Tag Archives: multicare

Breaking News, Health and Lifestyle, Local

As COVID rages, what’s next for Washington state

[KIRKLAND, Wash.] – (MTN) Washington state has set new records for COVID cases and hospitalizations, straining every aspect of life and leaving many to wonder, what is next?

Malcontent News has been tracking the Omicron wave in South Africa and the United Kingdom and using the data from these nations to build models for Washington. The path the current surge is taking aligns closely with the progression in South Africa.

New Cases

It took 28 days for the first SGTFs to show up in PCR tests in South Africa at a significant number, to the peak in cases. If Washington follows the same path, new cases in the state should peak on Jan. 17. The last update from the Washington State Department of Health (WSDOH) was supportive of an approaching statewide peak. An analysis of new case data indicated that the Olympic Peninsula, Central Puget Sound, the South Sound counties out to the Pacific Coast have already peaked. In Eastern Washington, many areas are still seven to ten days away.

In South Africa and Europe, cases declined rapidly. If Washington follows the same pattern, new daily cases will be 50 percent of peak by Feb. 2, and then drift to a plateau of 30 to 35 percent of the peak. The plateau will hold until Feb. 14, before starting to decline again.

Washington moved to test only symptomatic and close contacts on Jan. 4. Over the weekend Seattle Children’s Hospital reported they were incapable of testing most pediatric cases for COVID at urgent care clinics, reserving the dwindling supply to only the sickest of patients. The University Washington Medicine is struggling to test staff and immediate family, in compliance with the United States Centers for Disease Control CDC) guidelines.

Clark County residents have appealed to the state for additional testing resources and more access to booster shots. Among the eight locations receiving National Guard support by Jan. 24 for additional testing resources, Vancouver, Washington was not among the locations.

The University of Washington Virology lab is struggling to provide test results to Washington, and some Oregon healthcare providers, processing 12,000 to 14,000 a test a day. On Sunday, 31.9 percent were positive, creating some doubt that a peak in cases has arrived.

Hospitalizations

Hospitalizations are a trailing indicator. We predicted on Dec. 26. that Washington hospitals would run out of available resources by Jan 15. Governor Jay Inslee deployed the national guard and suspended all non-emergency surgeries on Jan. 13, to support overwhelmed hospitals.

In South Africa, seven percent of new Omicron cases resulted in hospitalizations. The unvaccinated made up 82 percent of all COVID hospitalizations. That rate was between 22 and 31 percent of the earlier Delta wave. The exact difference is hard to track after South Africa changed its testing criteria on Dec. 24, testing only people who were symptomatic or had close contacts. Adjusting for South Africa’s higher hospitalization rate versus the United States, and accounting for the lower hospitalization rate among Omicron patients, we initially estimated Washington would experience a 1.14 to 1.34 percent hospitalization rate. Currently, it is between 1.8 and 2.4 percent depending on the hospital region.

The single biggest factor that impacts the outcome of a COVID infection is age. In South Africa, only 5.7 percent of the population is over 60, while 34.1% is under 19. Although it is true that only 26% of the population is fully vaccinated, in Gauteng Province, which bore the brunt of the Omicron wave, 44 percent of the population is fully vaccinated.

In Washington, Stevens, Pend Oreille, Skamania, Asotin, Ferry, Whitman, Klickitat, and Columbia Counties have lower vaccination rates. According to the WSDOH on Thursday, 80 percent of all COVID hospitalizations statewide were unvaccinated – which mirrors the data released from South Africa on Sunday.

In South Africa, the surge of new hospitalizations peaked 10 to 14 days after the new cases reached a peak. If Washington follows that path, new hospitalizations will peak at the end of January.

Despite reports that many cases resulted in short hospitalizations, this was among vaccinated individuals. South Africa found that among unvaccinated individuals, the progress of illness was no different than prior strains of COVID.

The number of hospitalized COVID patients peaked in South Africa on Dec. 31 and remained almost unchanged through Jan. 6. Currently hospitalized coronavirus patients in the African nation are still at 83 percent of peak. The decline has been slow.

For Washington hospitals, this will be an insurmountable challenge. Although the governor announced a pause in elective surgeries statewide on Thursday, many hospitals had already voluntarily taken that step to expand resources. MultiCare reported ten days ago they were forced to implement CDC crisis staffing standards, having COVID positive workers who are experiencing mild to moderate symptoms continue to work.

