Oregon’s health care system is stretched nearly to breaking point as more than 1,000 Oregonians are now in hospitals with COVID-19.
Both COVID-19 and non-COVID patients face waits for beds in emergency rooms and intensive care units. Some get emergency treatment in crowded hospital lobbies and hallways.
The pandemic has broken record after record. On Tuesday, Oregon had 1,000 patients hospitalized with COVID-19. That figure reached 1,080 on Wednesday, the Oregon Health Authority said.
Nearly 300 of them are in intensive care, filling the state’s ICU bed supply dangerously close to capacity. Some hospitals are out of intensive care beds and others are nearly at that point. Statewide, there are only 44 available intensive care beds, 7% of the state’s supply.
Almost all the people being hospitalized for the virus are unvaccinated, and the highly contagious delta variant is driving these seriously ill residents into hospitals at an ever-increasing pace.
“We are facing a perfect storm right now that has led to overcrowding in our hospitals,” said Dr. Mary Giswold, associate medical director at Kaiser Permanente, in a press call on Wednesday, during which Portland-area hospital leaders outlined the crisis.
Meanwhile, the size of the additional workforce that will aid hospitals with medical services and general labor continues to grow. Hundreds of out-of-state health care workers will pour into Oregon this week. Hospitals continue to push to hire their own health care workers, nurses and clinicians, often offering signing bonuses to lure hesitant candidates.
No Field Hospital
At the same time, not all the state’s efforts have unfolded according to plan. Oregon state officials have backed away from an ambitious request for four staffed field hospitals that they sent to the Federal Emergency Management Agency earlier this month, records show. They are no longer seeking even the one field hospital that officials publicly disclosed a week ago.
The 500-strong workforce of Oregon National Guard troops who are now cleaning hospital rooms, serving meals and unloading freight may eventually increase to nearly 1,700 people, according to an internal document reviewed by The Lund Report. That’s almost 200 more people than the 1,500 figure that officials have previously cited.
State officials on Wednesday announced two contracts with medical staffing companies outside Oregon to bring in nurses and clinicians to aid hospitals as well as long-term care facilities that will receive hospital patients who are being moved out to free up acute care beds. A contract with Jogan Health Solutions will put up to 500 health care professionals in hard-hit southern and central Oregon this week. On its website, the company says it offers “turn-key vaccination, testing and surge medical staffing in multiple states.” A separate contract with AMN Healthcare will put at least 60 nurses and clinicians out in the field. Those locations aren’t yet known.
(See related story: Oregon Abandons Field Hospital Idea.)
Intensive Care Beds Dwindle
About one in four of the 1,080 COVID-19 patients in hospitals are in intensive care beds. As a result, nearly 45% of the 662 intensive care beds in hospitals statewide have a COVID-19 patient. When factoring in patients with other medical needs, only 44 beds in intensive care units statewide are available. Outside the intensive care units, just 320 beds are available, or 8% of the 4,256 adult beds in Oregon hospitals.
It’s a thin margin that could disappear quickly.
Health care workers expect the picture to grow more dire in the weeks ahead as the flood of COVID-19 patients swells. Oregon Health & Science University modeling projects that Oregon could be short an estimated 400 to 500 hospital beds by Labor Day.
Health care workers pleaded in a press conference for people to take precautions. Debbie Sanchez, a registered nurse at a Providence Portland Medical Center’s emergency room, said at one point, four patients in the emergency department were waiting for intensive care beds because of the shortage. In one instance, a patient needed a breathing tube.Another patient came in and received a cancer diagnosis after avoiding a visit because of the crisis.
“Our staff are exhausted,” Sanchez said. “We’re struggling to meet patients’ needs.”
Oregon had to walk back its reopening as hundreds of mostly unvaccinated people with COVID-19 have flooded hospital emergency rooms and put more demand on a system that had been trying to play catch up with patients who delayed elective procedures in 2020.
For hospitals and public health officials, it’s a frustrating and unnecessary crisis. That’s because the COVID-19 vaccines greatly reduce the odds of a patient going to the hospital. On average, about 85% of patients hospitalized with COVID-19 are unvaccinated.
“The war has changed,” said Lewis Cole, an intensive care nurse for Providence in Portland. “The enemy has gotten meaner and society as a whole has sort of let its guard down.”
Cole spoke of putting young patients in their 20s, 30s and 40s in body bags or holding hands of patients as they died.
With the vaccine, he said, it’s become “senseless” and “none of this had to happen.”
