GRANTS PASS, Ore. — With coronavirus hospitalizations only continuing to rise beyond already-critical levels, hospital administrators in southern Oregon are looking at every possible contingency to continue accepting patients and meet the dire need.
From the outside, however, local hospitals have looked much the same as usual — the real turmoil has been on the inside, where the critical care units are well over capacity. Asante Three Rivers Medical Center started breaking the outer illusion last week when it added a tent out in front of the emergency department.
Hospital officials said that the pavilion is open during the peak hours of the day for emergency patients with lower-acuity needs, like sprains and minor stitches, to reserve the indoor area for more critical cases.
According to senior administrators at the hospital, the tent is just the tip of the iceberg.
Asante Three Rivers is licensed for 125 beds. When hospitalizations started reaching that limit, Asante lobbied the Oregon Health Authority to issue emergency licensing, expanding that capacity to 177 beds.
The hospital's traditional 12-bed critical care unit is now a 20-bed unit dedicated to COVID-19 patients. Another area has been converted into a separate 12-bed critical care unit for other patients. There are also 10 patients in a "non-traditional" inpatient area, and more areas of the hospital are being retrofitted to meet the surge.
Though they've been able to meet the need for beds thus far, staffing levels continue to be another barrier that cannot be remedied by similar ad hoc means. Some physicians are being pulled from their normal duties to perform care outside of their field of specialty, and administrators are trying to pull in as many traveling physicians or "locums" as they can get.
"This is a full-blown healthcare crisis," said Win Howard, CEO and senior vice-president at Asante Three Rivers. "I've been in a healthcare leadership role for 25 years — I have never experienced anything like this before. This is, I want to be clear, this is an absolute crisis."
Howard confirmed that Three Rivers has been canceling elective surgeries for a matter of weeks, amounting to hundreds of procedures, so that the hospital can meet the needs of patients in a medical emergency. However, just because these surgeries are elective does not mean that they are cosmetic — canceled procedures include hernia repairs, orthopedic surgeries, carotid surgeries, and surgeries to remove cancer.
"The list goes on and on, and these aren't things that would traditionally be thought of as elective in all cases," Howard said. "I talked to one of the surgeons, they had to call several patients and say 'I have to delay your cancer surgery because we have such a surge of patient volume, and I can't even tell you when I can reschedule that.' It broke her heart, and she also thought how difficult it would be for that patient to get that call."
Howard said that Asante is also on the verge of needing to obtain refrigeration units to serve as mobile morgues, potentially within a matter of days.
As bad as things are for Asante right now, Howard said that things are likely to get worse. Coronavirus modeling produced by OHSU, which has so far tracked the progression with relative accuracy, does not anticipate that cases and hospitalizations will peak until the beginning of September.
On Tuesday morning, Howard joined five other health professionals in a briefing on the current COVID-19 outlook for the Josephine County Board of Commissioners. Howard said that they asked the Commissioners to support masking, support social distancing, and encourage constituents to talk to their medical providers about getting a COVID-19 vaccine.
"That was our ask, and we asked them to be 'a voice of one' around that," Howard said. "That was the purpose of meeting with them, and for them to understand the seriousness of where we are as a community at this point. So, I think it was clear — we got the message across, I think they heard us, and we'll see how they respond."