WAITING FOR CARE
About 98 percent of Texas ICU beds are full, with 43 percent used for virus cases
As COVID patients overwhelm hospitals, those with other medical issues delay treatment.
When Jazz Paz learned that the 93-year-old woman she takes care of waited 24 hours for a hospital bed, she choked back tears.
The woman’s family hired Paz, a retired nurse, to be a companion for the woman back in February. Paz found her absolutely endearing. She laughed at her quick wit, keenly listened to her childhood stories about living through the Great Depression and was impressed that someone her age was exercising daily.
“Every day I was just amazed at how strong this woman was mentally and physically,” said Paz, 69, of Southwest Houston. “She didn't have any indications of being sick until she got this urinary tract infection.”
Given the woman’s age, her family and her doctor had pause about sending her to the hospital while the ICUs were near capacity, Paz said. Initially, they decided to treat her with antibiotics and keep her at home when she became ill.
Data suggests that Paz and her client family’s decision wasn’t unfounded. About 98 percent of Texas ICU beds are full, and of those full beds 43 percent are used for COVID-19 patients, according to the Southeast Texas Regional Advisory Council, which oversees a 25-county hospital preparedness region including the Houston area.
The majority of hospitalized COVID patients — 86 percent — are unvaccinated, according to the Peterson Center on Healthcare and Kaiser Family Foundation.
Meanwhile, as hospitals across Texas and the nation fill and emergency rooms and ICUs are crowded with COVID patients, those with other medical needs, like Paz’s client, are left waiting.
A ‘dire situation’
“We're still in a very dire situation, the hospitals are absolutely full, the emergency departments are full,” said Dr. David Persse, the chief medical officer for the city of Houston, where hospital occupancy closely reflects the state trend. In Harris County, 98 percent of beds are full, with COVID patients occupying 39 percent of those beds, according to SETRAC
“There are so many people that didn’t take their shots, and now they are overwhelming the system. I’m just very angry that my friend is coming home on hospice because she couldn’t get the immediate care she needed.”
Jazz Paz, retired nurse
data as of Friday.
“The ambulances are having prolonged times to offload patients, because there's no room in the emergency department, and the situation is very bad,” Persse said.
Paz’s client became one of those patients waiting. She didn’t respond to the antibiotics and the infection reached her blood, so she had to be hospitalized a couple of days after her diagnosis. She returned home on hospice after four days at the hospital. Paz said it was the right decision keeping her out of the hospitals, but wonders if she would be coming home on hospice if she had gone to the doctor earlier.
“There are so many people that didn’t take their shots, and now they are overwhelming the system,” Paz said. “I'm just very angry that my friend is coming home on hospice because she couldn't get the immediate care she needed.”
Paz and her client aren’t the only ones.
Daniel Wilkinson, a U.S. Army veteran who earned a Purple Heart in Afghanistan, went to the hospital in Bellville, west of Houston, to be treated for gallstone pancreatitis, a treatable condition in which a gallstone blocks the pancreatic duct and causes inflammation. For nearly seven hours, Wilkinson waited.
Multiple hospitals told his doctor they didn’t have a bed for him because they were taking care of so many COVID patients, according to news reports. By the time a bed in a Houston V.A. hospital opened, it was too late. Wilkinson died the next day at only 46.
This problem isn’t unique to Texas. Martin DeMonia of Cullman, Ala.,died of a cardiac emergency after not being able to get a bed. Hospital staff contacted 43 hospitals in three states in search of a Cardiac ICU bed and finally located one in Mississippi, according to his obituary.
Managing crisis
The effects of the overflow are felt before patients even step foot in a hospital. During COVID spikes, first responders have kept patients on stretchers for up to five hours waiting to transfer care, Persse said. It has since improved, but wait times remain.
On a Wednesday afternoon in mid-September, about 26 out of the city’s 104 ambulances waited in emergency environments across the region — six for more than an hour.
“This hospital overcrowding we’re dealing with was and is 100 percent preventable,” Persse said. “Many of those people (in the hospital) were exposed by somebody who was unvaccinated. So, almost all of these COVID admissions could have been avoided if people got vaccinated.”
About 59 percent of Texans are fully vaccinated, according to data from the Centers for Disease Control and Prevention. In Harris County, 62 percent of the eligible population — those who are 12 or older — are fully vaccinated, according to the Texas Department of State Health Services.
About 128 patients were waiting for an ICU bed on Aug. 19 in the SETRAC 25county area, the highest level that month. In September the peak was 95; it’s currently about 65. Although, it's an improvement, it’s still above prepandemic levels, when fewer than 20 people waited at a time.
The recent decrease in the number of patients waiting is due to the hospitals’ ability to adapt, rather than a downturn in COVID cases, which continue to plague the area, said SETRAC CEO Darrell Pile.
Some have received additional beds as they hired more nurses. And many hospital administrators tell Pile they have been able to shorten COVID patients' stays in the ICU with medications to treat symptoms and more beds staffed in the general hospital.
“The hospitals are doing a fine job managing this terrible crisis,” Pile said, “but the volume remains extraordinarily high.”
There are 310,411 active COVID cases in Texas, according to the Texas Department of State Health Services, including 56,985 in Harris County.
Triage and solutions
Anyone who thinks they need urgent medical attention should seek care, Pile said. He recommended calling 911 and describing their symptoms to the paramedics who can determine if they need hospital level of care.
Other medical experts, like Dr. Jill Weatherhead, assistant professor of pediatrics at Baylor College of Medicine, recommend telemedicine.
“Patients have definitely held off on routine screenings and seeking medical care to limit their exposure,” Weatherhead said. “One thing that is being done is telemedicine. It ensures that patients are able to be in contact with their provider.”
Danielle Rushing, 51, of Hunters Creek, has found telemedicine helpful when deciding whether to send her 76-year-old mother to the hospital.
Her mother stays at Belmont Village Senior Living, which started using a telemedicine platform specialized for urgent care since the onset of the pandemic , leading to an 85 percent drop in emergency room visits among residents.
Rushing said she used the platform four times, and its helped her determine when it’s necessary to take her mother to the emergency room. After a bad fall, doctors determined it was necessary to go to the emergency room. But the screening did save her at least one emergency room trip: When Rushing’s mother experienced stomach issues and lost her appetite, Rushing grew concerned she had a UTI and took her to the hospital.
As the symptoms persisted she wondered if she’d have to take her again. Together, Rushing and her mother decided to use the telemedicine program again.
In addition to the standard video chat with a health professional, the telemedcine apparatus included machines to capture the patient’s vitals and other medical equipment.
“They ran the test and assured me that she didn’t have to go to the ER again,” Rushing said, “And that to put her in the ER again during COVID when there are (limited) hospital beds available would be very distressing for her.”
Eventually, COVID cases will be low enough where people like Rushing and Paz won’t have to debate whether to send loved ones to the emergency rooms, Persse said.
In the mean time, people need to get vaccinated so the health care system won’t be flooded with COVID cases, he said.
“We clearly failed at that because hospitals are completely overwhelmed,” Persse said. “This impacts not only patients who have COVID but all the patients who have any other medical problems for which they would need emergent care.”