Logan Health has joined a growing list of major Montana hospitals to seek National Guard help amid record hospitalizations for COVID-19, while once again preparing an alternative care unit built by the US Army Corps of Engineers last year on the vacant third level of Kalispell Children’s Hospital.
The 25 guards assigned to Logan Health Medical Center (LHMC), as of October 2, are among eight National Guard requests in Montana since September 15, in response to COVID-19 patients straining capacity and hospital staff across the state. The guards will assist Logan Health in his non-clinical duties.
On October 4, two additional guards will be assigned to Logan Health Whitefish, formerly North Valley Hospital, which recently saw more than half, and sometimes more than 70%, of its available beds occupied by COVID-19 patients. Whitefish Hospital stopped all inpatient surgeries two weeks ago due to the surge in COVID patients.
Local hospitals and public health officials say unvaccinated young patients account for a larger share of COVID-related hospitalizations and deaths. Dr Cory Short, a hospitalist at LHMC and physician in charge of the acute care line, said patients in their 30s and 40s had no underlying issues diagnosed, but shared the common traits of being unvaccinated and seriously ill.
“This time around, we saw a younger unvaccinated population,” Short said. “These are probably the sickest patients we’ve seen. These are very sick young patients in their 30s and 40s who require prolonged hospitalization with high flow oxygen or mechanical ventilation.
Short, speaking on September 23, could think of four recent deaths from COVID-19 of people in their 30s and 40s, an age range where “some of us still think we can be invincible in a to a certain extent “.
“It’s hard; it’s really hard to see,” he said. “It’s hard to see patients with young families at home. It’s hard to hear about mistrust of them. vaccines, hesitation about vaccines. Hell, we see some really, really sick individuals who haven’t been vaccinated. I can’t help but think, “Boy, the data has shown that if they had been vaccinated, they would not have had to come to the hospital. ”
Between LHMC and Logan Health Whitefish, there have been between 54 and 57 COVID-19 hospitalizations in Flathead County each day this week. Prior to the current outbreak, the county’s previous record for day-long hospitalizations was 39 on November 30, although the county has consistently exceeded that number in August and September.
Flathead County also experienced its third deadliest month of the pandemic in August with 18 deaths from COVID-19, following November and December last year, which resulted in 20 and 25 deaths, respectively, although outbreaks in homes in care contributed significantly to the figures at the end of 2020 while the current deaths are mostly from the general population and tend to be younger.
In the wake of a deadly August, nine deaths from COVID-19 occurred in a recent two-week span this month, while five more deaths were added to the tally this week, bringing the county’s death toll to 32 in August and September, and 141 total since the start of the pandemic, as of September 24.
Led by the county’s record hospitalizations for COVID-19, Logan Health is routinely operating at over 90% of the capacity of its Kalispell adult acute care beds, including days above 100%. The hospital has made adjustments to deal with the overflow, including boarding patients in the emergency room and sometimes using pediatric intensive care unit (ICU) beds.
“We have used some of our clinical spaces that have not historically been used for adult patients,” said Short.
The hospital has also been forced to be “very selective” in which elective procedures it approves, Short said, and has rescheduled or canceled some procedures.
“Fortunately, we didn’t get to the point where we had to use the hallway space like you see in other hospitals,” Short said.
Between 30% and 40% of the 126 adult acute care beds available at Logan Health’s Kalispell campus have been regularly dedicated to COVID-19 patients, an unusually disproportionate number for a single illness at a large regional hospital.
“In my career, I’ve never seen anything like it,” Short said. “I’d rather never see that again.” “
Meanwhile, at Logan Health Whitefish, COVID-19 patients have frequently occupied 10 to 13 of the hospital’s 18 available beds in recent weeks.
“This team has done an incredible job working with their COVID patients,” said Short.
Riley Polumbus, a spokesperson for Logan Health Whitefish, said the hospital had an average of nine COVID-19 patients over the past week, although that number has risen to 13. The hospital has 25 beds in total, but seven are in the birthing center, putting the hospital’s actual number of available beds at 18 in total, meaning that sometimes COVID patients have occupied more than 70% of all available beds.
Polumbus said 15 of the 18 rooms have been converted to treat COVID patients, while the other three will be converted next week. In addition to ending all inpatient surgeries, Whitefish Hospital converted its cafeteria into an overflow waiting room to accommodate symptomatic emergency department patients, while also building a respiratory screening center on campus. and establishing a walk-in clinic for overflow and symptom patients who wish to see a provider.
Whitefish Hospital also has 15 travel nurses currently working.
“They have been a great help, a relief to our staff and we are grateful that they are here,” Polumbus said of the mobile nurses in an email.
Logan Health asked for help from the National Guard this week to help with his non-clinical duties such as screening and other duties. The hospital joins St. Peter’s Health in Helena, Billings Clinic and St. Vincent Healthcare in Billings, St. James Healthcare in Butte, Bozeman Health, Benefis Health System in Great Falls and Missoula County to seek help from the Guard national since September 15.
“On behalf of a grateful state, I thank the men and women of the Montana National Guard who are mobilizing within their communities to serve their neighbors,” Governor Greg Gianforte said in a September 22 statement. “As we face an increase in the number of new cases and hospitalizations, the best long-term solution to this crisis is for the people of Montan to speak with their doctor or pharmacist and get vaccinated. While we don’t make vaccination mandatory in Montana, vaccines are safe, they work, and they can save your life. “
At least four hospitals in Montana, including St. Peter’s Health in Helena, have Crisis Care Standards in place, a rarely used emergency declaration that means treatment and resources can be rationed for patients.
“For the first time in my career, we are at a point where all patients in need will not get the care we wish we could provide,” said St. Peter’s Health Chief Medical Officer Shelly Harkins last week. . “In almost every way, we are in a much worse situation than ever in the winter of 2020, when we had our first push. “
Short said Logan Health is working on a plan to implement crisis care standards if needed.
“Fortunately, we are not there yet, but we are definitely putting a plan in place,” he said.
This week, the hospital is preparing its alternative care unit, built last May in anticipation of a potential peak in COVID-19. The U.S. Army Corps of Engineers (USACE), as part of a Federal Emergency Management Agency (FEMA) mission in support of the State of Montana, oversaw construction, which transformed the 26,250 square foot empty space located on the third level of Logan Health Children’s Hospital in a facility of nearly 100 beds.
Logan Health officials said the state of Montana took over the facility’s medical equipment after the declaration of a state of emergency, put in place by former Governor Steve Bullock, was revoked by Gianforte in January.
Logan Health is now equipping the alternative care unit with its own equipment as a proactive measure. If activated, the unit would treat non-COVID-19 patients to create more capacity to treat COVID-19 infected patients in acute care facilities in the hospital system.
“Let’s keep our fingers crossed, we don’t have to come to this,” Short said. “But if we do, we’ll be ready for it.”
Short and other medical officials say the best way to slow down and start reversing the current trend is with widespread immunization. Combined in the LHMC’s four weekly situation reports since September 1, 34 of 35 COVID patients in intensive care and 19 on ventilators have not been vaccinated.
Vaccination saves lives and reduces pressure on hospitals, reducing stress for frontline staff, Short said.
“Morale continues to be tested on a daily basis, but resilience is the word I would use, an incredible amount of resilience,” he said. “Emergency nurses and doctors, pulmonologists, hospitalists, intensive care, many people intervene to help each other.”