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Published in Health Care

Health care officials issue warnings as unvaccinated, deferred care patients push capacity

BY Sunday, November 21, 2021 07:00pm

Health systems and emergency medical service agencies in a 13-county region of West Michigan say they are at a “tipping point” from high patient volumes.

The Region 6 Healthcare Coalition warned in an open letter last week that people can expect longer wait times at emergency rooms, urgent care centers and primary care offices as well as prolonged ER stays while waiting for an inpatient bed if they need to be admitted.
Patients can also expect delays in ambulance transfers and deferrals of surgeries and procedures, according to the coalition.

The problems result from a steady rise in COVID-19 patients and hospitalizations that have occurred since summer, as well as an increase in people now seeking treatment for a condition after they previously deferred care.

“The health care systems within Region 6 are at a tipping point — our individual and collective resources are being overwhelmed, and we need our communities to help to get back on track,” Region 6 Healthcare Coalition Medical Director Dr. Jerry Evans wrote in the letter, which was one of multiple warnings from area health systems last week. “The hospitals and EMS systems in our region are operating at extremely high capacity — and have been for weeks. While other areas of the country have seen the number of patients with COVID-19 decline, our numbers are on the rise. We are also seeing more patients with other serious health issues that cannot be further delayed or ignored.”

The Region 6 Healthcare Coalition consists of health systems and EMS providers in Clare, Ionia, Isabella, Kent, Lake, Mason, Mecosta, Montcalm, Muskegon, Newaygo, Oceana, Osceola and Ottawa counties.

Leaders at Spectrum Health also reported last week that the Grand Rapids health system’s hospitals across the region were nearing capacity because of the ongoing influx of patients, including those whose conditions worsened after delaying care.

“The challenge is (that) COVID is so much more now and the volume is so much more that it throws hospitals across our state well over what is a manageable capacity. That makes it really challenging not only to care for COVID patients, but to give the best care possible for people without COVID,” Spectrum Health West Michigan President Dr. Darryl Elmouchi said. “We have not experienced anything like this throughout the entire pandemic: The combination of non-COVID acuity and volumes, coupled with dramatically increasing COVID care.”

Spectrum Health last week received approval from the Michigan Department of Health and Human Services for an emergency request to add 28 temporary inpatient beds at Butterworth Hospital. In its request to the state, Spectrum Health said occupancy is “surging beyond capacity due to the number of COVID-19 patients we are caring for, but also, what we believe is deferred care because of the global pandemic.”

Spectrum Health’s average occupancy of 63 percent increased to 91 percent “in a matter of weeks and we expect this to continue,” the health system said.

After delaying care, patients now seeking treatment are often sicker, resulting in an acuity level — or the severity of a patient’s illness — “higher than it’s ever been persistently at Spectrum Health,” Elmouchi said.

At one point last week, a state database listed some Michigan hospitals at 100-percent capacity and several others above 90 percent.

Among the patients hospitalized with COVID-19 at Spectrum Health earlier this month, 85 percent were unvaccinated, Elmouchi said while urging people who have yet to get vaccinated to do so. Of the patients on a ventilator, 95 percent were unvaccinated, he said.

Staffing shortages

The high patient volumes from COVID-19 cases and pent-up demand, coupled with acute staffing shortages, are further stressing health systems’ ability to provide care. A story last week in Crain’s Business Detroit also highlighted how a federal Centers for Medicare and Medicaid rule requiring health care providers to mandate a COVID-19 vaccine for employees by Jan. 4 could worsen the staffing shortages for small, rural hospitals.

“Our team members are exhausted and are doing their very best to care for our communities,” wrote Evans, who is chief of emergency medicine and medical director at Mercy Health Muskegon. “It is important to note that the strain on our system is due to the COVID-19 response, plus the many other demands our teams are facing to care for seriously ill patients. If more people were vaccinated, that would help reduce the number of COVID-19 patients, as most of the COVID-19 patients in the (emergency department) and admitted remain unvaccinated. This is impacting our ability to care for those who are seriously injured in a car accident, suffer a heart attack, stroke, or experience another medical emergency or issue.”

Evans urged people to use urgent care centers or their primary care physicians for non-emergency care, to follow COVID-19 safety protocols, and to get vaccinated if they haven’t already. He also worried about the potential for flu outbreaks on top of the present COVID-19 case surge.

Directors at Holland Hospital last week issued a similar letter to the community, pleading for people to “do what you can to help.”

“The pandemic has absorbed much of our energy, time and resources over the last 19 months. People ask us: ‘How are things going at Holland Hospital?’ The answer is we are feeling that strain now more than ever,” according to the Holland Hospital letter. “Our community is experiencing a period of increased serious illness taking a toll on Holland Hospital’s team and resources, and the challenges we face impact the entire community.”

The U.S. Centers for Disease Control and Prevention reported last week that Michigan was the worst COVID-19 hot spot in the nation.

In an economic outlook last week, a University of Michigan epidemiologist said COVID-19 cases have been rising this fall in every state — and the younger, school-age population is driving transmission.

“The big concern is we’re starting to move into the big holiday wave for 2021,” said Marisa Eisenberg, an associate professor of epidemiology at University of Michigan’s School of Public Health. “That is the big concern on everybody’s mind for the near term.” 

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