Just a little update from purgatory.
My little rural hospital is now officially in crisis. Inpatient census is 120% of capacity with gasping coughing COVID patients packed into every available nook and cranny. All surgical procedures were put on hold this week because there’s nowhere to put post-operative patients, and the OR nurses have been drafted for COVID care. Wait times in the ER now average 2-6 hours as the ER nurses and docs are also caring for numerous COVID patients boarding in the ER for lack of beds upstairs. Everything is gridlocked because desperately ill COVID patients take weeks to months to improve, or die, before their bed is freed up for the next person.
The ICU is full, every room occupied by a COVID patient on a ventilator. We had to borrow more ventilators from the nearest city at the end of last week, and they’re already in use. As of last week the closest open ICU bed was 250 miles away, in the State capitol. On the brighter side, I now know who to call and what to do for expedited authorization for Emergency Use Authorization treatments like Baricitinib; the Infectious Disease Department gurus in the city have learned to trust our judgement and we no longer have to beg.
Every hospital floor is a frenzy of beeping monitors, terrified wailing patients and harried, overworked nurses. The hospital isn’t doing Regeneron antibody infusions for the simple reason that there isn’t a single open room or space that could be dedicated to infusions that doesn’t have a COVID patient in it already. I have twice come upon nurse practitioners quietly crying at their desk.
And we’re just starting to see the incoming post-Thanksgiving Tsunami. Two days ago I saw numerous patients in my office with respiratory symptoms, and I swabbed them all. So far ~30% have come back positive for COVID, and I don’t have all the results yet, so the final percentage will likely be higher. Add another week for decompensating patients and….next week is looking very, very grim right now.
Despite all this, the overwhelming majority of people in our communities have absolutely no clue about the catastrophe unfolding right here. Two of the three mainstream network television stations in the nearby city are Sinclair media, and the other is Fox. They do a brief bland update on local numbers now and then, before moving on to lurid crime reports, never (ever!) showing viewers what a hell-scape all the regional hospitals are right now. When patients in the office ask me “How’s it going at the hospital?”, they are invariably stunned, shocked into silence, when I tell them.
And yet I still every single day get rancid push-back from multiple Trump-loving anti-vaxxers when I suggest that maybe, just maybe, they should protect their children and vulnerable frail parents by getting vaccinated, rather than delivering COVID to them for Christmas.
