NOT MY PROBLEM...:

One hospital being overwhelmed isn't a one-hospital problem, it's an every-hospital problem. Even if your community is not awash with Covid-19 or if most people are vaccinated, a major outbreak in your broader region, plus all the other patients hospitals are treating in normal times, could easily fill your hospital, too. That makes it harder for the health system to treat you if you come to the ER with heart attack symptoms or appendicitis or any acute medical emergency.

Already, because of existing staffing shortages, rural hospitals are finding it difficult to find room for their patients at larger hospital systems. With omicron spreading rapidly, increasing the number of patients seeking care while sidelining health workers who have to quarantine, systemic overload may not be far off.

"When you have a Covid patient who needs ICU care, those hospitals are turning away patients," Carrie Saia, CEO of Holton Community Hospital, located in a town of 3,000 people about 90 minutes east of the Kansas City metropolitan area, told me earlier this month. "We're sending our patients farther away. Not because they're full, they're just out of staff."

At earlier points in the crisis, large hospitals would limit transfers from smaller facilities in order to preserve their capacity to treat the most seriously ill patients. As a new wave driven by the omicron variant takes off, that could happen again.

As Karen Joynt Maddox, a practicing cardiologist and associate professor of medicine at Washington University in St. Louis, told me in August: "During Covid surges, we were told to limit transfers only to patients who had needs that could not be met at their current hospital (i.e. decline transfers because the family requested it, but equal services available at both places) because that was the only way we could make sure that we did have the ability to accept patients that only we (or another major referral center) could handle."

The feedback loop works in reverse as well. Recently, the HCA hospital in Conroe, Texas, about 40 miles north of Houston, was dealing with such a staffing shortage in its emergency department that the facility temporarily asked ambulances to bypass it because the ED couldn't handle any more patients, according to a spokesperson. Suddenly, hospitals in the heart of Houston were seeing an unexpected surge of patients who needed emergency care, causing long wait times at their facilities.

Tweet   @brothersjudd