POST 187. August 11, 2021. CORONAVIRUS. “As a result of the increase in COVID-19 cases and hospitalizations, the state of Florida requested 300 ventilators from the federal government.”… “An 11-month-old girl with Covid-19 is stable and no longer intubated one day after she was airlifted to a Texas hospital 150 miles away because of a shortage of pediatric beds in the Houston area.”

for links to POSTS 1-187 in chronological order, highlight and click on

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“The request was made on Friday “to replace expended state stores,” the document said.

The ventilators were expected to be delivered on Monday, though it was not said how they will be allocated.

Gov. Ron DeSantis said Tuesday that he was not aware of such a request when asked about it.

“I have not heard about that, so I have to check to see if that’s true or not,” he said. “I would honestly doubt that that’s true, but I’ll look. We have a lot of stuff that we stockpiled over the last year and a half through the department of emergency management. I have not had any requests across my desk. I haven’t been notified of that.””(A)

“Dozens of Texas hospitals have run out of intensive care unit beds as COVID-19 surges faster than any other time during the pandemic, propelled by the new delta variant.

The state is divided into 22 trauma service areas, and half of them reported 10 or fewer available ICU beds on Sunday. As more than 9,400 COVID-19 patients fill the state’s ICUs, which are reserved for the patients who are the sickest or most injured, the trauma service area that includes Laredo reported no available ICU beds, while the area that includes Abilene reported having one.

At least 53 Texas hospitals have no available ICU capacity, according to numbers reported to the federal government during the week ending Aug. 5. In Austin, five hospitals were at or above 90% of their ICU capacity during the same period, with two reporting no available ICU beds.

“This surge is by far the fastest and most aggressive that we’ve seen. Almost all of our hospitalizations are due to unvaccinated patients developing severe illness,” Dr. Desmar Walkes, Austin-Travis County’s health authority, told reporters last week. “ICU staff are seeing a younger population in our hospitals. Patients in the ICU are sicker and stay in the hospital longer than with prior surges, putting more strain on hospital resources.”

Around 87.1% of all hospital beds in Texas are in use — the highest level since the start of the pandemic — with 14.1% of those beds occupied by COVID-19 patients. When Gov. Greg Abbott began to relax some COVID-19 restrictions on businesses in October, his order maintained reduced restaurant capacity and kept bars closed in regions in which 15% or more of hospital beds were filled with COVID-19 patients…

Medical professionals are afraid that hospitals will become so overwhelmed by COVID-19 patients that they won’t have space for new patients — a situation that many hospitals faced during previous COVID surges.

“We need to make sure that there’s beds and hospitals and staff in hospitals available to take care of people who don’t just have COVID-19, but … all of those other conditions,” said Dr. Jennifer Shuford, chief state epidemiologist for the Texas Department of State Health Services. “As we see hospitalizations increasing at this rapid rate, we are afraid that we’re going to stress hospitals to the point that they can’t take care of some of those other people who are coming in to the hospital for a stroke or a heart attack or any number of other things.”

Already, Shuford said she’s heard of hospitals that can’t accept patient transfers from other hospitals because they have no beds open.” (B)

“A hospital system in Texas is prepping tents for the overflow of patients after a surge in Covid-19 cases filled its hospitals to the verge of capacity.

Harris Health System in Houston is reporting 1 in 4 patients at its two hospitals have tested positive for Covid-19.

Ben Taub Hospital’s intensive care unit is at 95% capacity with 27% of utilization by Covid-19 patients and Lyndon B. Johnson Hospital, where the tents are being set up, is at 100% ICU utilization with 63% Covid cases, Harris Health spokesperson Bryan McLeod told CNN in an email.

“They are still in the process of completing set up, and installing IT equipment, etc. There is no pre-determined time for when they will begin to be used, but they want the tented environment to be ready to go in the event they are needed,” McLeod said…

Another lagging problem is personnel shortages. Porsa said he would welcome federal aid to relieve some of the pressure. The hospitals are 254 nurses short leaving hospitals with no options but to hire agency nurses at high prices, he said…

“The situation is bad and only getting worse. We are not heading towards a crisis, we are in the middle of a crisis,” Porsa said.” (C)

“The resurgence of COVID-19 in Texas has put some cities’ health systems in dire circumstances, as intensive care unit beds fill up, officials say.

