POST 176. July 9, 2021. CORONAVIRUS. Mercy Springfield ( Missouri) hospital…” ran out of ventilators for its patients over the Fourth of July weekend…”…“Mercy will require all current and future employees to be fully vaccinated.”…“The US government is deploying a Covid-19 surge team to provide public health support in southwest Missouri

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“The highly contagious Delta variant of the virus that causes Covid-19 is prompting a surge of coronavirus cases in Missouri, a warning sign of what may happen this summer in other areas of the U.S. with low vaccination rates, public-health experts say.

For more than a week, Missouri had the highest case rate in the country, according to data from the Centers for Disease Control and Prevention. As of July 1, the seven-day average of new cases hit 898, up from 511 three weeks earlier, data from Johns Hopkins University show.

The Missouri state health department tests wastewater to track the spread of Covid-19, including which variant is dominant. Data from June 14, the most recent available, showed the Delta variant was present statewide. At the beginning of May, the variant wasn’t present in the wastewater sampled, the data showed.

“The uptick is powered by the Delta variant,” said Clay Dunagan, chief medical officer at BJC HealthCare, a system serving St. Louis, southern Illinois and mid-Missouri.

The variant, which is about 40% to 60% more contagious than the previous dominant variant, is sending more people to hospitals in the northern and southwestern parts of the state, health officials say.” (H)

On Monday, Mercy Springfield hospital officials reported that more ventilators had arrived, a second COVID-19 ICU unit was opened and that more respiratory therapists are needed to help the “tired” ones working now.

Situations like that, public health officials say, are avoidable if people would get vaccinated.

Chief administrative officer, Erik Frederick, tweeted Sunday that the hospital “spent the night looking for ventilators because we ran out.”

He wrote that the hospital had 47 patients on ventilators, “a lot of those are COVID but not all.”

He said more ventilators were on their way from Mercy St. Louis and Mercy Northwest Arkansas in Rogers, Arkansas, other hospitals in the Mercy health system.

Frederick tweeted on Monday that the hospital was, “Running almost 50 vents now. We are expanding to 2nd COVID ICU and a 2nd step down. Physicians, nurses and respiratory therapists are tired. Heck everyone is tired. Travel RN’s coming this week. Physician support being arranged. If you’re a RT, call us.”

Running out of ventilators was the nightmare scenario hospital administrators across the country feared at the outset of the pandemic. COVID is a respiratory illness that, at its worst, can cause extreme respiratory distress.

Ventilators, also known as life-support machines, pump air into a patient’s airways when they can’t breathe on their own. They are used for the sickest of COVID patients, while hospitalized patients with less severe symptoms are now treated with medications.” (A)

“As a result, the hospital is bringing in ventilators from surrounding Mercy hospitals, including Northwest Arkansas and St. Louis.

“St. Louis, Northwest Arkansas, and Oklahoma City Mercy hospitals are not seeing the COVID surge that we are seeing. We are grateful they are here to provide us additional support,” said Frederick.

As of June 5, Mercy Springfield received 14 ventilators from surrounding hospitals and is immediately putting them to use.

“We put one right into service, and we have about 14 on standby right now. When we look at our census of 115 patients, about 85 of those patients right now are on some kind of mechanical ventilation support. That’s pretty scary,” said Frederick.

Forty-nine patients are currently on ventilation at Mercy, and 25 of those are COVID-19 patients, according to Mercy.

“We are expanding to 2nd COVID ICU and a 2nd step down. Physicians, nurses and respiratory therapists are tired. Heck everyone is tired. Travel RN’s coming this week. Physician support being arranged. If you’re a RT, call us,” tweeted Frederick.

The overflow of patients recently has been a issue as well. Mercy Springfield is sending some COVID-19 patients over to Kansas City for treatment.” (B)

“As of Monday, CoxHealth and the city’s other hospital, Mercy Springfield, were treating 213 COVID-19 patients, up from 168 on Friday. As recently as May 24, the two hospitals had just 31 patients.

“After what we’ve seen in the last month everyone is just holding their breath, especially after a holiday weekend like this, knowing that there were large gatherings,” said Erik Frederick, the chief administrative officer of Mercy Springfield.

