As the United States adds a new coronavirus case every second, hospitals from West Texas to Wisconsin are overwhelmed with the soaring number of critically ill Americans.
In many cases, it’s not a lack of hospital beds, therapies or equipment that worry managers amid the surge, with more than 229,000 deaths from COVID-19 in the U.S. It’s the depleted and exhausted hospitals staffs needed to care for those who need life-sustaining therapies.
The head of the Utah Hospital Association this week warned the situation is getting so dire hospitals there might soon need to ration care. Hospitals in North and South Dakota are seeking staff reinforcements to care for patients in crowded intensive care units. And in Wisconsin, hospitals are opening makeshift ICU wings even as they desperately look fornurses and other clinicians to staff the facilities.
“We can keep converting ICU space,” said Jeffrey Pothof, an emergency room doctor in Madison, Wisconsin. “But the constraint will be the staffing … that’s the thing that worries us the most right now.”
More than 536,000 Americans tested positive for coronavirus over a 7-day period ending Thursday, a new one-week record. Another 46,000-plus were hospitalized as of Thursday. And perhaps more troubling, the share of positive cases is increasing in 41 states – a sign cases are on the upswing.
The worsening outbreak, fueled by Americans’ coronavirus fatigue and inconsistent mask wearing and distancing, means hospitals need more doctors, nurses and therapists to fill shifts. Not only do hospitals need extra workers to handle the surge, they also need to replace shifts when their own staffers are sick or quarantined.
But with the virus accelerating in so many states at the same time, hospitals nationwide are tapping the same limited pool of travel nurses, therapists and other clinicians who sign contracts to fill shifts on a temporary basis.
Rising cases in Phoenix, Arizona, in June and July made the nation’s fifth-largest city the epicenter of a summer surge that spilled over to other Sunbelt states. Because cases were largely under control elsewhere, Arizona recruited out-of-state travel nurses and respiratory therapists to temporarily fill shifts in crowded ICU units
With contract workers working side by side with full-time staffers, Arizona hospitals averted the deadly initial surge that overwhelmed New York hospitals during the early days of the pandemic.
Banner Health, Arizona’s largest health system, recruited more than 1,000 contract nurses and respiratory therapists from June through mid-July. Without those extra trained workers, the hospital might have used similar measures that Utah hospitals are now considering – rationing care.
Banner Health CEO Peter Fine worries hospitals can’t depend on stopgap staffing again.
“The real issue is staff burnout,” Fine said. “It’s a very real phenomenon and with a countrywide breakout we no longer can count on contracted staff to save us.”
‘More jobs than we could ever fill’
Staffing agencies that place travel nurses in hospitals and clinics say they’ve never been busier. In the past four weeks, RN Network, part
Atlas, a neuroradiologist, not an infectious disease expert, strongly supported a decision in August to revise federal guidelines to de-emphasize the need to test people without symptoms, according to two sources familiar with the process. He shared his view with state officials, including Republican Gov. Ron DeSantis and several others in Florida, according to transcripts of public events and accounts from private meetings in that state.
“The purpose of testing is to stop people from dying,” Atlas said during one stop, captured on video. “When you start introducing closure of schools because people have positive, asymptomatic tests, that’s sort of not the purpose of testing.”
“I think, Dr. Atlas, we’re in agreement on focusing strategies in school on people who are symptomatic,” DeSantis said in another joint news conference that day.
Their push to de-emphasize tests coincided with a dramatic drop in testing across Florida, even as the country was careening toward a fall coronavirus surge. A CNN analysis of the Florida state official numbers, aggregated by the Covid Tracking Project, shows that testing dropped off at the end of July and early August, with a peak seven-day average over 90,000 tests per day on July 18. Six weeks later, in early September, the seven-day average dropped by nearly half, with fewer than 48,000 tests per day, and hovered between there and 60,000 during the fall.
If Atlas and DeSantis’ advocacy in Florida is, in fact, responsible for the state’s testing decrease, that would be in keeping with the wishes of Trump, who for months has falsely suggested that the US has so many coronavirus cases only because it conducts so many tests. In June, Trump even said publicly that he wanted to “slow the testing down, please.”
Though both Atlas and DeSantis declined to discuss their views with CNN for this story, they have articulated them in public. Some state and local officials believe the pair was influential in taking Trump’s anti-testing pronouncements and helping to turn them into public policy. And the drop-off in testing is of deep concern to some. It took place as positivity rates remained high, in the range that the Centers for Disease Control and Prevention considers indicative of high community spread.
Asymptomatic Covid-19 carriers are still contagious, experts say. A lack of widespread testing makes it harder to map the disease as it spreads and to warn those at risk of illness.
“There’s no question more people are going to die,” says Miami Beach Mayor Dan Gelber, a critic of DeSantis’ approach to testing and other matters of the governor’s pandemic management. “We are flying blind without tests.”
At the moment, the nation is experiencing another surge of illness. Daily case numbers are reaching levels not seen since late July, and Florida is starting to see its numbers go up as well. Experts say that widespread testing, including of asymptomatic carriers, is critical to limiting the spread of the virus.
