‘Triple whammy’
Yrmc grapples with influx of patients sick with viruses
Yuma Regional Medical Center is dealing with a “triple endemic” of COVID-19, respiratory syncytial virus and flu, causing long ER wait times and a shortage of beds.
The winter season is typically the busiest time for the hospital; however, the numbers have escalated much higher and much earlier than usual.
YRMC is being slammed with patients seeking treatment for COVID-19, RSV and the flu, leading to complaints of long wait times in the Emergency Department and delays in getting a bed.
From October to November, visits to the Emergency Department jumped by more than 1,000.
“It’s like this triple whammy, and it’s just overwhelming,” said Deb Aders, YRMC chief nursing officer and vice president of patient care services.
“There’s been a lot of people coming in. Our units are pretty full. We’ve been staying very full,” she added. “We are four weeks ahead. This is everything we usually see here in January, and we started already in November.”
This strain on the hospital and the local healthcare system prompted Tony Reyes, chairman of the Yuma County Board of Supervisors, to declare a state of emergency in the unincorporated areas of the county in response to an anticipated influx of asylum seekers and migrants due to the end of Title 42.
Title 42 is a Trump-era public health rule issued in March 2020 in response to the COVID-19 pandemic. Under the order, Border Patrol can turn away asylum seekers at the border or return them to their country of origin.
“The projected increase of asylum seekers and migrants has and will continue to strain the ability of medical staff and local hospital resources to provide essential and necessary medical care to Yuma residents as well as the migrant community,” the declaration states.
YRMC confirmed that the hospital is indeed strained due to the “triple endemic,” which refers to the combined viruses of COVID-19, RSV and flu. Although YRMC treats migrants brought into the Emergency Department by Border Patrol, the “triple whammy” of viruses circulating in the community is what is causing issues more than anything else.
Cases of COVID-19 are
going up, enough for the Centers for Disease Control and Prevention to raise Yuma County’s COVID-19 community transmission level to high.
YRMC had 25 patients hospitalized with COVID-19 on Wednesday. “It’s nowhere near the pandemic levels, but we had been under 10,” Aders said.
The pediatric cases of RSV went up almost 800 in the same timeframe. “It’s definitely a huge jump in the kids that we’re seeing for RSV,” Aders said.
“Parents have been hearing about RSV,” she added. “Some of the rush to the ED is because they’re afraid and they don’t know what’s going on.”
The flu numbers are the highest the hospital has seen in many years. “It’s even higher than, if you remember in 2019, which was a bad flu season. According to the CDC, this is the highest hospitalization for flu they see across the U.S. since 2010,” Aders noted.
In addition, YRMC is the only hospital in Yuma County that accepts ambulances. Legally, the hospital cannot turn away any patient, whether they walk in or come in by ambulance.
What YRMC isn’t seeing yet is a greater influx of migrants. “No, we’re not seeing any more than we normally see. Not right now,” Aders said.
LONG WAIT TIMES
Wait times in the Emergency Department depend on the day and time a patient arrives. They fluctuate constantly. Sometimes ambulances come in one right after the other or 50 people walk in within a 30-minute timeframe.
On average, wait times are from 4 to 6 hours from arrival to discharge for patients who are not admitted.
“That’s not saying it could be longer,” Aders said. “That’s not saying that you won’t have those days where I waited eight hours, 10 hours, because again, is it the day when all ambulances or when all the 50 people showed up?”
Patients are not seen in the order they come in. They are assessed when they walk in and treated based on the severity of their condition.
“We hate the wait times as much as anyone else, and we’ve been doing a lot of different things in the ED too, to bring them down, but when you have that volume, and then you have a full house for admission (patients waiting for available inpatient beds), it’s a whole constant circle,” Aders said.
ADDRESSING ISSUES
In response to the influx of patients, YRMC has expanded room capacity, extended hours and added additional nurses and providers.
To give patients options other than the Emergency Department, the walk-in clinics are now open seven days a week, 8 a.m. to 8 a.m. Monday through Friday, and from 8 a.m. to 5 p.m. on Saturday and Sunday.
The pediatric clinics have expanded their hours from 7 a.m. to 6 p.m. Monday through Friday, with one of them from 8 a.m. to 2 p.m. on Saturday.
A board-certified emergency pediatric physician is also available in the Emergency Department from 12 p.m. to 12 a.m.
WHAT YOU CAN DO
Sometimes going to the Emergency Department is not necessarily the best thing.
“I think sometimes people are just scared and can’t get into their physician’s office or their pediatrician,” Aders said.
After consulting with a pediatrician, Aders offered advice for sick patients and parents of sick children. Any child 3 months or less with a fever over 100.4 should go to the ER because of their age.
Infants should also go to the hospital if they are having trouble breathing or are belly breathing or having chest wall retractions (the chest “caves in” in between and under the ribs), are not drinking or eating and haven’t had a wet diaper for eight hours. Or if the soft spot on their head sinks in and they have dry lips, they should go to the Emergency Department.
If a child has a persistent headache or if they’re really excessively sleepy or fussy, despite the treatment of the fever, they should also be taken to the ED.
“Just the fussiness of the child, keeping the fever down, if you can’t keep it down and if they’re having trouble breathing, those are the big things to remember,” Aders said.
“But remember, the meds will take at least an hour to work,” she added.
She acknowledged shortages in children’s medicines. “We’ve heard that it’s difficult to find children’s Tylenol and Motrin now,” Aders noted. “Pediatricians are calling in prescriptions because that’s the only way parents can actually get children’s Tylenol and Motrin.”
For adults with flu, the best treatment is to get a prescription for Tamiflu as early as possible.
Those uncertain whether to go to the Emergency Department can call the hospital’s Careline to get health advice from registered nurses 24 hours/7 days a week: 928-336-CARE (2273).
Aders shared a reminder that flu shots and preventive measures are the best protection against illness. “I can’t stress enough about flu shots and washing hands and covering coughs, because again, those are things we all know,” she said.
“People really need to be cognizant of the holidays. They really need to think about it before they actually attend big events or family events. If you have grandma or grandpa or you have a newborn, they’re the hardest ones being hit right now, the elderly and the very, very young,” Aders noted.
If someone is not feeling well, but they feel they must attend an event, they should wear a mask and keep at a distance from others.
“Just to be safe for those that are around,” she added.