Colorado hospitals prepare for potential COVID surge

Within two months, it was unlikely that a Colorado hospital would need to consider whether to postpone surgery or where to send the patient if the intensive care unit was full.

New COVID-19 infections are declining, and the worst possible future could appear to be a limited outbreak in under-vaccinated communities.

And then Delta came.

Colorado hospitals aren’t as full as last winter, but we’re worried about new hospitalization trends. According to Colorado, Colorado, as of Thursday afternoon, more people were hospitalized with confirmed COVID-19 than at any time since late January, and 18% of hospitals reporting to the state next week. Predicted that there could be a shortage of staff. Public health and the environment.

The latest state forecasts from late July show that Colorado could approach winter hospitalization levels if people have higher-risk interactions and immunization rates do not increase significantly. it was done. At its peak in early December, nearly 2,000 people were hospitalized with COVID-19 and the state wasn’t running out of beds, but health care workers said they were. Stretched to the limit..

The new hospitalization trajectory is closer to the worst-case scenario presented by the state modeling team than the more optimistic version, making it more likely to be a reprise.

This is a situation where you are unlikely to have to face it again. Doctors and nurses who spoke to The Denver Post likened the first vaccinations in winter to the lights at the end of the tunnel. It now appears dim as the more contagious delta variants of the virus spread and the intensive care unit begins to fill up again.

Dr. Michel Baron, Senior Director of Infection Prevention and Management at UC Health, has “significant concerns” about reaching levels that will be seen again at the peak of last winter, after seasonal flu has almost disappeared last year. , Said that there is a high possibility of recurrence this year. By anti-COVID preventive measures. As of August 21, the last day of available data Centers for Disease Control and Prevention “Minimal” influenza activity was reported in Colorado, but there was a “high” spread in neighboring New Mexico.

“We have the vaccine now … we don’t have a mask obligation and the school is in session,” she said.

Near the end of August, UC Health took care of about three times as many COVID-19 patients as in early July and began to postpone some non-urgent but potentially hospitalization procedures.As of Friday afternoon, 231 people I was taken care of by the virus there — Only 32 less than the peak of the spring 2020 wave.

Postpone surgery and transfer patients

Cara Welch, a spokeswoman for the Colorado Hospital Association, says that almost all hospitals postpone non-urgent procedures, transfer patients to larger facilities, add beds, or assign staff to assist in the unit they are in. It usually doesn’t work as I said I started some combinations such as. It happened, though not so much, during the fourth wave of the spring, she said.

On Friday, the Hospital Association announced a move to Tier 1 of the transfer plan. In this plan, large hospitals will play a greater role in helping coordinate the movement of patients to beds and staff-care facilities.

According to Welch, far fewer people will be hospitalized than when the plan was in use from November to February, but no one knows how long the current wave will last. She was vaccinated by the general public, wore masks in public places indoors, and urged her to stay socially distant.

“We’re back where we really need their help,” she said.

More than two-thirds of the targeted Coloradans are fully vaccinated, but like almost all children under the age of 12, about one in three adults and teens is not yet protected. .. In 27 counties, less than half of the affected people are vaccinated and infected with the virus. Countless opportunities to spread.

According to Baron, hospitals have the benefits of widespread practice for managing surges and have had time to stock up on protective equipment for this wave, but it’s important to allow employees to manage stress. is. Most people are resilient, but everyone is tired, she said.

Others do not expect to face a lot of tension in the coming weeks.

Heather Young, medical director of infection prevention and management at Denver Health, said the hospital is planning ways to manage possible surges, including postponing elective surgery. Hope you don’t have to use it. Almost everyone hospitalized with COVID-19 has not been vaccinated, so she said there is a way to prevent the levels of illness seen last year.

“At Denver Health, the number of hospitalized patients with COVID infections is increasing, but it remains at a relatively low level compared to other surges,” she said.

According to Young, there is some encouragement during the Australian flu season as few people are ill. It is worth noting that Australia still has mask man dates and travel restrictions.

Dr. Gary Winfield, chief medical officer at HealthOne hospitals in the region, including Colorado, said he does not expect hospitalization to reach December levels again. He expects to treat about 160 COVID-19 patients at the peak of this wave. This is about half of last year’s peak. Currently, few patients require mechanical ventilation and hospitals have experience with viral treatments, so mortality is likely to be low, he said.

Treating patients with COVID-19 “really, will be part of our routine all this time,” he said.

However, in some hospitals, the need for ventilators has not diminished as the number of patients changes. The median age of COVID-19 patients at UC Health in June was 62 years. That is, half were older and half were younger. According to Baron, the number dropped to 43 in July and early August, and younger patients needed intensive care at the same rate as they did a few months ago. She said the majority were unvaccinated and most of the vaccinated people in the hospital had an impaired immune system or were over 65 years of age.

According to Welch, staffing is now a bigger concern than equipment such as bed space, ventilators and masks. Some health care workers have left the state to earn higher wages elsewhere, while others have retired due to exhaustion or have found a job in another industry, she said. Said.

And unlike the first wave, where most of the pain was concentrated in the northeast and some big cities, and in the summer of 2020, when the virus struck the south, hospitals are now full nationwide. It has become. This means that it is unlikely that other states will be able to reduce the pressure on hotspots by sending nurses or accepting patients who have been transferred.

For the past few weeks, the pain has been mainly concentrated in the south, but now it is in some hospitals. Kansas When Oregon Also, beds are starting to run out.Nationwide Over 100,000 hospitalized For COVID-19 as of Thursday.

One model estimated 98,000 Americans If the current trend continues, it is possible to die from COVID-19 between now and December 1, but if most people wear masks and restrict face-to-face interaction, the charges will be significant. May be low.

“Unfortunately, the rest of the country is also fighting this surge in delta variants, so there aren’t many national resources that Colorado can trust to support staffing,” Welch said.

Medical staff depressed

Olivia Thornton, Associate Nurse Manager at UCHealth University of Colorado Hospital, said nurses moving from hotspot to hotspot are exhausted and relatively few people leave the field, but everyone is important during a surge. It states that.

Now that the vaccine is widely available, she said it’s “depressed” to see another surge.