‘Hospital after hospital’: Kansas City area intensive care maxed out with COVID cases
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Kansas City COVID-19 news
As the delta variant of the COVID-19 virus surges across the Kansas City region, officials, hospitals and communities have had to react. Here is our latest coverage.
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Intensive care units across the Kansas City region had the most adult COVID-19 patients they’d ever had just last week, with 215 beds filled due to the virus. It was higher than the onset of the pandemic. Higher than the winter surge.
Almost every day since, they’ve exceeded the milestone. Wednesday saw the highest count yet, with 224, according to hospital data tracked by the Mid-America Regional Council, a regional planning agency.
The council’s data includes Jackson, Wyandotte, Johnson and Clay counties.
Health care workers say the increase in coronavirus cases, the severity of the illness in those patients, staffing shortages and the refusal by so many to get vaccinated, has led metro hospitals to the avoidable challenge they now face.
Finding space for patients
Allison Edwards, a doctor and the owner of a small direct primary care clinic in Midtown, also travels across Kansas, Missouri and Colorado, working as a physician in mostly rural, critical access hospitals.
Last weekend, while working in a small emergency room, she found herself responsible for a patient with nowhere to go.
The man was severely anemic and suffering from what appeared to be a gastrointestinal bleed. He did not have COVID-19.
She said he needed care beyond what the small hospital with limited access could provide. So, the ER technician started making calls across the Kansas City area.
“Hospital after hospital after hospital did not have beds,” Edwards said. “There was absolutely no room for this patient to be taken.”
The patient stayed in the ER. it wasn’t ideal, but it was the only option. They provided him what critical care they could, and he improved overnight. By morning, he had stabilized to the point where he was able to get a general floor bed.
It was a really fortunate outcome for him, Edwards said. But that might not have been the case for everyone.
“It just breaks my heart that we’re at this point,” Edwards said. “I don’t even know how to begin to ration care. How do you start to make these decisions of where to put your priorities when business as usual can’t happen?”
As they got rejection after rejection from hospitals without beds, Edwards said she felt every emotion wash over her. Frustration that she couldn’t do what was best for the patient. Anger that society is facing yet another wave of the deadly virus. Then numbness.
Then, back to work she went.
ICU capacities at all-time high
Hospitals across the metro have reported that their COVID patients are staying three to four times longer than typical patients not suffering from the virus, said Jennifer Sutherlin, who serves as the emergency services, health and medical program manager as well as the healthcare coalition coordinator for the Mid-America Regional Council.
And while metro-wide case counts seem to be leveling out slightly, hospitals remain overwhelmed for a number of reasons.
“By and large we’re hearing that new hospitalizations continue to outpace discharges,” she said of COVID patients. “And so, while the new admissions may be slowing down just a little bit, the discharges just aren’t keeping up so hospital census remains very very high.”
It’s not just the COVID patients who are sicker than in previous waves. She’s heard anecdotes from doctors that non-COVID patients are staying bed-ridden longer, too
She and others have pointed to delayed care during the pandemic as a factor. Many surgeries were deferred last year. People skipped their wellness checkups. Now, many non-COVID positive patients are sicker than in years past.
Area hospitals have had to transfer patients, both with and without COVID, as far away as Chicago and Oklahoma City, Sutherlin said. Their rural health care partners who can’t get patients into Kansas City beds are sending them to Denver and St. Louis.
Meanwhile, emergency rooms, which in many cases are boarding would-be ICU patients who can’t get a bed, are feeling the pressure too, she said.
The ER capacity increases, as does the demand of the doctors’ and nurses’ time and resources.
Sutherlin said ER wait times are up across the metro, though the busyness of one hospital to the next can change hour to hour.
And so the stress on the system multiplies. What happens next depends on individual decisions.
“If we don’t increase vaccination, we are going to continue to see this,” Sutherlin said, hopeful the FDA’s full approval of the Pfizer vaccination will motivate those holding out. “You know we’re going to continue to be in this space as long as we have low vaccination rates.”
Hospital staff is exhausted
Eighteen months into the pandemic, Tim Williamson, vice president of quality and safety with the University of Kansas Health System, said medical workers are as tired as he’s ever seen them.
While there had been a lapse in deaths that lasted a few weeks at his hospital, the reminder of mortality is crashing over them again. Last week, nine people died of a disease that is largely manageable.
He sees the patients getting younger. He recently had three women, either pregnant or postpartum, put on life-support after their coronavirus diagnosis.
One colleague told him that as they were putting someone on life support, the patient was still actively denying they had COVID.
“I think just the sheer magnitude of death and suffering that these providers are seeing on a daily basis is overwhelming,” he said.
All of this weighs endlessly on hospital staff as some choose to leave the profession.
Edwards, the doctor, said she’s overheard ER nurses — the most intimate caretakers of patients — talk about leaving their jobs because they know they can be paid more if they became travel nurses, a position currently in high demand.
Sometimes “empathy fatigue” sets in as doctors and nurses watch patients beg forgiveness of their families for not getting vaccinated, or, from their deathbeds, beg their families to get the shot, Williamson said.
As of Thursday, 42% of Kansas City residents had been fully vaccinated, according to data from the Missouri Department of Health and Senior Services.
Williamson weighs the vaccination rates with the current case counts and fears what the numbers might look like in the coming weeks, as schools and universities open their classrooms again.
On Thursday, the area encompassing Kansas City and Jackson, Clay and Platte counties in Missouri and Johnson and Wyandotte counties in Kansas gained 802 new cases for a total of 178,590 to date. Since the pandemic began, 2,509 people in the metro have died.
This story was originally published August 27, 2021 at 5:00 AM.
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