Ascension St. John Medical Center in Tulsa is delaying some nonemergency surgeries because COVID-19 has created “severe hospital overcrowding,” according to an internal email sent Tuesday afternoon.
“The surge equals or exceeds the previously seen levels of hospitalizations and has resulted in severe bed shortages,” the email from two Ascension St. John officials says. They noted that outpatient cases without need of an overnight bed can continue.
COVID hospitalizations in Tulsa County now number 436, a 13% leap from 385 on Monday and a 24% jump from 351 on Friday, according to the recent three-day average released by the state Wednesday.
That hospitalization level is on par with COVID’s wave in December and January, when some Oklahoma hospitals were operating under crisis standards of care.
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Gov. Kevin Stitt has conveyed no intention of declaring a state of emergency, which would allow hospitals to expand their capacity as well as let schools implement mask mandates without defying a new state law.
The state stopped releasing hospital capacity data in early May and hasn’t returned to that practice amid the ongoing surge that ranks the state among the worst in the U.S.
The Ascension St. John letter to medical staff is from John Forrest, regional chief medical officer, and Don Maciver, medical director of surgical anesthesia services.
They wrote that a strategy has to be implemented to increase bed capacity and that they are hopeful that the situation will be short-lived.
Nonelective procedures that can continue include surgery for malignancy, severe inflammatory disease or a debilitating condition from an underlying pathologic process, according to the email.
“I sincerely regret this action but the course of the pandemic dictates this response,” the email states.
Candice Evans, marketing and communications director for Ascension St. John, wrote in a statement Wednesday that the surge is a “public health crisis” that has placed great pressure on hospitals and health care professionals who need the community’s support.
The best tools are wearing a mask in public indoor spaces, avoiding large gatherings and getting vaccinated, Evans said.
“Safe and timely access to essential care is vitally important, and the safety of our patients and staff remains our top priority,” Evans wrote. “While we have a surge plan in place and are still performing surgeries and procedures our patients need urgently or in an emergency, the current surge of COVID-19 cases may require that we adjust our staffing needs and limit other services we are able to offer to patients.”
On Tuesday, Dr. Dale Bratzler described Tulsa-area hospitals as “very, very full,” with the state nearing the limits of its capacity.
Bratzler, the University of Oklahoma’s chief COVID officer, said hospitals’ ability to repurpose beds and bring in contingency staffing is dependent on a statewide emergency executive order.
“If our hospitalizations keep going up, then that may be necessary,” Bratzler said, also noting that OU’s hospital system has had to put up temporary barriers again to create COVID units because of the dramatic increase in cases.
A Hillcrest Healthcare System spokesperson said officials there are evaluating elective procedures on a “case-by-case basis to ensure adequate resources and staffing.”
A Saint Francis Health System spokesperson said that system’s hospitals haven’t limited or postponed nonemergency surgeries yet but “assess this every day.”
Oklahoma State University Medical Center also hasn’t had to adjust nonemergency procedures yet, according to a spokesperson.
Bruce Dart, Tulsa Health Department executive director, called COVID’s cases and hospitalizations a “dangerous upward trend” here.
“We are at a critical juncture with the highly infectious Delta variant circulating in Tulsa County,” Dart said in a written statement. “Most people who are hospitalized with COVID-19 are unvaccinated, which underscores the importance of vaccination to help reduce the strain on our health care systems.”
Dart encouraged a layered prevention approach: vaccination, masking indoors, frequent handwashing and social distancing to protect the community.
Tulsa County’s record for COVID hospitalizations is the 468 inpatients reported Jan. 11.
Since June 30, COVID-19 hospitalizations in Tulsa County have skyrocketed 790%, going from 49 to 436 inpatients, according to three-day averages released by the state.
Of the 436 hospitalized COVID patients, 136 were in intensive care.
Bratzler, during a weekly Healthier Oklahoma Coalition virtual conference with media outlets, offered a reminder that there are also many non-COVID patients who need beds in hospitals.
He said a shortage of nurses prevents facilities from being able to open up all of their beds.
“I think we are approaching the limits of capacity,” Bratzler said.
Much faster than what the state endured in 2020, the delta variant outbreaks in Missouri and Arkansas flooded into northeastern Oklahoma and spread west and south.
Nearly two weeks ago, the situation was dubbed a “crisis” by an Oklahoma Hospital Association vice president who said hospitals in Grove, Miami and Tahlequah already were full.
For the first time in 42 days, the statewide average of COVID-19 hospitalizations decreased Tuesday.
The recent three-day average was 919, down 6% from the 973 reported Monday.
The level reported Tuesday is similar to those reported in October. It took several months to reach those numbers in 2020, as compared to just several weeks this summer.
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Dr. Dale Bratzler, OU Health chief COVID officer, describes a recent outbreak of delta variant among vaccinated people. Breakthrough cases also point to new variants happening, experts say.
