Sam Bereny, an EMT at Metro West Ambulance, administers a second dose of the Moderna vaccine at a drive-thru COVID-19 vaccination clinic at Centennial Park in Woodburn, Ore. on Thursday, April 1, 2021. (Amanda Loman/Salem Reporter)
On Friday morning, Salem Hospital passed a grim threshold. Eighty-one people were in hospital beds sick with Covid - the highest total since the pandemic began 18 months ago.
It’s more Covid patients than are in any other hospital in the state. Nearly all are from Marion and Polk counties, said Cheryl Wolfe, Salem Health’s CEO, and 70 were not vaccinated against Covid. Fourteen are so sick they’re in the hospital’s intensive care unit.
“These folks are really sick,” Wolfe told Salem Reporter. “They need a pulmonologist, they need cardiac assistance, they need monitoring.”
As hospitals around Oregon are sending patients to Boise and Reno for lack of beds or boarding people in emergency department hallways, Salem Hospital is weathering the state’s most serious surge of Covid patients - without diverting people elsewhere or rationing care.
Wolfe said the Salem community can expect they’ll be able to get care at the hospital if they’re in a car crash or have a heart attack, even as Covid numbers continue to climb.
Starting next week, the hospital will likely cancel a few elective surgeries that can be postponed without harming patients, Wolfe said. Setting up tents in the parking lot remains a possibility to care for patients who are aren’t asill if beds continue to fill.
“We’re beyond full,” Wolfe said. The hospital’s Friday morning census showed 477 of 494 staffed beds occupied.
Maintaining the hospital’s service is taking a toll on health care workers who are putting in more overtime to make sure beds can be filled.
“I just appeal to the community to understand that your health care workers are so exhausted,” Wolfe said.
The number of Covid patients in Salem has climbed quickly. One month ago, just six were in the hospital, Wolfe said. Two weeks ago, it was 22 people. By Wednesday, it had climbed to 65.
“I'm really concerned,” Wolfe said. “I don't see this wave stopping.”
She said getting vaccinated against Covid is the best way to stay out of the hospital.
Around Oregon, hospital and health officials say the situation is dire.
Thursday night, Jackson County asked state officials for help establishing a 300-bed field hospital where medical providers in Jackson and Josephine counties can divert non-critical patients, Jefferson Public Radio reported.
JPR also reported that Curry General Hospital on the southern Oregon Coast was sending patients as far as Reno, Nevada to get care, because there wasn’t room in the ICU.
Gov. Kate Brown announced on Friday that she was deploying up to 1,500 members of the Oregon National Guard to support frontline health care workers.
The announcement came on the back of new data on Friday that showed 733 Oregonians hospitalized with Covid, including 185 in the ICU.
“I cannot emphasize though the seriousness of this crisis for all Oregonians,” Brown said in a statement. “Especially those needing emergency and intensive care. When our hospitals are full with Covid patients, there may not be room for someone needing care after a car crash, a heart attack or other emergency situation.”
Beginning Aug. 20, 500 guard members are being deployed to hospitals around the state. Brown’s announcement didn’t specify where.
“The light we saw at the start of summer, it’s fading quickly and it feels like groundhog day. Now we’re back where we started all over again,” said Kevin Mealy, communications manager with the Oregon Nurses Association.
Mealy spoke with ICU nurses in some of Oregon’s hardest hit areas this week and said there’s a feeling the state is breaking all the wrong records.
A statewide nursing shortage is exacerbated by burnout and ongoing trauma.
“People are getting worse care from exhausted staff that are caring for two times as many patients as they would normally consider safe. We’re seeing workers leave the profession because they don’t feel it’s safe,” he said.
Mealy said the state is getting to a point where in some areas going to the hospital might mean heading to a tent at the fairgrounds.
In a joint statement Friday, professional organizations representing more than 4,700 Oregon physicians and health workers voiced their support for Brown’s renewed statewide mask mandate, and urged her to more quickly implement a rule requiring vaccination or regular Covid testing for health care workers. That rule is slated to take effect Sept. 30.
