On Friday, Springfield’s two major hospital systems, Mercy and CoxHealth, issued a strong warning to the public: They are drunk due to a wave of COVID-19 patients, and it is also starting to affect non-COVID patients.
At a news conference Friday, health officials said admissions have risen in the cloud this week. Hospitals have started mixing dates for optional surgeries to maximize staffing, but the lack of beds and staffing also affects acute and acute care.
Leaders from both hospitals as well as from Greene County and the City of Springfield once again asked Missouri Governor Mike Parson to issue a statewide mandate to help control the spread of coronavirus, saying the spiral-shaped numbers lead to potentially bleak scenarios.
Dr. Shawn Usery is the Chief Medical Officer of CoxHealth. He cited the example of a patient from Texas County in southern Missouri who had a neurological emergency and nearly died because all major hospitals in the region were full.
“We can not accept these patients locally. They end up going, as I think most people have heard, to other states, ”Usery said.
To give an idea of how fast hospitals are filling up, CoxHealth had about 130 COVID patients on Monday. By Friday, it had risen to more than 160.
“We have worked to add capacity to a larger number of patients. Within the next few weeks, CoxSouth will have added an additional 147 beds. It is equivalent to a medium-sized hospital, ”said Usery.
Preparation for the extraordinary: rationing of life-saving healthcare services
Both CoxHealth and Mercy have begun preparing for the extraordinary goal of rationing emergency or critical health care, if they have to. This is where doctors have to withhold treatment from some patients to treat others due to lack of resources.
Springfield hospitals do not need to ration emergency or critical care yet, the leaders said at Friday’s press conference – but due to the lack of staffing and space, they have the difficult ethical conversations as the number of hospital admissions is rapidly going in that direction.
A pandemic is exactly the type of situation that can lead to a lack of trained staff, critical care beds or equipment such as fans. When a hospital runs out of these life-saving resources, it becomes impossible to treat all patients – so hospitals are forced to “rationize” their health resources and prioritize some patients over others based on a set of ethical criteria.
According to the National Institutes of Health, bioethicists have traditionally recommended allocating resources primarily based on a patient’s chances of surviving discharge to the hospital. This means that patients who fall into a demographic that are less likely to eventually heal and be discharged – such as the elderly or people with disabilities – could ultimately be denied access to potentially life-saving treatments while these resources go towards younger and healthier patients.
Dr. Mayrol Juarez is a critical care physician and vice president of hospital-based services at Mercy Springfield.
“So far, and fortunately, we still have the resources to take care of our community. But as this process progresses, we have a plan in place where we will have to have challenging conversations, always take care of society and have our most ethical approach to it, ”Juarez said.
As an example, Juarez said that one thing that medical teams are preparing for is how to approach a patient’s family to express in detail the clinical condition and prognosis of their loved one and determine if it is possible to “put a patient in challenging situations that just make their lives get stuck. ”
At this point, they have not needed to have those conversations yet, Juarez said.
“But if we do not intervene now, we will get there soon,” Juarez said.
A Springfield COVID nurse: ‘Who cares for them?’
Wanda Brown is a registered nurse with Mercy Springfield, who works at one of the hospital’s COVID units.
She describes herself as “just one of many nurses who have held the hands of patients who have died unnecessarily from this unforgiving virus.”
Mercy Springfield has already moved three of its devices and the ICU from taking normally acutely ill patients so it can care for COVID patients, Brown said.
“We are running out of space. Not only for our COVID patients, but also for our other acute patients. So we ask again: where are these patients going and who will take care of them? Said Brown.
On Friday, Brown joined the chorus of local authorities and health leaders to ask the public to change their behavior by wearing masks, keeping their distance and staying home whenever possible.
“I know we have all heard statements about how hospitals are not overwhelmed and our ICUs are not full. But this is untrue. And that’s misleading. And I think it gives a false sense of security to our society. It does not represent what our property really is. The reality is that our beds cannot be occupied without staff to take care of these patients. And the available beds are full, ”she said.
Many of the COVID patients at Springfield hospitals live in rural counties outside the Springfield area.