Hospital exec: Surge the worst yet

Alma hospital now rationing health care amid ongoing Delta variant cases in hard-hit Michigan

Over the weekend, staff at Midmichigan Health-alma tried to find critical care beds for patients in need. They didn’t find any in Michigan. Nor Toledo. Nor Fort Wayne.

“This is real and it’s really serious,” said Marita Hattem-schiffman, president of Midmichigan Health’s central region. The facilities she oversees include the hospitals in Alma and Clare and the emergency department in Mt. Pleasant.

The cause is the latest wave of COVID-19, which Hattem-schiffman is said is the worst yet.

On Monday morning, there were 69 patients in line for the Alma hospital’s 54 beds available for COVID patients. Approximately 40 percent were seeking treatment for COVID-19.

Normally, only 40 of the hospital’s 97 beds are available for patients with acute diseases, but the hospital has increased the number of its beds to 54. It still isn’t enough.

“The need is so much greater than that,” she said.

Social media rumor is that the staffing shortages have contributed to a shrinkage in the number of beds available, leading to artificial full-to-capacity reporting.

That’s true in some hospital networks, she said, but not Midmichigan Health. They remain staffed for 54 beds, but it’s an open question of how long they can maintain with fatigued workers.

Demand is being driven by two things. The first is that the latest COVID-19 wave is the worst one yet. Looking back, hospital officials point to late July as the start.

All of the previous waves saw rapid increases followed by a general plateauing. That was followed by a decline in new cases.

Hospital officials hoped that the current wave would resemble past ones.

It didn’t. In the last three weeks, cases have rapidly increased, she said. The causes are likely the change to cold weather, which

Rationing health care has also led to curtailing some services previously readily available.

prompted people to move indoors, and the more transmissible Delta variant of the SARS-COV-2 virus.

There was another difference. The age of patients seeking hospital care and the duration of time they require it.

“The patients are younger and the stays are much longer,” she said. The stays are averaging a day longer, from five days to six.

The average age of patients admitted for COVID-19 is also lower. Midmichigan Health has provided care, including intensive care, for people in their 20s, 30s and 40s. That’s a change from previous waves when hospitalizations almost exclusively involved elderly people. The average age of people admitted for COVID care has dropped to 48.

Some of those younger people have died. Most — 80 percent — are unvaccinated. That percentage holds for current patients and people who’ve been discharged.

More people receiving hospital care for longer has put a significant squeeze on health care resources overall, she said. Patients are seeing longer wait times for appointments and are seeing availability shortages in emergency care.

“There are times when life-preserving care is needed but is unavailable,” she said.

Rationing health care has also led to curtailing some services previously readily available. Four beds used for sleep studies at the Alma hospital were converted to COVID care beds, she said. People with sleep apnea are at elevated risk for death.

“I don’t know how it can’t lead to worse outcomes in the future,” she said.

Contributing to that is that the NON-COVID patients they are seeing right now are sicker than they were previously.

The working theory is that people put off preventative care during the first year of the pandemic, and are now worse off than if they’d sought care all along.

Unlike previous waves, this one currently shows no signs of slowing, she said. A transmissible variant combined with a general return to life before COVID — just as mid-michigan moves into the holidays — has decreased the urgency to take measures to slow the disease’s spread.

That could lead to the hospital scaling back the number of beds it has available amid increased demand and fatigued employees.

Two things could help health care providers, she said. People could wear masks and get vaccinated, especially in low-vaccine areas like mid-michigan.

“We know that historically that vaccinations stopped so many deadly diseases,” she said.

But people could help by doing something as simple as self-quarantining after a potential exposure to the SARS-COV-2 virus.