Oklahoma hospitals and physicians are sounding alarms that haven’t changed Gov. Kevin Stitt’s view that the government won’t solve COVID-19 and that “personal responsibility” is the way to go.
Hospitals are trying to reserve beds for the “sickest of the sick” but are at capacity, with no apparent relief in sight as exhausted caregivers say the burden is untenable, according to Oklahoma Hospital Association President Patti Davis.
She and other medical professionals described a troubled scene across the state during the Healthier Oklahoma Coalition’s weekly COVID-19 briefing with reporters Tuesday.
Dr. Jason McElyea, a rural emergency room physician, had a gunshot victim in his facility whom for hours he was unable to transfer to a higher level of care because no one had space. One of McElyea’s colleagues had to send a severely ill COVID patient all the way to South Dakota.
“They had sat in a small hospital needing to be in an ICU for several days and that was the closest ICU that was available,” McElyea said.
Dr. Mary Clarke, president of the Oklahoma State Medical Association, said Stillwater Medical Center has a patient with a cardiac issue that it can’t handle. The patient has been in its care for three days as health care workers keep her stable while trying to find a hospital in Oklahoma City where it can send her, Clarke said.
“I’m trying to help people understand this is not just COVID,” said Clarke, a family practitioner based in Stillwater. “This is a domino effect to every other health condition that may need a hospital bed. Everything else. Period.
“COVID — yes — is taking up room, but COVID we can prevent (with vaccination). I can’t prevent someone tomorrow from having a heart attack.”
Davis said the Oklahoma Hospital Association’s recent survey of hospitals found there are about 200 fewer staffed beds in the state than in December.
“That is very much a concern because we know there’s a great deal of fatigue right now of health care providers just saying, ‘We can’t continue to do that,’” Davis said. “That’s affecting them not only professionally but personally, and we are very concerned about that.”
Three major Oklahoma City hospital systems have reported no available ICU beds — and a fourth has reported no room for COVID patients — in point-in-time census counts. Some hospitals have halted select services or are delaying nonemergency procedures.
The governor appears to have no intention of pivoting toward some level of restrictions rather than relying on a message of “personal responsibility” to help hospitals or protect vulnerable individuals.
“The Governor’s position has not changed,” wrote Carly Atchison, spokesperson for Stitt. “He does not believe government will solve the COVID virus now or at any point in time. He will always trust Oklahomans to do the right thing.”
Davis said the Oklahoma Hospital Association’s top concern is the availability of intensive care beds, which she knows is “very tight.” She described how an ICU bed might open at 11 a.m. and be filled five minutes later.
“We know that patients are being transferred out of state for beds,” Davis said. “We are increasingly concerned about the number of holds that are in emergency rooms waiting for ICU beds.”
She said the recent growth in confirmed cases — particularly among school-age children — is alarming because that often is a harbinger of more hospitalizations to come in the near future. Sick children might not need hospitalization as often as adults, but Davis said they could infect their parents.
“We need every tool used right now that we can possibly use to keep people out of the hospital because we’ve got to reserve those beds for the sickest of the sick,” Davis said, referencing monoclonal antibodies and other strategies, such as vaccination, wearing masks, socially distancing, and washing hands or using hand sanitizer frequently.
McElyea, a frontline family physician working in emergency rooms in eastern and southern Oklahoma, said the gunshot victim who came in normally would have been no problem to transfer out of a small hospital that had no neurosurgeon and minimal critical-care capacities.
“We had a critical patient sitting in our ER for hours, and we simply couldn’t find a place for him to go,” McElyea said. “Another colleague in a place across the state: same situation. A traumatic brain injury with internal bleeding — couldn’t find a place to place these patients.”
The other patient with head trauma and internal bleeding was sent to Missouri, he said.
McElyea touched on one of the financial ramifications to families, too. He noted that insurers don’t pay for patients to be transferred back in state.
“Where it recently hit home for me was I had a colleague tell me they transferred a patient to South Dakota,” McElyea said. “These families have to worry about not just how their loved one is doing but how to get them back when they’re better.”
Dr. David Kendrick, chairman of the Department of Medical Informatics at the OU School of Community Medicine, said COVID patients are staying longer in ICU beds because they are trending younger and healthier.
Kendrick said that means they can tolerate being on a ventilator longer to hopefully come off it than those who were already ill before infection.
Davis said the Oklahoma Hospital Association’s members aren’t conveying any sense of a light at the end of the tunnel for overwhelmed hospitals.
“I think we’ve got a ways to go to get to a level where as a state the hospitals can breathe a sigh of relief and say, ‘We’re headed in the right direction,’” Davis said.