An analysis of available hospital resources indicated that additional emergency staffing and converting PACUs to COVID wards added 60 to 75 acute care and 10 to 15 ICU beds statewide. With over 250 new COVID patient admissions a day, that added capacity was likely wiped out over the weekend.

If Washington follows the same hospitalization trend, by Jan. 26 the worst of the surge will be hitting our facilities. The number of COVID patients will peak on Feb. 4, and hold until Feb. 10. Although a decline will be accelerating by Feb. 20, a load of 83% of the peak would be unsustainable.

On Friday the WSDOH reported there were 2,135 COVID patients in Washington hospitals, an all-time record. Hospitalizations are increasing 50 percent every week. The IHME model projects almost 4,000 hospitalized coronavirus patients on Feb. 4, either in acute care or the ICU. If Washington follows South Africa, the number would reach 5,038 and then sustain at that level for two weeks before dropping to 4,000.

Last Monday patients were being transferred out of King County to Moses Lake, Richland, and Missoula, Montana. King County hospitals, University of Washington Medicine, and Harborview Medical Center are caring for a record number of COVID patients. In Spokane, Providence and MultiCare hospitals can’t take transfers. Doctors reported angry and desperate phone calls from rural hospitals trying to move patients to larger facilities.

MultiCare and Providence hospitals on both sides of the mountains have deployed tents again. In Everett, Providence Hospital was treating patients in the emergency department waiting room and the halls are lined with patients waiting for beds.

Deaths

Looking to South Africa, the number of deaths from Omicron was significantly lower compared to Delta. The age of the population, a 66% vaccination rate for those over 50, a historically lower COVID death rate compared to Europe and North America, and more available resources contributed to the better outcomes. Additionally, it is summer in South Africa.

COVID-related deaths started to increase on Dec. 11. It is unknown if deaths have reached a peak yet, but on Jan. 16, the 7-day moving average was 105 deaths a day. All signs in South Africa indicate the Omicron surge is reaching its finality.

In Washington, the population is older and in poorer health. Vaccination rates are higher, but almost one-third of the entire population is not only unvaccinated but politically indoctrinated into the status being part of their identity. They not only dismiss vaccination but all proven public health measures such as indoor mask wear.

Unlike prior waves in Washington, Omicron overwhelmed the larger and better equipped Puget Sound region facilities first. Idaho is starting to surge with new cases and Oregon is straining under its own tidal wave of cases. COVID patients in Eastern Washington will have fewer options than ever before.

If Washington follows the same as South Africa, COVID-related deaths will start to peak in mid-February.

Services and Infrastructure

It is estimated eight to ten percent of all American workers are sick, caring for a sick family member, or quarantining. The United States was already dealing with a worker shortage in 2021, which has been made worse by Omicron. By early February, up to 25 percent of all Washington workers could be sidelined with COVID.

Some of the impacts have already rippled through the region. Empty store shelves, recently restocked after the mountain passes reopened, will struggle to stay full. Pharmacists are warning people to refill their medications now, unsure of their ability to serve the community and have an adequate supply of pills.

Postal workers are driving routes for 12 to 16 hours to fulfill deliveries, and school districts are looking for parent volunteers or moving to virtual learning. In some cities such as Seattle, students have staged walkouts due to high infection rates. In Lakewood, the Walmart Super Center was forced to close for three days for a deep cleaning after 63 workers became sick with COVID.

The day-to-day impact for everyone will include school and daycare closures, spotty store shelves, delayed deliveries, and businesses forced into short-term closures due to a lack of staff. The economic fallout could last for much longer.

Without a dramatic increase in support, state healthcare workers and Washington residents will face a brutal five to six weeks where only the absolute sickest individuals will be able to get medical services, and basic goods and services will require patience to find.

Breaking News, Health and Lifestyle, Local

Washington hospitals are on the brink as COVID cases spiral upward

Editor’s Note: An early version of this story reported that the first Omicron case detected in the United States has been changed from Dec. 15 to Nov. 15.

[OLYMPIA, Wash.] – (MTN) The Washington State Department of Health (WSDOH) reported the 7 day moving average for new COVID cases had jumped to 1,047.9 over the weekend, obliterating previous records. There were 1,773 people hospitalized with COVID across Washington on Sunday, just shy of the previous record set on Sep. 6, 2021.