In Austin, the health department said there were only nine ICU beds available on Friday in the 11-county trauma service region that includes the city and serves 2.3 million people.

“We are running out of time and our community must act now,” said Dr. Desmar Walkes, Austin’s medical director/health authority. “Our ICU capacity is reaching a critical point where the level of risk to the entire community has significantly increased, and not just to those who are needing treatment for COVID. If we fail to come together as a community now, we jeopardize the lives of loved ones who might need critical care.”…

San Antonio is also facing a nursing shortage caused by an increase of coronavirus patients. City leaders had hoped the state would help fill the shortage, but in a letter sent Thursday to city and county leaders across Texas, the state directed local governments to instead make their own plans to increase hospital staffs before asking the state for help, the San Antonio Express-News reported.

The state previously hired staffing companies to send traveling nurses, doctors and respiratory therapists to help hospitals cope with COVID-19 surges.

In San Antonio, COVID-19 hospitalizations on Saturday were up by 430% since the start of July, the newspaper reported.

“We have patients waiting in the lobby; we have patients in the hallway,” said Tommye Austin, the chief nurse executive for University Health, one of the largest hospitals in San Antonio. “Every nook and cranny in this organization has a patient.” (D)

“As hospitalizations for COVID-19 continue to rise, health leaders have been warning for weeks that staffed ICU beds are in short supply. They’ve asked the community to get vaccinated and return to mask-wearing to help with the surge.

In a joint meeting with Austin City Council and Travis County Commissioners last week, Dr. Desmar Walkes, the local health authority, said area hospitals were already going into what’s called “diversion” mode. That means the hospital has to ask EMS to take patients elsewhere…

Dr. Walkes also said in that meeting that the Austin-Travis County area has adopted a mass casualty care plan to prioritize patients based on severity and resources available, should we hit a point where hospitals area-wide are over capacity, and patients cannot be transferred…

We have previously reported that the Austin Convention Center could turn into an alternate hospital to take in patients who need critical care. It was not clear how that facility would be staffed.” “ (E)

“”What I am seeing during my shifts is just as bad, if not worse, than what I saw last year,” said Dr. Owais Durrani, an emergency medicine physician who works at several freestanding emergency departments and hospitals in East Texas. “Before COVID, sending patients home on oxygen was unheard of. We are now sending patients home on oxygen again due to hospital capacity issues.”

Critical access hospitals and freestanding emergency departments, like the ones Durrani works in, usually aren’t designed or staffed to keep patients for extended time periods. Instead, they rely on transferring patients to other facilities for critical care. But given the lack of available beds across the state, transferring is now nearly impossible, Durrani explained.

“We are having extreme difficulty transferring patients out,” he said. “I have personally transferred patients to other states due to not having any Texas beds.”….

He shared the story of a patient he treated with an acute medical issue that required surgery. ER physicians are trained to stabilize patients, not perform surgery. During non-pandemic times, that patient’s wait would have been a few hours. Instead, the patient sat in the emergency department for 16 hours because partner hospitals with surgeons were full.

“This patient of mine was vaccinated, not a COVID patient, but due to the pandemic brought on by the unvaccinated they received suboptimal care,” Durrani said.” (F)

“Arkansas, among the states hardest-hit by a new wave of coronavirus cases linked to the highly contagious delta variant, says it is down to eight unoccupied ICU beds statewide with which to care for COVID-19 patients.

Gov. Asa Hutchison, in a tweet on Monday, said the latest report highlighted “startling numbers.”

“We saw the largest single-day increase in hospitalizations and have eclipsed our previous high of COVID hospitalizations,” the governor wrote. “There are currently only eight ICU beds available in the state.”

“Vaccinations reduce hospitalizations,” he added.

Hospitalization of COVID-19 patients jumped by 103 to 1,376, the report cited by Hutchison shows. It’s the biggest daily jump and total in the state since the start of the pandemic.

“This is unlike anything that we experienced before during the COVID-19 pandemic,” says Dr. Cam Patterson, who serves as chancellor of the University of Arkansas for Medical Sciences, which includes the UAMS Medical Center hospital in Little Rock…

About 17% of nursing positions at the hospital are vacant, which increases the load on the current staff.

