center. They refused to accept the patient, she said, and the man died.
“I’ve been here 24 years and I just do not remember ever being able to transfer a patient,”
Rural doctors and hospital administrators in West Texas and the Panhandle say they are in a bind as larger hospitals in Lubbock, Amarillo and El Paso are filled with coronavirus patients, leaving the smaller facilities unable to transfer their most seriously ill patients to receive higher levels of care.
Texas is experiencing another wave of coronavirus admissions, an increase of more than 75% since early October. On October 28, there were more than 5,600 people with COVID-19 in Texas hospitals, a patient volume not seen since August, when the state experienced a fall in love with patients pushing some South Texas hospitals to their limit.
The recent increase has been strongly felt in El Paso, where executives recently converted a conference center into an emergency room to provide additional hospital beds that are so exceeded that some patients are flown out of town.
And in Lubbock, where Texas Tech University has reported more student infections than any other university in the state, as doctors warn hospitals are full.
And in Amarillo, where dozens of nurses have recently had to miss shifts because they either became ill with coronavirus or were quarantined due to exposure and stretched hospital beds thin.
But the consequences of Texas’ burgeoning “fall wave” of the coronavirus pandemic extend hundreds of miles beyond these remote cities. The rural areas of the surrounding Texas plains and arid regions are not immune to the spread of the virus, with many small towns reporting highlights from time to time for coronavirus cases.
And even in rural counties that have yet to see a wave of infections, health professionals warn that the spread of the virus could threaten the health of any patient experiencing life-threatening emergencies: a heart attack, a stroke, a car wreck.
Fewer than half of the state’s rural hospitals perform surgeries or give birth to babies, said John Henderson, executive director of the Texas Organization of Rural and Community Hospitals. When city hospitals fill up, it puts pressure on smaller facilities to find beds for patients in crisis.
“When you are a small, rural, isolated hospital, and you have a patient who not only exceeds your staffing capacity, but your range of service functions, it becomes really difficult,” Henderson said. “Rural hospitals are trying to make it, but it’s never been harder than it is right now for most of the West Texas, South Plains and Panhandle.”
In Childress, the hospital’s six-bed emergency room is stretched out thin, Holcomb said, and healthcare professionals have asked patients with COVID-19 symptoms to wait in their cars whenever possible. “They pile up either in the waiting room or out in the parking lot,” she said.
Small-town physicians throughout Texas report that they must keep extremely ill patients in emergency rooms and ambulances for eight hours or longer due to lack of beds in the intensive care units of major hospitals. And many say they have had to look for special care hundreds of miles away, sometimes across state borders.
Dr. Robert Hancock, who works at several hospitals in Texas and Oklahoma and is president of the Texas College of Emergency Physicians, said one of the hospitals recently hospitalized a COVID-19 patient with a number of other medical problems that needed special treatment.
“We had called every hospital in Oklahoma that had the capacity we needed, every hospital system in Dallas-Fort Worth; Little Rock, Arkansas; Lubbock; Amarillo; Wichita Falls, ”Hancock said.
“Over an eight-hour period, we were told ‘No’ by everyone,” he said. “We settled on having to keep the patient and just do the best we could, with the resources we had.”
As winter approaches, icy roads and the flu season are also threatening. Along with rising coronavirus infections, executives of Eastland Memorial Hospital, located near Interstate 20 between Fort Worth and Abilene, are headed to prepare for a very busy four-month stretch.
“It’s pretty much all hands on deck here in Eastland,” said Ted Matthews, the hospital’s chief executive, adding that the county is already “running at virtually a peak time” for COVID-19 cases. Eastland County, home to fewer than 20,000 people, has a daily average of about 50 active quarantined infections and exposures, Matthews said.
The hospital transfers about 45 patients each month, and Matthews said he keeps an eye on capacity in nearby cities. So far, it has been less of a threat than a more pressing issue: his own staff fell ill with COVID-19.
“We take care of our community at this point, but it’s always a problem to have the number of employees we need, so when we lose two or three really good nurses, we have our backs to the wall,” he said.
Jerry Jasper, CEO of Brownfield Medical Center, located about 40 miles southwest of Lubbock, said the hospital’s capacity is the most pressing issue facing his community.
The 18-bed hospital is struggling with its own influx of COVID-19 patients. Doctors and nurses who are able to care for these patients except those who need a ventilator, Jasper said. But the unpredictability of whether Lubbock hospitals are able to accept transfer patients makes it difficult to plan emergencies.
“If we get into a situation and need to transfer someone out who needs services over what we can offer here, it is very worrying,” he said.
In Deaf Smith County, which borders New Mexico southwest of Amarillo, a local shortage of beds in nearby towns has alarmed. The county is home to beef processing plants, several state roads and a short stretch of Interstate 40.
“I made a pretty deep warning to our community that I was afraid we’re going to get to a point where we’re having a hard time finding a place to transfer someone to,” said Jeff Barnhart, the county’s executive director. hospital district. “We’ve been sitting on ICU patients for four or five days because we had nowhere to send them to.”
Whenever possible, he has sent patients by plane to Dallas, Fort Worth, Albuquerque and even Oklahoma City, but he fears the day when there is no helicopter available for the trip.
“I’m afraid I want an ambulance out on the road soon and it’s going to be a 16-hour ride,” he said.
Disclosure: The Texas College of Emergency Physicians and Texas Tech University have been financial supporters of The Texas Tribune, a nonprofit, nonpartisan news organization funded in part by donations from members, foundations, and corporate sponsors. Financial supporters play no part in Tribune’s journalism. Find a complete list of them here.