The president of Spectrum Health West Michigan wanted to highlight the significant strain being felt on hospitals during Michigan’s extended fourth wave of COVID-19 cases, and to ask for patience in the face of unrelenting challenges.
“It is very clear, whether in command center meetings or rounding in our urgent cares, emergency departments and hospitals, that we are truly in unchartered territory,” Elmouchi wrote on Oct. 12.
“Together, we made it through a ‘pseudo-surge’ last March and two huge and very real surges last fall and spring. What we are in the midst of now is different from all of that. The pandemic and its lingering effects have upset the delicate balance of nearly everything.”
As the letter went out to hospital employees, Spectrum had reached 239 COVID-19 patients, which was a high point for the current surge. With increased non-COVID patient census on top of that, the system has hit record patient counts and has had to delay some non-emergency procedures over the last 4-6 weeks in an effort to free up staff and hospital beds.
In addition to working through the personnel shortages plaguing most hospitals nationwide, the West Michigan health system has also struggled through supply shortages. A typical pre-pandemic month had about 36 supplies on back order, but in September there were more than 1,100.
“On top of this we have huge volumes of very sick patients, a surge of workplace violence against healthcare workers that is being felt nationwide and a workforce that is ready for all of this to be behind us,” Elmouchi wrote.
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The state’s fourth wave hasn’t come close to the peaks of the previous two surges, but its duration has stretched longer. During the spring surge, hospitalizations climbed for about seven weeks before they began coming down. The state stayed above 100 hospitalizations per 1 million people for about 11 weeks.
Fast forward to late October, hospitalizations have been climbing for more than 12 weeks, and the state has been above that per capita patient threshold for almost 11 weeks and counting.
“We’re more or less on a plateau and that plateau is way too high and isn’t going down,” Elmouchi said.
As of Monday, Oct. 25, there were 2,256 hospitalized patients with confirmed or suspected case of COVID-19. For context, that number was above 4,000 during the previous surge peaks before vaccines were widely available. During the summer lulls, it’s been below 500.
Spectrum Health isn’t alone. In speaking with his peers around the state, Elmouchi has heard talk of similar pressures.
Last month, Henry Ford Health System reported temporarily closing 120 hospital beds throughout its hospitals to better focus staffing resources. Similarly, Beaumont Health closed 180 beds.
A spokesperson for Michigan Medicine in Ann Arbor noted high patient volumes and intermittent supply chain challenges in recent months, but said “we’ve been able to manage the supply chain issues without significant impact to patient care.”
Dr. Allison Weinmann, an infectious disease specialist for Henry Ford in Detroit, noted that while staff are worn out, hospitals remain safe places and she stressed that individuals in need of care should continue to seek it. Her system hasn’t yet had to cancel or delay any non-emergency procedures.
“The problem is if we get a lot of unvaccinated people, and that’s who we’re seeing in the hospital for COVID, especially under-vaccinated or unimmunized people, and unfortunately these folks are filling up our beds. We don’t want that to occur with influenza as well,” she said.
“We want to be available for all types of health care emergencies and for elective surgeries as well.”
Her colleague, Dr. Dennis Cunningham, said Henry Ford hasn’t reached a crisis point with hospitalizations. But there’s concern that a big flu outbreak on top of the coronavirus pandemic could put even further strain on an already taxed health system.
Dr. Elmouchi estimates about 80% of Spectrum’s COVID patients are not vaccinated, and that rate is about 90% in the ICU. On average, vaccinated COVID hospitalizations are patients in their 70s with four comorbidities, compared to the non-vaccinated, which are on average in their 50s with two comorbidities.
“That tells us that sicker older people who are vaccinated might get admitted, but the vast majority of the unvaccinated people with COVID here are younger, healthier and they’re really sick,” Elmouchi said.
In previous COVID surges, hospital leaders have gone public with their concerns — sort of a sounding of the alarm. Asked if it was time to do so again, Elmouchi was conflicted.
“I’m personally not a believer in ‘sounding the alarm’ anymore per say, because you’d be sounding the alarm every day and the alarm isn’t very effective when it’s always going off,” he said.
“The thing is, and it’s going to sound like a broken record, but we need you to get vaccinated. At the end of the day, we won’t see you and you won’t need us most likely. That’s really what we want for everyone.”
To find a vaccine near you, visit Michigan’s COVID-19 vaccine website or go to VaccineFinder.org.
Read more on MLive:
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FDA approves Moderna, J&J booster shots, also says it’s OK to mix vaccines
COVID-19 Q&A: Why do vaccinated people get infected? Can they get long-COVID?
Coronavirus data for Thursday, Oct. 21: Michigan sees glimpse of hope despite climb in hospitalizations
CDC: Unvaccinated people 11 times more likely to die from COVID-19
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