COVID-19 cases are surging again and Parkland Health Center in Farmington is feeling the stress.
According to Parkland President Annette Schnabel, there are 32 inpatients who are COVID positive, which is 56% of the hospital’s census.
“Our highest census actually was in November of last year,” she said. “We are getting close to where we were at that point now. It's been escalating up.”
As of Thursday, seven patients were on ventilators, which is a record for Parkland.
“We've never had that before,” she continued. “And that doesn't count for people who have other kinds of support for the breathing, such as CPAP (continuous positive airway pressure), BiPAP (bi-level positive airway pressure) and oxygen.”
Schnabel said they’ve had more deaths occurring, as well.
“Through January, we had a total of 43 deaths from COVID here,” she explained. “And since mid-July, we've had another 14.”
The hospital is also seeing higher numbers of younger patients during this wave, she added.
In the BJC HealthCare system, 6.9% of the COVID admissions last month were pediatric. Parkland doesn’t keep pediatric COVID patients for inpatient care, Schnabel said, instead they are transferred to tertiary care centers.
To deal with the resurgence, Parkland had to close their private geriatric mental health unit to open it up to house medical-surgical patients.
“We're having to house patients there, as well, in order to care for all the patients,” Schnabel added.
Caring for COVID patients takes extra time and resources for the staff.
“When you talk about it stressing our resources, they have to recognize that we have to do a lot of gowning up, masking up, etc., as we care for these patients,” she said. “So it's a lot of time spent for the staff to do that to be protected as they go in and out rooms to care for these patients.”
Transferring patients to the St. Louis area through the BJC Transfer Center can be challenging, Schnabel said, as those hospitals are also inundated.
“We really do focus on trying to keep the patients here, if we can manage them, versus sending them to a tertiary care center,” she added.
Parkland can provide breathing assistance via oxygen, CPAP, BiPAP, and ventilators. But once a patient needs the next level of care, ECMO (extracorporeal membrane oxygenation), they are transferred to Barnes-Jewish Hospital or Missouri Baptist Medical Center. ECMO, she said, takes the effort off the lungs and the heart.
“They’re often full for that purpose, as well,” she continued. “So keep we keep moving people to the next level of care as needed, but try to keep them in the lowest level of care possible. So that we're not inundating the other sites, as well. So that they're available to take our patients when they actually need to.”
Schnabel said Parkland is working collaboratively with area hospitals in Iron, Madison, Ste. Genevieve, and Washington Counties.
“We have a higher level of care with ICU and stuff here,” she explained. “We work with them to take their more critical patients when they're not tertiary-care level.
"But we've also had a couple of times where they've taken a lower level patient from us in order to make sure we had bed capacity for the higher level patients here. So we are trying to work with our area hospitals to be able to care together for the region.”
Not only is it affecting inpatient care, it is also affecting their emergency department and convenient care clinic.
Schnabel said they’ve been having to board more patients in the emergency department, which means they’ve been evaluated as needing inpatient care but there is no bed available for them.
“This morning, we had 10 patients waiting for beds,” she said. “A couple of them were for transfers to another facility. Otherwise, they were waiting for beds here because we did not have beds to place them in.”
Sometimes patients are having to stay in the emergency department for several days, which is not what the department is intended for.
“That becomes a problem from our emergency room perspective,” she said. “Because when you have 10 of your beds being used for patients that you've already evaluated and know need to go inpatient, that decreases your capacity to manage new emergency room patients coming in. And so from a patient care perspective, they may see increased waiting time to be seen in the emergency room.”
As far as the convenient care clinic on campus that is managed by BJC Medical Group, Schnabel said they saw a record number of patients – 202 – on Tuesday.
“A high percentage of those were for the purpose of COVID, for either COVID testing, COVID treatment, or COVID vaccination,” she added. “We're happy to be giving out the COVID vaccination to help reduce this overall.”
Schnabel said her staff is physically and emotionally drained. They are busy working more hours and picking up extra shifts to ensure community members are getting the care they need.
“The emotional stress that they're under, the physical stress that they’re under is something that I'm very passionate about,” she said. “And I want to make sure people understand that and they respect that my staff members are truly doing the best that they can to care for this community.”
She encourages community members to continue to wear a mask and social distance.
“If you have symptoms, please quarantine,” she continued. “We were really don't need people out exposing other people. It's transmissible enough. With the Delta variant, it's become more transmissible.”
Getting the COVID vaccine is also encouraged.
“It is a safer approach,” she added.
Parkland offers the vaccine through their medical clinic. They mainly offer the Moderna vaccine but can get the Pfizer vaccine if requested.
According to data from BJC HealthCare, of the 652 COVID patients hospitalized between Aug. 1-15, 530 were unvaccinated; 86 of 103 in the ICU were unvaccinated and 32 of 38 on ventilators were unvaccinated.
With the state’s effort to increase the availability of sites that offer monoclonal antibody treatments, Schnabel said Parkland is hoping to soon offer the treatments, maybe as soon as next week.
The treatment is for people who have tested positive for the virus and have mild to moderate symptoms.
“We can do this treatment to help hopefully reduce their symptoms and help them to recover more quickly and avoid hospitalization,” she said.
According to an update from the St. Francois County Health Center, the county recorded 298 confirmed COVID cases for the week of Aug. 29 to Sept. 4. There were also 44 probable cases.
The seven-day testing positivity rate is 16.5%.
Nikki Overfelt-Chifalu is a reporter for the Daily Journal. She can be reached at email@example.com.
“Through January, we had a total of 43 deaths from COVID here. And since mid-July, we've had another 14.”
Annette Schnabel, Parkland Health Center president