“Given the circumstances, the urgency of protecting the health of front-line health care workers and reducing spread from health care workers to others is more important than ever,” said the statement from the Oregon Chapter American College of Physicians, Oregon Chapter American College of Emergency Physicians, Oregon Pediatric Society and Oregon Academy Of Family Physicians. “Delaying action until the end of September puts front-line health care workers at risk and jeopardizes the ability of our health care infrastructure to meet the demands of caring for Oregon’s rising tide of COVID-19 patients.”
The Oregon Health Authority has set up a command center for hospitals to work together to ensure respiratory equipment can be repositioned around the state based on need, said OHA spokesperson Tim Heider.
Heider also said OHA is working in partnership with the Oregon Department of Human Services and long-term care facilities to move people who can be placed into community-based care facilities to free-up hospital beds
In addition, a nurse crisis team is being mobilized to help hospitals with the greatest demand and OHA is working with hospitals to expand patient care workforces in order to operate more hospital beds. Heider did not say where the nurses would come from given the statewide shortage.
Stephen Bomar, spokesman for the Oregon Military Department, said there haven’t been any discussions of turning the Oregon State Fairgrounds into an overflow hospital to handle a surge of Covid patients, similar to what was set up last March but went unused.
Mark Bjorklund, battalion chief for Marion County Fire District No. 1, said emergency services have still been able to take people to the emergency room in Salem.
“Transports are up, we’re seeing a lot of Covid patients. Not that’s impacted the ER numbers that we can’t take them there,” he said.
Ben Stange, chief of Polk County Fire District #1, said the only impact for their service has been sometimes longer waits at the emergency room to transfer a patient to the hospital’s care.
“We can’t leave a patient until they have a bed available in the ER so we from time to time end up with ambulances kind of stacked up with patients on gurneys trying to find an available bed,” he said. “That’s taking an ambulance out of service.”
It’s not just Covid patients keeping hospitals busy. Other pandemic-related factors have compounded the bed shortage, said Wolfe and Dr. Steve Vets, the chief medical officer at Santiam Hospital.
Many hospital beds are filled with patients who delayed care for serious chronic health problems like diabetes earlier in the pandemic. As a result, they’re now sicker and staying in the hospital longer.
Discharging patients from the hospital is also taking longer because of staffing shortages at skilled nursing facilities. That means fewer beds are open to take people who may need rehabilitation after a stroke, but don’t need hospital-level care.
Wolfe said Salem Hospital had 43 such patients Friday morning.
Other Marion County hospitals have few Covid patients. Legacy Silverton had just three on Friday, spokesman Brian Terrett said, and 24 total beds occupied out of 47 that are staffed.
He said Covid patients who need intensive care are admitted to Legacy’s hospital in Tualatin.
Santiam Hospital is so far managing, Vets said, though the hospital set a June record for the total number of patients who came through the emergency room, and again broke that record in July.
“We are kind of blessed that we’ve just dodged bullets over and over again, but sooner or later our number’s going to come up,” Vets said.
Though they’re licensed for 40 beds, Vets said he typically only has enough employees to staff about 20.
“It is truly day by day and sometimes shift by shift because the main issue is staffing,” he said.
The hospital has once or twice in recent weeks searched for care as far away as Coos Bay for patients they didn’t have space for, but Vets said they’re generally able to take care of people.
But after multiple surges of Covid patients over the past 18 months, Vets said he and the hospital’s staff are burning out.
“It is super fatiguing. In the first push … alls you had to do was just hold on until the vaccines get here. And now there’s no foreseeable end. There’s no cavalry to come save us. This is what we’re going to be dealing with for the foreseeable future,” he said.
Caitlyn May contributed reporting.
JUST THE FACTS, FOR SALEM - We report on your community with care and depth, fairness and accuracy. Get local news that matters to you. Subscribe to Salem Reporter starting at $5 a month. Click I want to subscribe!