Washington medical association urges Gov. Inslee to aid hospitals operating at ‘crisis capacity’

The Washington State Medical Association (WSMA) has requested that Gov. Jay Inslee and state Secretary of Health Dr. Umair Shah officially declare Washington state in crisis.

The request asks that the state provide immediate assistance to emergency departments and hospitals that are declining elective care and procedures to accommodate a surge in COVID-19 hospitalizations.

The WSMA represents more than 12,000 physicians and medical personnel throughout the state.

“The time has come to officially make the call; we are in a state of crisis,” the WSMA request reads.

“As physicians, we know when we can do no more for our patients, and that time is now. We are effectively operating crisis capacity strategies throughout our health care system. Our emergency departments are overrun, our hospitals are full. We are emotionally and physically exhausted.”

WSMA’s formal request outlines a number of actions to be taken under the crisis designation:

• Continue or increase incentives to long-term care (LTC) providers for serving patients who are discharging from hospitals.
• Increase the budget for the Department of Social and Health Services to immediately hire more staff to facilitate transitions out of hospitals.
• Immediately address barriers to guardianship for patients who are ready to be discharged from acute care hospitals, including allowing family members to agree to transfers rather than languishing while waiting for guardians to be appointed.
• Use the national guard to assist with staffing shortages in long term care facilities and hospitals, including many non-clinical services such as patient transport, meal service, and laboratory assistance.

Dr. Shah responded to the request in a state Department of Health press briefing Thursday morning. He affirmed that crisis standards of care are a specific, peer-reviewed set of guidelines, contingent on a number of thresholds that Washington’s hospitals have not met. The guidelines refer to select triage decisions medical professionals make in the event of limited resources brought on by a disaster.

“Crisis standards of care would be at that point where every institution across the state have no other way to … move patients … who were seeking care to other alternate places, … and also that there is an inability for resources to be coming into the health care system for support,” Shah said. “We’re obviously not there yet.”

Dr. Ettore Palazzo, chief medical and quality officer at EvergreenHealth, affirmed in a Washington State Hospital Association press briefing that, although he has been able to avoid a “crisis intensive care situation” throughout the pandemic, “we are closer than we have ever been.”

“For us, we see this as a very unique convergence of events, and the omicron wave certainly has brought record breaking cases here locally. … Statistically, you can’t argue that when we look at the exponential number of cases, there will be more individuals that need the acute care,” Palazzo said.

That convergence relates to not just the omicron wave, but staffing shortages brought on by fatigue and COVID cases among medical personnel. Compound that with the lack of access to long-term care facilities — Palazzo stated that EvergreenHealth has “50 patients that don’t need to be here” — and his hospital is dangerously close to “crisis.”

“In the last three weeks we now have seen a 60% increase in COVID cases here at Evergreen,” Palazzo continued. “Right now, as of this morning, half of our ICU beds are being taken, are full with COVID patients, and many are very, very sick.”

While Washington’s lack of infrastructure to meet the demand for long-term care facilities is a significant reason for WSMA’s request, public health officials Thursday continued to stress that the omicron wave is causing a surge in hospitalizations.

Dr. John Lynch, medical director of Harborview Medical Center’s infection control program, pointed out Thursday that King County has seen an average of 31 COVID-19 hospitalizations a day, “an increase of 76% in the last seven days.”

“This is the largest number of COVID-19 inpatients we’ve had in the entire two years,” Lynch continued. “And we’re going to see this exact same trend in every single hospital in our state. If they haven’t gotten there already, it’s going to be there in days and weeks.”

Listen to KIRO Radio’s Nicole Jennings’ latest coverage of how hospitals have been impacted by the omicron wave here:

Gov. Inslee’s office could not be immediately reached for comment.

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