“They’re taking care of more patients than they’re used to and they’re just flat worn out,” he says…

In April, Hutchison signed into law a statewide ban on further mask mandates. However, in a news conference last week, the governor said he regretted signing the measure, which has complicated his state’s efforts to control the spread of the virus.

“In hindsight, I wish that it had not become law,” he said. “But it is the law, and the only chance we have is either to amend it or for the courts to say that it has an unconstitutional foundation.” “ (G)

“There is only one COVID ICU bed available in the state Tuesday morning with five hospitals showing limited bed space for COVID patients.

“We have nowhere to send COVID-19 patients within the State of Arkansas. There is limited bed capacity at trauma centers increasing pressure on the time-sensitive healthcare system,” said Jeff Tabor, program director for the COVIDComm system, which helps match covid-19 patients with hospitals.

Tabor said the one COVID ICU bed which is available is located in southern Arkansas. There are five hospitals, also in southern Arkansas, showing limited COVID bed space.

Tabor said some COVID-19 patients are so critical at rural Arkansas hospitals that they cannot be transferred to other hospitals because the patient is too critical and because of bed space.

UAMS struggling amid pandemic while staff shortage at its peak

“It’s been a slow-moving train to this situation over the last couple of days,” said Tabor, noting that hospital capacity is affecting all Arkansas hospital systems.

Tabor said that with less staff and fewer beds the situation has become “the perfect storm.”” (H)

“A steep increase in seriously ill COVID-19 patients has pushed hospitals statewide into crisis mode again this week, prompting worries that the new surge may overwhelm facilities already struggling to find enough nurses to adequately staff emergency rooms and intensive care units.

Large hospitals in metro Atlanta frequently went on diversion status this week because they were so full, sending ambulances elsewhere. Some elective procedures started to get pushed back across the state to free up medical staff and hospital beds.

Everywhere, top doctors monitored a trendline driven by the highly contagious delta variant they worry could surpass the January surge that flooded every hospital in Georgia….

With cases and hospitalizations rising quickly across Georgia, it’s hard for hospitals from one part of the state to help out hospitals elsewhere that are overloaded.

“This is an extraordinary point of the pandemic,” said Dr. Dianna Grant, chief medical officer at the Phoebe Putney Health System in Albany, which was the first in Georgia to be hit hard by COVID-19. “Seventeen months ago, when the Albany area was an early hotspot, we were an outlier. Other hospitals that were not dealing with an onslaught of patients had the ability to help. That’s not the case now. All hospitals are operating at capacity.”

The trendlines suggest that the coming days will further test a healthcare workforce that has already been on the front lines for more than a year.

“This is the most rapid of all the surges,” said Dr. Danny Branstetter, medical director of Infection prevention for the Wellstar Health System. “How far will it go? Will it get to those peak numbers we saw in December or January? Who knows. But the quickness with which it is getting there is of concern today.”…

While large hospitals in Atlanta struggle for nurses, rural hospitals often face even greater challenges finding the staff they need. Angela Ammons, CEO of Clinch Memorial Hospital in Homerville, also is a registered nurse. Because of staffing shortages, she is also working on the floor while she serves as CEO. She went to work Tuesday in her scrubs and packed an overnight bag in case she had to stay at the hospital because of the rise in cases.

She said she has been calling an agency that provides nurses to healthcare facilities, but the agencies have no more nurses to send to her.

“If we don’t have enough staff to come in and patients start flooding our ER, we’re not turning them away,” Ammons said. “We will do the best we can. It’s similar to another wartime effort, like what we were in last year. We’re doing the best we can with what we got.”…

Wait times are longer at almost every emergency room right now, whether it’s a large hospital in Atlanta or a rural hospital in a small town. At Southeast Georgia Health System, the hospital publishes statistics every day showing that the vast majority of hospitalized COVID patients have not been vaccinated.

“It’s very hard, very disheartening for our health care teams to be going through this again. The hardest part is that we aren’t experiencing the community support that was shown last year when there wasn’t a vaccine available,” said Michael D. Scherneck, president and CEO at Southeast Georgia Health System.

