How are Vermont's hospitals faring? COVID patients receive treatment in a board room, but leaders say they're not over capacity
COVID hospitalizations in Vermont continue to surpass record highs, as omicron cases appear to be leveling off in parts of the northeast.
At several of the state’s hospitals, more staff are back to work than earlier in the month, bolstered by continued support from nurses and paramedics contracted through the federal government.
But capacity remains tight, and healthcare workers are weary. “I think our staff are as tired as I've ever seen them,” one hospital representative said.
For the third week in a row, VPR’s Lexi Krupp spoke separately with Dr. Trey Dobson, the chief medical officer at Southwestern Vermont Medical Center in Bennington; Meg Oakes, a nurse leader and senior director of quality and safety at Rutland Regional Medical Center; and Dr. Stephen Leffler, the chief operating officer at the University of Vermont Medical Center in Burlington. Their responses are below and have been edited for clarity.
Lexi Krupp: What’s changed in the past week?
Trey Dobson: We are getting more COVID patients in, as well as just hospitalizations. But it's been incremental. And the increments have been small enough that we’ve really been able to handle the situation without moving into that phase where capacity exceeds our resources and staff. Today we are closer to that threshold where the capacity exceeds our resources, but we haven't passed it.
Meg Oakes: Our ICU is full. Our COVID patient census has gone up quite a bit. Volume’s high everywhere.
Stephen Leffler: COVID numbers are still climbing a little bit. There’s more people in the ICU this week than last week. That's pretty common with the COVID wave. Oftentimes, a little bit further into the wave, more people get really sick.
Today we are closer to that threshold where the capacity exceeds our resources, but we haven't passed it.
What are staffing levels like now?
Meg Oakes: It seems to be getting a little better, today anyway. So we're down to around 2% of staff being out with COVID, down from almost 4%. And we have six nurses from FEMA. Without those nurses, this is a whole different story.
Trey Dobson: We probably had more staff out yesterday (Monday) than we've had.
Stephen Leffler: Our hospital’s staffing has been challenging all week, but gradually improving. We have less people on COVID protocols — under 300 today (Compared to nearly 400 staff out earlier in the month).
We have some National Guard workers that are also helping us with environmental services (Including custodial work and cleaning). But we do still have significant staffing challenges. We did have to close a cafeteria, which is the one that most employees get meals through, this week because we are so short staffed in that area.
What are some of the things the hospital is doing to handle high patient volumes?
Meg Oakes: We've enacted another part of our surge plan, in which we are caring for some people who are not symptomatic — but who have tested positive for COVID — in rooms that are not negative pressure (A type of hospital room that prevents the spread of airborne diseases).
Stephen Leffler: We converted our board room basically to a patient care area. We have patients coming in who are qualified for monoclonal antibodies (A COVID treatment that usually requires an intravenous infusion), but we want to do it as close to the outside of the hospital as possible so they wouldn't be walking through the hospital with COVID. And our board room is very, very close to the elevator and it was space that we had.
Earlier this week, Dr. Mark Levine said COVID patients account for about a quarter of ICU beds in the state. Could you put that number into context?
Trey Dobson: First off, that's a heck of a lot. The second is, COVID-19 patients, by far, take up more personal protective equipment, more staff time and more resources in general. So they might be 25% of the ICU population, but they also may take up 50% of the staff time, 75% of the personal protective equipment, which, by the way, takes a while to get on and off. And it's hot, and it makes you more tired. So I think that the COVID-19 patients have a greater effect than their numbers might appear on the surface.
We never expected to see like, having the employee cafeteria closed or giving monoclonal antibody treatments in our board room.
What’s the status of elective surgeries?
Stephen Leffler: We're doing much, much less elective surgery. We're really limiting how many surgeries happen where the person has to be admitted to the hospital afterwards. We're sorry for the patients that impacts. That's what we need to do right now to have enough capacity for Vermonters who have urgent and emergent problems right now.
Meg Oakes: We are still able to perform elective clinically-necessary procedures, which we're glad about. It's good for patients. Doing things like implementing our surge procedure around negative pressure is part of what helps us preserve our capacity.
How are you thinking about the next few weeks?
Trey Dobson: Our hospitalizations are going to keep going up. They're going to lag weeks behind cases starting to decline. New hospitalizations may start tapering off, but the numbers of people in the hospital remain high. The effects will continue to last up until around 28 days. A good example of this is South Africa (There, cases have dropped precipitously but deaths have only started to decline in recent days).
Meg Oakes: For me, it's getting through to the middle of February. If nothing changes for the worse in the meantime, then I would expect after that to be seeing things clear out a little bit.
I’m looking forward to remembering [the pandemic]. I’m looking forward to finding a mask, way in the back of some drawer and saying, "Oh, remember when we had to wear these things?"
Lexi Krupp is a corps member for Report for America, a nonprofit national service program that places journalists in local newsrooms to report on under-covered issues and regions.
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