The vaccine reduces the odds of contracting the virus as well as the chance of the illness becoming severe enough to warrant hospitalization.
“We have the power to stop the spread of the delta variant by taking simple protective measures,” said Dr. Seth Podolsky, chief medical officer of Legacy Health. Those steps, he said, are getting the vaccination and using masks and social distancing.
Out-of-state Workers Arrive
Hard-hit hospitals in central and southern Oregon will get nurses, paramedics and other health care workers through state contracts.
Medical staffing company Jogan Health Solutions will send out up to 500 health care personnel to hospitals in central and southern Oregon and long-term care facilities statewide. Long-term care facilities are a key part of the state’s plan to make more hospital beds available, with nurse teams in place to treat hospital patients who are released to long-term care facilities to recover.
“The deployment of crisis response teams should provide some welcome relief to our hospitals, particularly in Central and Southern Oregon, that are overwhelmed given the recent surge in hospitalizations among mostly unvaccinated individuals," Gov. Kate Brown said in a statement. “The hospital crisis we are facing isn’t just about beds –– it’s about having enough trained health care professionals to treat patients.”
The Jogan Health Solutions providers will go to central Oregon to support the St. Charles Health System in the Bend and Redmond areas, and to southern Oregon to support Asante hospitals in Medford, Ashland, and Grants Pass, as well as Providence Medford Medical Center and Mercy Medical Center in Roseburg. They’ll serve as hospital crisis response teams, with up to 300 registered nurses, 20 paramedics, 61 certified nursing assistants, 34 respiratory therapists, and 5 medical technicians.
Through a separate contract, Oregon has an agreement with AMN Healthcare for about 60 more nurse and clinical positions. State officials said they are still determining the positions and locations.
The state will put as many workers as possible out in the next day or so, said Charles Boyle, a spokesman for the governor’s office. Initial figures were unavailable.
Oregon is seeking reimbursement from FEMA for those costs. The Jogan Health not-to-exceed figure is $100 million; the AMN not-to-exceed figure is $19.6 million, Boyle said.
“This is a much-needed infusion of qualified medical personnel that can help us get through this critical time in the COVID-19 pandemic,” said OHA Director Patrick Allen in a statement. “These crisis teams will be completely re-deployable.”
Central Oregon Hospitals Weigh In
Hospitals officials welcome the aid, yet stop short of saying it will meet their needs.
In Central Oregon, St. Charles Health System’s hospitals had 72 people hospitalized and 14 of them in intensive care and on ventilators.
The hospital system had 127 Oregon National Guard troops arrive to help last week. Those troops will stay when the health care workers arrive, a St. Charles spokeswoman said. Guard troops are committed until at least Sept 30.
St. Charles Health System, which has hospitals in Bend, Redmond, Prineville and Madras, submitted a request to the state for nearly 200 nurses, respiratory therapists and certified nursing assistants. The hospital system requested 58 acute care nurses; 76 critical care nurses; nine emergency department nurses; five respiratory therapists; and 46 certified nursing assistants.
“At this time, it is unclear whether St. Charles will receive the full number of health care workers requested, when exactly they will arrive and how long they will stay,” said Lisa Goodman, a spokeswoman for St. Charles Health System. “Considered a state resource, the travelers could be redeployed to other high-need hospitals in Oregon at any time.”
Dr. Jeff Absalon, St. Charles’ chief physician executive, said the public can do more.
“Receiving help from the Oregon National Guard—and now these traveling health care workers—is of course very appreciated,” Absalon said. “But our pressing need for these resources should speak to the seriousness of the situation we find ourselves in right now. Only when the number of COVID cases in our community begins to decline will the pressure on our health system ease. We’re urgently asking our community to help by wearing masks and getting vaccinated.”
Guard Deployments May Rise
Brown has already deployed 500 Oregon National Guard troops to hospitals in central and southern Oregon. Earlier, state officials announced they would send up to 1,500 total Guard members when another 1,000 go to hospitals in the Portland and Salem areas.
Yet that figure could also change. Guard records obtained by The Lund Report show the potential deployment figure could rise to 1,686.
The deployments could rise to that level of 1,686, said Stephen Bomar, a spokesman for the Oregon Military Department. For now, though, the Guard anticipates more clarity about the additional 1,000 troops this week, Bomar said in an email. Guard members are currently in 11 hospitals and they eventually will support about 20 more, he said.
You can reach Ben Botkin at [email protected] or via Twitter @BenBotkin1.