Community

COVID-19 spike stresses St. Anthony Hospital care

For most Gig Harborites, COVID-19 has played out as a hidden pandemic. Even the recent surge, driven by the virulent delta virus strain, is known mostly second-hand, through newscasts and inconveniences such as school mask mandates and canceled summer festivals.

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Lack of available inpatient beds at St. Anthony has led to more “boarding,” or temporarily holding admitted patients in ER hallways and elsewhere until beds are available. Ed Friedrich / Gig Harbor Now

But as new cases rocketed upward in Gig Harbor this summer, reaching 544 in August (or almost 78% more than in the previous worst month, November 2020), Virginia Mason Franciscan Health’s St. Anthony Hospital – and particularly its ER – emerged as one place on the peninsula where people were likely to encounter the true crisis nature of the pandemic, in all its fear and fury. Emergency room visitors describe a sometimes chaotic, distressing and possibly risky scene.

Lauren Smith, an Olalla resident, arrived at 9 p.m. on a Sunday in mid-August with her husband who was in pain from an apparent gallstones recurrence.

“After checking in and having vitals taken, I sat down next to an elderly man who repeatedly coughed into his mask,” she recalled.

The man said he’d been waiting four hours, and mentioned that COVID might be his diagnosis, Smith said. Patients who had left the lobby earlier after long waits, attempted to return later and re-check-in.

“Some patients said they waited six or more hours earlier,” she said.

It got worse.

A large majority of patients who contributed to the surge were not vaccinated. Ed Friedrich / Gig Harbor Now

“A man in a wheelchair was pushed into the lobby and loudly announced he was COVID-positive,” Smith said. After having vitals taken behind a partition, the man returned and waited with everyone else. A sick man collapsed on the floor, experiencing vomiting and diarrhea as his wife repeatedly asked the staff how long until he could be admitted, Smith said.

“The nurse’s response was, ‘We’ve been extremely busy all day,’” Smith said.

“I began to panic because I was sitting directly with two people who were risking my exposure to COVID,” Smith said.

She decided to leave and take her husband to the Seattle Veterans Administration Hospital ER the next day. While leaving, she said to the desk admin, “You know it’s bad if I’m willing to risk going to the VA instead.”

“She agreed with me and said they were understaffed,” Smith said.

Other ER visitors described similar experiences, while administrators and staff confirmed St. Anthony Hospital has been stretched during the COVID surge.

Responding to the accounts, St. Anthony Hospital Chief Operating Officer Dino Johnson said that, “We make all efforts to ensure appropriate guidelines are followed to protect the safety of our patients and staff. Our policies include universal masking, social distancing, and isolating all known COVID patients.”

The total COVID inpatient count has hovered around 25 cases since mid-August, compared to single-digit COVID caseloads in June and July, according to data through mid-September published by the U.S. Department of Health and Human Services. (St. Anthony Hospital has just over 100 inpatient beds.)

Lack of available inpatient beds at St. Anthony has led to more “boarding,” or temporarily holding admitted patients in ER hallways and elsewhere until beds are available. This practice has “gone up significantly since the surge started,” Johnson said in an interview this week. The hospital has also postponed or canceled many elective surgeries, to free up more beds for sick patients, he said.

Just recently, it appeared the surge might be easing, as least as measured by new COVID cases. The Tacoma Pierce County Health Department reported 116 new COVID cases in Gig Harbor and on the Key Peninsula for the week ending Sept. 23, and just 78 new cases through Tuesday, Sept. 28 (which is five days into the current week, as reported by TPCHD). That’s an improvement over the 203 new cases reported in Gig Harbor and the Key Peninsula for the week ending Sept. 2 (the sickest week in the surge so far), but still higher than pre-surge numbers.

On Monday, Johnson voiced cautious optimism about the state of the surge. From his viewpoint, it “is starting to show signs that we have peaked,” although “there is no sharp decline yet,” he said. “It’s hard to know the peak without a few weeks of data after it.”

“This particular surge affected (St. Anthony Hospital) to a much greater extent than prior surges,” Johnson said. “What we saw in this particular surge, the vast majority to the extreme majority of patients who were admitted, were unvaccinated.”

Johnson speculated that low vaccination rates in the areas served by St. Anthony might have led to greater stress on the hospital and its ER.

While growth in new cases drives more patients into the ER, healthcare staffing shortages nationwide have also increased the potential for tumult there. Historically, healthcare professions are chronically in need of workers, and a year-and-a-half of pandemic has fueled burnout among front-line caregivers, and likely discouraged new entrants to the field. The American Nurses Association recently urged the U.S. Department of Health and Human Services to declare the staffing shortage a national crisis, describing the unavailability of trained nurses as a “more dire” threat to patients’ well-being than the shortage of equipment like respirators that received much attention early in the pandemic.

St. Anthony Hospital faces staff shortages “across [its] whole workforce,” Johnson said, but has been especially challenged to hire enough RNs, who represent the largest job category there. All inpatient beds are now (as of Sept. 27) either occupied or available to new patients, but there have been times during the surge when they “have had to close some beds” due to a lack of staff to support the beds, he said.

Adding to the staffing challenge, St. Anthony now faces losing some of its employees who do not accept Gov. Jay Inslee’s mandate that healthcare workers become fully vaccinated against COVID by Oct. 18.

Johnson said some staff have requested medical or religious exemptions. It is “not a large number,” he said, and hospital management is trying to address anti-vaccination sentiment with conversations and with approaches such as town hall meetings featuring medical experts. Johnson declined to state the current vaccination rate among his hospital’s employees or the number or percentage of workers who have asked for exemptions.

As St. Anthony faces the prospect of losing much-needed staff who fear the vaccine or resent the mandate, the great majority of caregivers there see the shots from Pfizer, Moderna and others, if accepted widely, as the ray of hope that could light the way out of their current grueling situation. What’s most frustrating, said one, is the number of COVID patients arriving at the hospital unvaccinated and the general carelessness of people, until they are really sick.

According to the health department, 2,876 COVID cases have been reported in Gig Harbor, including 34 who died, and 958 on Key Peninsula, where seven have passed away.