Washington hospitals worried about capacity ahead of potential omicron wave

The Washington State Hospital Association (WSHA) is preparing for an influx of COVID-19 cases as the omicron variant spreads across the region.

“Omicron is serious and it is rapidly spreading and, honestly, our heads are spinning a little bit about how fast it’s spreading,” said Taya Briley, executive vice president of the WSHA.

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Briley said Thursday that hospital capacity is more restrained now than it has been at any point during the COVID-19 response with some hospitals at or above 120% capacity. However, she clarified that capacity is not primarily driven by patients with COVID or even patients who need hospital care at all.

“Right now, surgeries and scheduled procedures are being canceled and patients are being cared for in hallways and waiting rooms,” she described.

Briley acknowledged early reports that patients with omicron don’t get as sick, and even fewer will need hospital care, but that doesn’t mean that no one will need care.

“We have a math problem,” she pointed out. “That is, even if most people don’t get really sick, there are a lot of people who are getting infected with omicron and some portion of them will get severely ill and need hospital care. Even if it’s a small portion of the overall total, this could mean a huge number of people getting sick enough to need hospitalization.”

While there are an average of 12-15 deaths per day related to COVID in Washington state, and the average number of patients on a ventilator last week was 85, Briley noted the numbers have been dropping. Over 100 patients were on ventilators the week prior. COVID related hospitalizations have also dropped from 626 to 575 in the past two weeks.

“As we’ve said before, the thing most driving these hospitalization numbers is the fact that patients who don’t need acute care are stuck in hospitals,” Briley said. “And they really need to be in more appropriate settings where they can receive the type of care that they need and more community-based settings like a nursing home or other long-term care.”

She said that unless they can move people into more appropriate settings immediately, they’re not sure they can take care of everyone if they get a spike of COVID cases.

Briley said most of the solution to the current capacity issue lies with the state. Hospital leaders met with state leaders this week and they feel confident that laws will change to help ease the burden on the state’s health care system.

The hospital leaders are asking for help in assessing patients faster for placement into long-term care settings, and they want staff at those long-term care facilities to be paid a higher rate. They believe better pay will prevent staffing turnover.

Dr. Mark Taylor, associate administrator at Harborview Medical Center, and also the director of operations for Washington Medical Coordination Center, said he believes hospitals in Washington have done an excellent job at coordinating the distribution of patients so far, but it is a challenge.

“The pandemic impact is not equally spread throughout the state,” Taylor explained. “It disproportionately impacts some communities more than others.”

Patients with severe COVID infections may need to be moved to facilities better equipped to handle that care. This becomes difficult in geographically isolated communities, or when hospitals are dealing with high capacity.

Briley said they’re doing everything they can to avoid tipping into crisis standards of care.

“We’re worried. We’ve been preparing for crisis standards,” Briley said. “We want to avoid it. We’re doing everything we can to avoid it.”

She added that they’ve been rolling out new guidelines, and hospitals are studying those to be prepared for a crisis standard of care situation.

Michael Myint, MultiCare Connected Care’s physician executive, said traditionally, the levers that trigger that crisis standard of care are the number of available beds and ventilators.

“What we’re really into right now are staffing issues,” Myint said. “Staffing through the holidays is really going to be important.”

He added that they’re encouraging staff to get their boosters and they’re paying close attention to federal guidelines around quarantine standards.

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Briley is pleading with people to do everything they can to stay healthy, which includes getting vaccinated and a booster shot, investing in high-quality masks, being thoughtful about holiday gatherings and events, and keeping distanced in well-ventilated areas.

“Whether or not you’re vaccinated, if you are experiencing COVID-19 symptoms, even if they’re minor, please get tested,” she said. “Isolate yourself until you get a negative test result and follow guidelines for care at home.”

Briley added that it’s important to seek care from a primary care provider early. Don’t wait until you’re having an emergency.

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