A White House spokesman claimed Atlas had never advocated reducing testing, despite the
WEST ALLIS, Wis. — A hospital in Idaho is 99 percent full and warning that it may have to transfer coronavirus patients to hospitals in Seattle and Portland, Ore. Medical centers in Kansas City, Mo., turned away ambulances on a recent day because they had no room for more patients. And in West Allis, just outside Milwaukee, an emergency field hospital erected on the grounds of the Wisconsin State Fair admitted its first virus patient this week.
More than 41,000 people are currently hospitalized with the coronavirus in the United States, a 40 percent rise in the past month, and cooler weather that pushes more people indoors is threatening to expand the outbreak still more. At least 14 states saw more people hospitalized for the virus on a day in the past week than on any other day in the pandemic, according to the Covid Tracking Project. Seven more states are nearing their peaks.
The nation has seen more people hospitalized at earlier points — during an onslaught of cases in New York City in April and in the Sun Belt in July — but the sharply rising numbers now are deeply worrisome, in part, because they are testing the limits of smaller hospital systems.
Patients are now spread more broadly across the country, with troubling hot spots from North Dakota to Kentucky. More people than ever are falling critically ill in rural areas, particularly in the Midwest and the Mountain West, where they must rely on hospitals that may have only a handful of beds. And experts worry that the growing numbers in need of hospital care will only get worse if cases continue to mount.
“I don’t really see any signs that things are slowing down and that concerns me a lot,” Caitlin M. Rivers, an epidemiologist at Johns Hopkins University, said. “It has to be our starting premise that it’s not going to slow down unless we force it to slow down.”
Even as hospitalizations and known cases of the virus have grown, daily deaths across the country have remained fairly steady at around 760 in recent days. But some experts fear that the rate of deaths is beginning to rise again. Upticks in deaths usually lag behind rises in cases and hospitalizations because of the time it takes for the virus to progress.
For families around the country, the mounting hospitalizations were frightening — and personal. Among the thousands of patients, there was a retired Air Force lieutenant colonel who had trouble catching her breath in Missouri, grandparents being treated in separate hospitals in Utah and a beloved uncle whose niece said he had been on a ventilator for five weeks in Wisconsin.
Amy Stadler, the niece, sat in a black minivan outside of the Milwaukee Brewers’ stadium this week as she waited for a nurse to swab her nose. She said relatives had collected messages for her uncle — who is gravely ill — to be shared if his condition were to grow even more
Montgomery County health officials confirmed 147 new COVID-19 cases Monday including a jump of 87 in active cases which pushed that total past 2,000.
According to the Montgomery County Public Health District, those 147 cases bring the county’s total number of cases to 12,991. Active cases are now at 2,030. The county’s number of COVID-related deaths remained at 144.
MCHENRY AND LAKE COUNTIES, IL — A spike in coronavirus cases and hospital admissions could mean Lake and McHenry counties could see an end to indoor dining or restrictions placed on sports activities as early as next week, health officials said Friday. Region 9, which includes Lake and McHenry counties, is teetering on the edge of the state’s thresholds that could trigger additional mitigations — all set up as a way to prevent the further spread of COVID-19.
McHenry County, in particular, has seen a steep spike in cases with the coronavirus positivity rate jumping nearly two percentage points in just one week. As of Oct. 14, the 7-day rolling average for COVID-19 positivity rate is 8.9 percent in McHenry County and 5.9 percent in Lake County, according to Illinois Department of Public Health stats.
Region 9 is currently at a 6.8 percent positivity rate — up from 5.6 percent a week ago.
Also on Friday, the state set a record for new coronavirus cases for a second day in a row totaling 4,554 new cases. Meanwhile, hospitalizations jumped more than 14 percent since the beginning of the week. And McHenry County was added to the state’s “watch list,” due to concerning trends in COVID-19 cases.
Similar health trends are cropping across the Chicago area and state health officials are urging mayors, police, state’s attorney’s office and other community leaders to take swift action to slow the spread of the virus as people, they say, are not abiding by rules set up to keep everyone safe and healthy.
“Public health officials are observing businesses blatantly disregarding mitigation measures, people not social distancing, gathering in large groups, and not using face coverings,” according to a news release from the state health department Friday.
Meanwhile, at least one school district in Region 9, Woodstock Community District 200, has decided to delay its move to hybrid learning due to COVID-19 trends. The school district only planned switch from remote learning to its hybrid model if McHenry County was on track on four of its COVID-19 metrics.
“According to the COVID-19 metrics provided by the McHenry County Department of Health, the county does not meet the metric for weekly count or new case increase. This number has increased for the previous two weeks and in fact has increased 51% for all of McHenry County residents and increased 42% for school age children in the last week,” District 200 Superintendent Mike Moan wrote in a letter posted on the school district’s website. “These significant increases caused the metric to fall short of the goal to move to hybrid instruction.”
In addition, area business owners are starting to worry what another shutdown could mean for their bottom line.
Melissa Blach, owner of Smoothology Smoothie Cafe in Crystal Lake, says her business has been destroyed by the pandemic, according to the Northwest Herald. Another shutdown for her cafe at 67 E. Woodstock Street if more restrictions are put in place for businesses in the county.