Republican Gov. Mike Parson tweeted a picture of himself at a fireworks celebration in the tourist town of Branson, a large crowd behind him. In the surrounding county, just 29.3% of residents have received at least one COVID-19 vaccine shot, state data shows. That is below the state rate of 44.7% and the national rate of 54.7% but not unlike several other southwest Missouri communities. Some have vaccination rates in the teens.

Parson last week urged people to get vaccinated. But he has consistently declined to enact restrictions to control the spread of the virus, instead asking residents to take “personal responsibility.” Missouri never had a mask mandate, and Parson signed a law last month placing limits on public health restrictions and barring governments from requiring proof of vaccination to use public facilities and transportation…

CoxHealth in Springfield has been transferring out four or five patients a day for the past week to 10 days as it tries to bring in more traveling nurses to help, said Ashley Kimberling Casad, vice president of clinical services at the hospital.

“Our projections are only showing us continuing to go up,” she said, noting that positivity rates are spiking. “We generally see an increase in hospitalizations about two weeks after big events, so knowing it was the holiday weekend and probably lots of people spent time with family and friends and with our vaccination rates so low, we are going to expect that in two weeks it gets really, really busy.”

The situation is complication because the hospital has only about one-third of the 280 traveling nurses it had at the peak of the winter surge and is working through a backlog of patients who deferred routine care during the surge. That means it can’t handle as many COVID-19 patients as it once could.

Kimberling Casad said traveling nurses are also now harder to come by.

“They worked really hard all winter and spring and made good money so they want to take off this summer and get to spend it with their family and have fun, so we have a lot of positions posted for traveling nurses, but we are just having a harder time getting them in,” she said.”  (E)

“Cox Medical Centers in Springfield are also struggling, with 97 percent of their ICU beds currently filled. Steve Edwards, the president and CEO of CoxHealth, put out a desperate plea on Tuesday for more respiratory therapists. “Springfield, Mo is struggling with surging Covid volumes,” he tweeted, adding that the hospital system’s “heroic” therapists needed reinforcements.

The plea followed an ominous tweet from Edwards on the fourth, in which he noted that the percentage of COVID-19 tests that have turned up positive had risen to 32 percent. “Very concerning!” he tweeted. He also reported that the hospital system had taken in four pediatric COVID-19 patients on Saturday alone, including one baby that was just a few weeks old.” (F)

“Mary Beck, Chief Nursing Officer at MU Health Care, said some rural hospitals don’t have the capabilities that they have for the higher level of care. MU Health Care has an increased number of pulmonary care specialists working in the ICU.

Beck said they have accepted some patients from other hospitals. “We also have to say that we can’t take everyone that they want to send. There are times where we say we’ll put you on a waitlist because we are at capacity with our other patients that need other procedures,” said Beck.” (G)

“The US government is deploying a Covid-19 surge team to provide public health support in southwest Missouri, where the spread of the virus is filling up hospital beds once again.

The surge of Covid-19 cases is so high in the city of Springfield, Missouri, that the CoxHealth hospital system began transferring patients infected with the virus to other facilities to provide better staffing. At Cox South, a Springfield hospital, 12 Covid-19 patients were transferred to other facilities in the region between Friday and Monday morning.

Over the past week, the Missouri Covid-19 caseload came in second highest in the country, with 15.5 new cases per 100,000 people daily, or 108 cases per 100,000 people, according to Johns Hopkins University data published Sunday. Arkansas claimed the highest rate at 15.7 new cases per 100,000 people each day, the data shows.

“We’re already starting to see places with low vaccination rates starting to have relatively big spikes from the Delta variant,” said Dr. Ashish Jha, dean of the Brown University School of Public Health.

“We’ve seen this in Arkansas, Missouri, Wyoming. … Those are the places where we’re going to see more hospitalizations and deaths as well, unfortunately. And any time you have large outbreaks, it does become a breeding ground for potentially more variants,” he told CNN on Monday.