With an estimated 242 new COVID-related hospitalizations a day, hospitals in the Evergreen State are on the brink of running out of beds and staff. The I-5 corridor from the Canada border to the Columbia River has the highest case rates in Washington, sparked by several super spreader events in Thurston and Pierce Counties on Dec. 4.

COVID cases have exploded in Eastern Washington, including Spokane, Yakima, and Moses Lake. New cases are forecasted to peak in King County by the end of this week but are expected to continue to surge in Eastern Washington.

The updated IHME forecast model is catastrophic for Washington, projecting 3,189 acute care and 804 ICU patients hospitalized with COVID by Feb. 4. Malcontent News estimates there are 375 staffed acute care and 95 ICU beds available in Washington state, with a coming surge of 2,000 more patients in less than a month.

The Washington State Hospital Association made dire predictions last week. Dr. Francis Riedo, medical director for infection control and prevention at EvergreenHealth in Kirkland, told reporters that the state has “never been closer” to moving to crisis standards of care.

In the same briefing, Dr. John Lynch, medical director of Harborview Medical Center’s infection control program, said that UW Medicine and Harborview Medical Center had more COVID patients under care than at any previous point in the epidemic.

The situation is already dire for Puget Sound hospitals, will more than 97 percent of acute care beds occupied. King County Public Health reported 255 new COVID hospitalizations from Friday to Sunday – a rate of a new hospitalization once every 28 minutes. Hospitalizations in King County have surged 110 percent in a week as new cases skyrocket.

Earlier projections based on case data from South Africa and the United Kingdom estimated that King County hospitalization rates would be by 20% to 30% from the previous Delta wave. Projections reduced the percentage of COVID cases that resulted in hospitalization from 4.7% to 1.14%. Based on data from the first week of January, the rate is almost double – 2.13% – driving hospitalizations to a higher level than previously forecasted.

EvergreenHealth in Kirkland reported 44 hospitalized COVID patients, including one pediatric patient and another four in Monroe. A majority, 70 percent, were hospitalized due to COVID. The remainder is hospitalized for other reasons and co-infected with coronavirus. Five patients are fully vaccinated with boosters, including one in intensive care.

On Monday night, Seattle Children’s Hospital advised parents that its four walk-in urgent care clinics would not accept patients without an appointment due to the unprecedented patient load.

The Washington State Medical Association appealed to Gov. Jay Inslee to declare a crisis and deploy the national guard to support area hospitals. Previous options, including stopping elective surgeries, limiting day procedures, and “boarding” patients in emergency departments, are already being done.

“The time has come to admit that stopping electives and non-urgent care is not enough. We must declare the crisis that our health system is in,” the Jan. 6 letter stated. Cassie Sauer, the Washington State Hospital Association CEO, also signed the letter.

Unlike Idaho, Montana, and Alaska, which had to use crisis standards of care last fall, Washington state will not allow a single facility to move to the emergency protocols. The declaration would come from the state and only occur after all possible options to extend services were exhausted. Under crisis standards of care, patients could be denied care based on need, survival chances, and available resources. Washington developed computer software with Massachusetts and Wisconsin to determine who would receive care. Last week, Oregon announced it was adopting the same computer program.

The physical, mental, and emotional toll of two years of a COVID crisis has decimated the ranks of hospital workers across the country. Omicron is highly contagious and has significant vaccine escape, resulting in hospital workers being sickened. As hospitalizations have surged in the first ten days of January, the number of staffed beds available has slowly declined.

On Thursday, leadership at MultiCare, which runs 11 hospitals across Washington state, reported they had moved to crisis staffing standards in Western Washington. The standard, announced by the United States Centers for Disease Control (CDC) on Dec. 23, can require workers who are sick with COVID to continue to work if necessary to continue to provide patient care.

The Omicron variant arrived in the United States on Nov. 15 and has shattered all previous records for new cases, daily new hospital admissions, and total hospitalizations. One model projects that nation will face another 300,000 hospitalized with COVID by the middle of February, an impossible task for all existing hospital resources.

On Dec. 26, Malcotent News forecasted Washington state hospitals would reach crisis standards of care by Jan. 15, without significant national guard support or FEMA intervention.