Dr. Sam Ratermann has seen firsthand patients who haven’t received the higher-level or specialty care they need because COVID-19 is inundating Oklahoma’s hospital system.
For weeks, if not months, he said, the intensive-care unit at Integris Grove Hospital has been completely full and staffed to the maximum. Ratermann said he spends a portion of his days playing resource manager, trying to fit together puzzle pieces as he works to get patients the care they require but that sometimes he can’t find.
Ratermann, medical director of the hospitalist program at Integris Grove, said he had a patient who needed a higher level of care over the weekend and the only available bed was 200 miles away in Kansas City.
On Monday, a hospital more than 300 miles away contacted him to try to transfer a COVID patient to his rural facility.
“I’ve personally seen patients — people I care deeply for — suffer the consequences of this lack of higher level of care and specialty care,” Ratermann said. “We’ve had patients that I’ve seen come and go and I’ve talked to other providers that have patients stuck in ERs for 16 hours or sometimes a day or two days waiting to get to the care that they need.
“That was never a problem before this pandemic. This is something new.”
The Healthier Oklahoma Coalition hosted a virtual news conference Tuesday in which the state’s former interim epidemiologist projected the state to be on track for 42 COVID-19 deaths each day by Jan. 1, or about 300 total deaths in the peak week. Dr. Aaron Wendelboe also projected there could be nearly 300 new COVID hospital admissions per day, or just fewer than 2,000 new admissions throughout the peak week.
For perspective, Wendelboe said, there have been 24 deaths per day in the past week or 168 total deaths in the past week. There are about 160 new hospital admissions per day or about 1,100 in the past week, he said.
In less than a year, he noted, COVID-19 has become the third-leading cause of death in the U.S.
“However, there are ways that we can still control transmission. With mitigation efforts we can prevent approximately 10 deaths each day or around 200 deaths before just the end of the year,” Wendelboe said. “If we practice simple prevention measures, such as keeping our distance from others, masking, washing our hands, we can bend the curve until a vaccine gets here.”
Healthier Oklahoma Coalition is a group representing the largest health care professional organizations in the state.
In addition to his work at Integris Grove, Ratermann is president of the Oklahoma Academy of Family Physicians.
He said sometimes his hospital makes about 25 calls trying to find higher-level or specialty care.
Ratermann described a recent instance in which a woman underwent cardiac arrest at home. Her family reacted correctly by administering CPR, calling paramedics and getting her to the hospital.
“The hospital did everything right — they were able to get her heart beat back, but she needed specialty level care and there wasn’t a single hospital that could provide it,” Ratermann said. “She sat in the ER I think for 16, 17, 18 hours in critical condition waiting for care.
“Now, she received care at the facility she was at, but not the level that she needed.”
Ratermann said the woman was eventually transferred to a hospital out of state, where she died.
“What’s heartbreaking is to watch patients suffer and die and watch my exhausted colleagues try and catch their breath under their facemasks and fogged face shields, only to see people walk around in the community not wearing masks and doing their part,” he said.
The data don’t look any better than Ratermann’s experiences.
The U.S. Department of Health and Human Services on Monday released a <&underline>dataset of COVID-19 hospital capacity by each facility</&underline>. Previously, the department said, data released were aggregated at the state level.
Dr. George Monks, president of the Oklahoma State Medical Association, said Oklahoma ranks in the top four states for highest rates of occupancy, along with Kentucky, Georgia and Minnesota.
Monks said that hospital capacity changes by the hour but that “we’re just maxed out.” He highlighted the state report Friday that showed only 33 — or 3% — of ICU beds were available statewide out of 1,007 overnight Thursday in a point-in-time survey.
“Our system is so strained right now that it’s compromised our ability to deliver good quality of care,” Monks said.
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