Coronavirus Watch: Asante Three Rivers still slammed with the sheer number of COVID-19 patients

For the second time in less than a month, doctors and administrators from Asante joined a conference call with the media on Wednesday to deliver a complete view of the dire situation.

Posted: Sep 1, 2021 2:11 PM
Updated: Sep 1, 2021 6:04 PM

GRANTS PASS, Ore. — Asante Three Rivers Medical Center in Grants Pass continues to suffer under a nearly month-long surge in hospitalized COVID-19 patients — one that has resulted in hundreds of canceled procedures, a desperate need to expand bed capacity to meet those needs, and a recent spike in deaths.

For the second time in less than a month, doctors and administrators from Asante joined a conference call with the media on Wednesday to deliver a complete view of the dire situation.

"For Asante specifically, we're almost three times what we saw in the winter surge, that's the kind of patient volume we're seeing now," said Win Howard, CEO at Asante Three Rivers. "We planned over the last 18 months for this day, you know, if we were going to get to this point, and I prayed it wouldn't happen — and it is happening, it has happened. We're at an absolute crisis of nothing like we ever thought was going to happen."

Asante Three Rivers currently has 146 inpatients, which is only possible because the hospital received emergency approval from the Oregon Health Authority to expand their license from 125 beds to 177 beds. Of those 146 inpatients, 78 patients — more than half — have COVID-19, and 91 percent of those are unvaccinated.

As a system, Asante has recorded 28 deaths from COVID-19 in the last seven days.

Even with a recent expansion of their Emergency Department, Asante is seeing between 10 and 20 "boarders" — patients who have been evaluated and admitted — per day, with a capacity of 30 beds in the entire department.

"So these are patients who are sick enough, that need to be admitted, that we purely do not have physical space for," said Laura Magstadt, vice president of Nursing at Three Rivers. "We started this morning, I believe we were at ten boarders, that number just moments ago was right around twelve or thirteen, I believe. We've sort of been living at that ten-to-twenty range in a thirty-bed ED."

Three Rivers' intensive care unit, originally a 12-bed unit, has been expanded to a 22-bed unit by having two patients share what were intended to be single rooms, separated by partitions. Ages of the ICU patients range from 32 to 78, and 90 percent of these patients are unvaccinated. All of the ICU patients have COVID-19.

"We have so many critically ill patients that unfortunately that was one of our only options," Magstadt said.

Two medical surgical (med surg) units at Three Rivers are completely full of COVID-19 patients, while a third surg unit is full of other patients. The COVID-19 patients in these surg units range in age from 27 to 97, many of them in their middle ages.

Outpatient care beds, which usually serve as temporary recovery spaces for people just coming out of surgery, are now long-term beds for inpatients. Because so many elective procedures have been canceled, the surgeons and staff that would otherwise have been performing those outpatient procedures have been reassigned to other duties.

Some things are starting to improve, Magstadt said. One of the biggest problems has been an ongoing bottleneck in transferring patients to long-term or hospice care after receiving treatment. Asante is now working with Oregon state officials to help solve the issue and find places for these patients, 15 of them at Three Rivers.

Magstadt said that the National Guard reinforcements have been incredibly helpful as well. There are 116 guardsmen at Asante facilities in southern Oregon — doing everything from washing dishes and cleaning rooms to running supplies and answering phones.

Staffing continues to be one of the biggest issues with the current surge. While beds can be "made" to a certain extent by converting rooms to other uses, staff cannot be similarly conjured out of thin air. With the recent announcement that Oregon has contracted several medical staffing agencies, Magstadt said that Asante expects to get 40 out-of-state nurses coming aboard today, followed by dozens more this week.

Jackson and Josephine counties continue to have the highest hospitalization numbers in the entire state of Oregon, according to OHSU's most recent modeling. Those are expected to peak early next week — but, general surgeon Dr. Estin Yang pointed out, the model shows that hospitals will continue to be at crisis capacity into mid-October even as hospitalizations gradually fall.

The downstream impacts will disproportionately land on people who require elective surgeries. Until Asante is out of that crisis capacity that started at the beginning of August and will likely continue into October, procedures will continue to be postponed. This includes cancer patients, people at risk of stroke or heart attack, and those who could lose a limb.

Dr. Megan Frost, another general surgeon at Three Rivers, said that calling patients to tell them that their procedures will have to wait for weeks or months is incredibly difficult. While some urgent cases are still getting called in for operations, the vast majority have been postponed.

"To say that my patient with cancer isn't as important right now as a patient in the hospital with COVID . . . that doesn't feel right, it doesn't sit with us very well," Frost said. "So I want to make clear that when we say we're canceling all our elective cases, these are still people with life-threatening conditions that we're having to delay their care."

Oregon Coronavirus Cases

Data is updated nightly.

Cases: 396501

Reported Deaths: 5268
CountyCasesDeaths
Multnomah61066850
Washington42631406
Marion40277517
Clackamas33256388
Lane30473363
Jackson25211363
Deschutes23984192
Umatilla15155184
Linn14966184
Douglas13608295
Josephine10357248
Yamhill9878145
Klamath9120152
Polk8347103
Benton622940
Malheur593592
Coos5806109
Columbia441156
Jefferson426066
Lincoln367952
Crook343958
Union341456
Wasco319646
Clatsop265435
Baker222533
Tillamook219846
Hood River217237
Morrow198425
Curry194239
Harney121733
Grant109116
Lake106318
Wallowa76313
Sherman1933
Gilliam1854
Wheeler1161
Unassigned00

California Coronavirus Cases

Data is updated nightly.

Cases: 5127121

Reported Deaths: 74911
CountyCasesDeaths
Los Angeles153745027248
San Diego4104514351
Riverside3912955388
San Bernardino3784085998
Orange3367395771
Sacramento1699162460
Kern1588341838
Fresno1581872284
Santa Clara1536961933
Alameda1262241513
San Joaquin1084911837
Ventura1049251194
Contra Costa1046451058
Stanislaus922291434
Tulare869791102
San Francisco57458674
San Mateo56861631
Monterey52973626
Solano48014360
Santa Barbara47846555
Merced45506672
Sonoma43609414
Placer42736473
Imperial39148778
Kings35547369
San Luis Obispo31803360
Madera26511311
Shasta26353462
Butte25690320
Santa Cruz22540224
Yolo21792263
Marin18728249
El Dorado18544168
Sutter14691186
Napa13501107
Yuba1084791
Humboldt10360119
Tehama10329133
Nevada10187105
Mendocino873799
Lassen801259
San Benito793979
Tuolumne782691
Lake7073113
Amador583267
Siskiyou480757
Glenn460336
Calaveras449988
Del Norte380442
Colusa329821
Inyo259446
Plumas19679
Mono19274
Mariposa163318
Trinity102117
Modoc7956
Unassigned3820
Sierra2210
Alpine1080
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