Staffing, not bed space, the biggest concern for hospitals facing potential COVID-19 surge

PeaceHealth Southwest officials say hospitalizations have fallen in recent weeks, but there are signs the reprieve may be temporary

VANCOUVER — Even as Clark County moved past 10,000 confirmed cases of COVID-19 this week, adding 1,153 since last Thursday, hospitalizations for the disease have actually fallen slightly.

As of Thursday, there were 53 people with a confirmed case of COVID-19 in Clark County hospitals, with seven others waiting test results, making up 9.6 percent of overall bed space.

PeaceHealth Southwest Medical Center was treating 27 COVID-19 patients as of Wednesday, down from 54 in late November. File photo
PeaceHealth Southwest Medical Center was treating 27 COVID-19 patients as of Wednesday, down from 54 in late November. File photo

That’s down from a high of nearly 13 percent bed space and almost 80 people hospitalized at the start of last week.

Doctor Lawrence Neville, chief medical officer with PeaceHealth Southwest Medical Group, said Wednesday that their COVID-related hospitalizations had dropped from 54 people on Nov. 25, to just 27 midway through this week.

“We see this as a brief period to catch our breath,” Neville said during a weekly media briefing via Zoom.

As of Wednesday, PeaceHealth Southwest had 37 percent of their overall ICU beds available, and 84 percent of their total bed space occupied.

“A lot better off than a lot of localities across the United States,” Neville said. “They’re reporting that their ICUs are 80 percent, or more, full.” 

Nationwide, an estimated 107,258 people were hospitalized with COVID-19 on Thursday, according to the Covid Tracking Project

In Washington, a total of 1,177 people are hospitalized, compared to California which leads the nation at nearly 12,500.

In Clark County, hospitalizations hovered near 30 over much of the Summer, then more than doubled in late October and through much of November, before the recent decline.

Part of this week’s reduction in hospitalizations came from PeaceHealth reopening a ward for COVID-19 patients at their St. John’s hospital in Longview. Five Cowlitz County patients who had been in Clark County were moved back there.

Thursday marks two weeks since Thanksgiving, when many people said they planned to have family gatherings despite warnings to avoid getting together with people from outside your own household.

To date, a true spike in COVID-19 cases has yet to emerge in Clark County that can be connected to the holiday, but given delay times between transmission, infection, and then testing results, experts warn the full picture won’t emerge for at least another week.

Neville says there are some early signs that hospitalized cases may start increasing again. 

PeaceHealth tracks patients exhibiting “influenza-like” symptoms, such as fever or cough. Without much actual flu evident in the community yet, these could be telltale signs of early COVID-19 infections.

“That has been pretty reliable as a predictor that we’ll see, unfortunately, some hospitalizations thereafter,” said Neville.

In an attempt to get ahead of the situation, PeaceHealth implemented new restrictions on visitors this week.

“We know it’s very hard on patients and their family members to have their loved ones in the hospital and not be able to visit them directly,” Neville said Wednesday. “We really have to wrap our patients and our healthcare workers in a bubble of protection, to make sure that they’re as safe as possible.”

Neville said the hospital will continue to make exceptions on a case-by-case basis, such as for allowing a parent to accompany a child, or someone to support a mother giving birth.

Should a new surge in COVID-19 patients emerge in the coming weeks, Neville says the greatest challenge won’t be finding space to put people.

“It really is about staffing,” he says. “We can have all the beds in the world, we can have all the medication in the world, and if all of our nurses — God forbid — were to get sick, we would as a community, be in a world of hurt.”

Neville says they have surge plans in place, including potentially using tents if necessary, or moving more non-Covid patients into other parts of the hospital.

Jackolyn DeCillo, RN, a nurse manager who is currently running her second COVID-19 unit, says the mood amongst her staff is much more confident now than earlier in the pandemic, despite the larger numbers of patients coming in.

“It was a challenge at first, but nurses adapt,” she says. “I think we’ve done an amazing job with continuing to change and evolve with the recommendations that come out, helping us to be prepared.”

PeaceHealth Southwest has also been selected as one of 17 hospitals to serve as a staging area for COVID-19 vaccines, including some of the first 62,000 doses of Pfizer’s vaccine, which received emergency approval Thursday from the Food and Drug Administration.

“We have developed very nifty and elaborate plans for how we’re going to get the vaccine initially to health care workers to keep them safe while taking care of others,” said Neville, “and are working to make sure that our emergency first responders throughout the communities are also protected.”

Neville said PeaceHealth won’t be making the vaccine mandatory for staff, but that most have expressed interest in taking it. The distribution plan will essentially give doses to only a few people in each department at a time, since trials have shown the vaccine can cause symptoms like the flu for a day or two.

“I will say I’ve just been amazed by how many folks have stepped up to help organize that campaign,” Neville said. “And to make sure that it goes flawlessly.”

Even with that light at the end of the tunnel, Neville said it’s important for people to continue taking every possible precaution, especially with Christmas just two weeks away.

“It certainly is not a great holiday gift to give grandma or grandpa COVID,” he said. “Please hear me on this and know that I am struggling with all of you and everyone at PeaceHealth with exactly the same desire: to have this behind us.”