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Hospitals filling up as Michigan records highest COVID case rate in U.S.

Emergency department
Emergency department staffs are running out of places to keep patients with COVID and other ailments as they wait for rooms to open. (Michigan Radio photo by Lester Graham)

Nov. 19: COVID testing is critical in Michigan. But how soon is too soon?
Nov. 17: 5 million Michiganders are vaccinated and COVID is surging. Here’s why

Heading into the holiday season, Michigan hospitals are filling up again with patients suffering from COVID and other ailments, as the state now also has the highest COVID-19 infection rate in the nation.

Patients in some hard hit areas sometimes wait hours — or even days — in hospital emergency departments before they can get a room, Dr. Gregory Gafni-Pappas, president of the Michigan College of Emergency Physicians, told Bridge Michigan Monday.

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“We're seeing all over the state ‘ED boarding’ where we have people who require admission and (end) up being in the hallways of emergency departments,” said Gafni-Pappas, who also is associate medical director of emergency medicine at St. Joseph Mercy Chelsea and rounds at St. Joseph’s in Ann Arbor.

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At other times, patients are assessed and then returned to the ER waiting area until a room is available, he said.

On Monday, Michigan’s hospitals cared for 3,247 patients with confirmed or suspected cases of COVID, an 18-percent jump from the 2,757 patients a week earlier, and a spike of more than 40 percent from two weeks ago, when hospitals cared for 2,305 COVID patients.

Back in July, during warmer weather and before the delta variant struck, there were fewer than 300 patients statewide being treated for COVID at times.

Short-staffed hospitals can sometimes feel they’re “walking on a razor’s edge,” Nick Gilpin, director of infection prevention and epidemiology at Beaumont Health, told Bridge Monday.

Monday morning, the eight-hospital Beaumont system was treating 478 patients with suspected or confirmed COVID, Gilpin said.

The more than 3,200 people in Michigan hospitals with COVID is still well below the peak of the spring surge, when 4,422 patients were being treated. But hospital leaders have warned since early September that patient loads were growing as the hospitals faced unprecedented staffing shortages. 

“Staff is one of our precious resources,” Gilpin said, “and we can't go out and just easily find more staff. We've got to do everything to keep them safe.” 

Hospitals in the six counties of metro Detroit have driven the recent surge in patients, with a 50-percent increase since Nov. 1, from 1,044 to 1,547.

The region has seen case counts rise rapidly too as the delta variant, which first hit rural Michigan, has slammed into southeast Michigan in recent weeks. Oakland County reported 2,156 cases on Monday, it’s highest three-day total since April, and suburban Wayne County (1,980) and Macomb County (1,905) were No. 2 and No. 3.

 

Northern Michigan is also struggling. Hospitals in the northern Lower Peninsula have now reached their highest patient level of the pandemic, with 147 patients, up from a 143 peak on Nov. 27 of last year. 

On Monday, state public health officials reported 21,034 new COVID-19 cases, or an average of 7,011 for each of the past three days and the state. The state now has the highest rate of confirmed or suspected cases of COVID in the country at 72 cases per 100,000 people, according to data compiled by the Centers for Disease Control and Prevention.

Detroit and 72 of the state’s 83 counties have seen infections rise in the past week, including all counties in metro Detroit.

Doctors offer several reasons for the increase.

Cold weather is driving people indoors. School children may bring COVID home to family members. And Michigan is not unique: Those states with the highest rates are all in the northern part of the country except for the mountain states of Colorado and New Mexico.

In past surges of the virus, there is typically a point at which a steady upward climb suddenly turns steep with “exponential growth,” said Dr. Natasha Bagdasarian, Michigan’s chief medical executive. 

“It's very concerning, and it's sad because the tools are here they are within our grasp,” she told Bridge Monday, referring to the widespread availability of COVID and flu vaccines.

COVID, she said, is “not going to go away.” But the availability of vaccines and other social protocols can allow communities “to live with the virus without it causing the morbidity and mortality that it’s causing right now.”

To be clear, most hospital patients are there for other medical problems — strokes, heart attacks, or appendicitis, for example. But COVID stays are rising. 

According to data compiled daily by the Centers for Disease Control and Prevention, 16.4 percent of patients in Michigan’s hospitals have or are suspected to have COVID, up from 13.3 percent Nov. 1 and 9.2 percent Oct. 1.

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That doesn’t mean hospitals are turning away patients, but rising caseloads are having an impact. 

Dr. Brad Uren, an emergency doctor at Michigan Medicine, said it’s like a restaurant in which you always get seated right away. But this time, there’s an extra, unexpected table of 15 guests. The restaurant still may not be packed, but it’s slowing down service. Staff gets stretched thin.

The difference, of course, is that hospital issues are often about life-and-death needs, not an evening out, said Uren, a past president of Michigan College of Emergency Physicians.

“We've got all the patients who we would ordinarily have, and then we have this additional layer on top” caring for COVID patients, he said. Patients with more serious cases of COVID require more care, including “high levels of oxygen, (intensive care), and some require intubation.”

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