About 56% of adults in Missouri have received at least one Covid-19 vaccine dose and 39.4% of residents are fully vaccinated, CDC data shows. Arkansas had fully vaccinated 34.6% of its total population as of Tuesday, CDC data shows…

“There are places in the world, where people would do anything to get vaccine, and yet we have a substantial proportion of people in very specific regions of the country who just do not want to get vaccinated,” he added.

In response to the more contagious Delta variant, the Biden administration said it would deploy response teams comprising officials from the Centers for Disease Control and Prevention, the Department of Health and Human Services and the Federal Emergency Management Agency to areas with a high spread of the virus and low vaccination rates.

In Missouri, the surge team will include an epidemiologist, research assistants, a health communication specialist, contact tracers and others who will help with vaccination and outreach, according to the health department.

“More team members will be added, both remotely and in person, to assist with data and research, vaccine uptake strategies and outreach,” said Lisa Cox, a communications director with the Missouri health department.” (C)

“Mercy will require all current and future employees to be fully vaccinated. The hospital has set Thursday, September 30, 2021, for the complete vaccination date for employees.

Mercy has updated this requirement as the Delta variant continues to spread rapidly across the region. Mercy hospital and clinics have branches in Joplin, Springfield, St. Louis, and other locations. Mercy serves communities in Arkansas and Oklahoma where the number of Delta variant cases are increasing…

“This is really to protect our co-workers, it’s an investment in our co-workers, an investment in our patients to ensure we are providing the very best protection,” said Brent Hubbard, the CEO of Mercy. “As a healthcare provider, we should expect that of ourselves.”

Across the Mercy network, there are 40,000 employees. The Mercy staff with vaccination is at 75%, and 25% are not vaccinated.

“It is essential that we take these steps in order to protect the health of our co-workers and our patients at Mercy,” said Dr. William Sistrunk, Mercy infectious disease specialist. “As health care leaders in our communities, it is important we set the standard to prevent the spread of COVID-19. Vaccination is our best defense against the virus and already has provided many of our co-workers with the protection they need to care for our patients. Our goal is to ensure the safest possible work environment for our co-workers and patients while also being a part of the effort to stop the spread of the virus in the communities we serve.”

Hubbard said there will be exceptions for people with medical and religious reasons, but those who otherwise refuse could face termination by October.” (D)

(A)Hospital in Springfield, Missouri, runs out of ventilators as COVID cases ravage the area, BY LISA GUTIERREZ, https://www.kansascity.com/news/business/health-care/article252579068.html

(B)Mercy Springfield runs out of ventilators, rise in patients forces expansion to a second COVID-19 ICU, By Lauren Schwentker, https://www.ky3.com/2021/07/05/mercy-springfield-runs-out-ventilators-rise-patients-forces-expansion-second-covid-19-icu/

(C) US sends Covid-19 surge team to southwest Missouri after Delta variant fuels rise in cases and hospitalizations, By Aya Elamroussi, https://www.cnn.com/2021/07/07/health/us-coronavirus-wednesday/index.html

(D) Mercy to require all employees to be vaccinated, by: Savannah Tennyson, Bailey Strohl, Ivie Macy, https://fox4kc.com/news/mercy-springfield-to-provide-an-update-on-covid-19-patients-and-new-policy/

(E) Ventilator Shortage as Missouri Virus Hospitalizations Spike, By HEATHER HOLLINGSWORTH, https://www.usnews.com/news/best-states/missouri/articles/2021-07-05/ventilator-shortage-as-missouri-virus-hospitalizations-spike

(F) Delta variant slams Missouri as ICUs fill and ventilators run low, by BETH MOLE, https://arstechnica.com/science/2021/07/hospital-ceo-tells-vaccine-disparagers-to-shut-up-as-delta-slams-missouri/

(G)Ventilator and staffing shortages force rural Missouri hospitals to seek help, by Chanel Porter, https://abc17news.com/news/2021/07/06/ventilator-and-staffing-shortages-force-rural-missouri-hospitals-to-seek-help/

(H) Delta Variant Fuels Missouri’s Covid-19 Uptick, By Melanie Grayce West and Talal Ansari, https://www.wsj.com/articles/delta-variant-fuels-missouris-covid-19-uptick-11625304601

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