He said that while vaccination rates are low in the community, patients are also complaining about long waits for emergency care at the overloaded hospital.” (I)

“Gov. Greg Abbott appealed for out-of-state help to fight the third wave of COVID-19 in Texas while two more of the state’s largest school districts announced mask mandates in defiance of the governor….

The Republican governor has directed the Texas Department of State Health Services to use staffing agencies to find additional medical staff from beyond the state’s borders as the delta wave began to overwhelm its present staffing resources. He also has sent a letter to the Texas Hospital Association to request that hospitals postpone all elective medical procedures voluntarily.

Hospital officials in Houston said last week that area hospitals with beds had insufficient numbers of nurses to serve them.

Abbott also directed the state health department and the Texas Division of Emergency Management to open additional COVID-19 antibody infusion centers to treat patients not needing hospital care and expand COVID-19 vaccine availability to the state’s underserved communities. He also announced about $267 million in emergency Supplemental Nutrition Assistance Program food benefits for August. That was on top of the $3.9 billion in benefits previously allocated since April 2020.

The governor is taking action short of lifting his emergency order banning county and local government entities from requiring the wearing of masks and social distancing to lower the COVID-19 risk. Abbott has said repeatedly that Texans have the information and intelligence to make their own decisions on what steps to take to protect their health and the health of those around them.” (J)

“COVID-19 cases have filled so many Florida hospital beds that ambulance services and fire departments are straining to respond to emergencies.

In St. Petersburg, some patients wait inside ambulances for up to an hour before hospitals can admit them — a process that usually takes about 15 minutes, Pinellas County Administrator Barry Burton said.

While ambulances sit outside emergency rooms, they are essentially off the grid.

“They’re not available to take another call, which forces the fire department on scene at an accident or something to take that transport. That’s caused quite a backlog for the system.”…

Burton stressed that the most serious non-COVID cases, such as heart attacks and strokes, still get prompt attention in emergency rooms. And he says the county is working with fire rescue officials to find more ambulances and have extra staff on hand. But “that really taxes on already overstressed fire and rescue staff,” he warned.

Nearly 70% of Florida hospitals are expecting critical staffing shortage in the next seven days, according to the Florida Hospital Association. The COVID-19 influx is also hitting as Florida hospitals are seeing “unusually high numbers of very ill non-COVID patients,” said the association’s president Mary Mayhew.” (K)

“More Florida children were hospitalized with COVID-19 on Tuesday than in any other state, reflecting a rapid rise in serious illness among an age group considered to be at the lowest risk of severe outcomes from the disease and many still not eligible for the vaccine.

A total of 46 pediatric patients were admitted to a Florida hospital with a confirmed infection while an additional 22 were hospitalized with a suspected case, according to the federal government’s hospital capacity data.

Only Texas reported a higher total number of pediatric patients in hospitals with confirmed COVID-19 on Tuesday — 142 children — compared to 135 in Florida…

Physicians and public health experts attribute the rise in pediatric hospital admissions to the more contagious delta variant of the virus that causes COVID-19 — which produces a viral load that is roughly 1,000 times higher than the original coronavirus strain — and the low rate of vaccination among those younger than 20.

‘It just went boom.’ ICUs are being overwhelmed with younger — and sicker — patients” (L)

“An 11-month-old girl with Covid-19 is stable and no longer intubated one day after she was airlifted to a Texas hospital 150 miles away because of a shortage of pediatric beds in the Houston area.

The baby has made “an amazing recovery,” said Dr. Dominic Lucia, a pediatric emergency physician and chief medical officer at Baylor Scott & White McLane Children’s Medical Center — Temple, where the child was transported on Thursday.

“She’s no longer requiring the breathing machine. She’s actually off that right now… and she’s actually resting with mom. She’s looking great.”

The child, Ava Amira Rivera, tested positive for Covid-19, according to Amanda Callaway, a spokeswoman for Harris Health System. Callaway said Ava was having seizures and needed to be intubated but Lyndon B. Johnson Hospital, where she was first taken, does not offer pediatric services.

None of the major pediatric hospitals in the area had beds available, Callaway said.” (M)

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