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Michigan hospitals at COVID-induced capacities, as moods turn angrier

 Marie Richards
Medical staff is increasingly feeling the pressure from patients seeking both COVID and non-COVID care. Marie Richards, a senior clinical nursing director, worked at a drive-through COVID-19 monoclonal antibody clinic at the University of Michigan Health System West Ann Arbor Health Center - Parkland Plaza in Ann Arbor in October. (Bridge file photo by Erin Kirkland)

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Nearly one-in-four Michigan hospital patients has a confirmed or suspected case of COVID-19, packing the state’s health systems to unprecedented levels Friday. Some hospitals said they’ve flown past near capacity levels and are now “beyond capacity” in some units.

The number of daily COVID-19 deaths in Michigan’s hospitals has doubled in the past month, with an average of 70 fatalities a day for the past week — equal to the worst days of last winter’s surge.

The latest wave of hospitalizations — the state’s fourth surge — has again led some hospitals to turn away people seeking care, cancel elective surgeries and fret about equipment shortages, including ventilators, dialysis machines and supplies that help feed patients.

 

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“When you look at the caregivers — all of us and all the folks that work with us — people are really struggling,” Dr. Darryl Elmouchi, president of Grand Rapids-based Spectrum Health, said at a press conference Friday. The hospital is seeing “unprecedented” patient loads, he said.

Unvaccinated patients at Spectrum make up 94 percent of those who are on ventilators, he said: “This is needless death, day after day.” 

The federal government recently sent three medical teams to help staff-strapped hospitals in Michigan deal with a chaotic atmosphere fueled by rising COVID caseloads and in which health care workers are increasingly being assaulted by frazzled patients. 

“Our staff are yelled at, hit, punched, scratched — we hear about these on a day-to-day basis. It feels unrelenting,” said Dr. Matt Biersack, president of Mercy Health Saint Mary’s in Grand Rapids. He said the hospital is at 98 percent filled overall, and at 100 percent occupancy in its intensive care unit.

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“As time (is) spent in the emergency department waiting, or as care is strained, and we wait longer for care, there tends to be even more hostility and more impatience,” Biersack said.

Across most of Michigan, hospitals have exceeded or are nearing the highest COVID-19 patient loads they have seen throughout the pandemic. Three regions — southwest Michigan, west Michigan and the south-central counties — are treating their most patients ever and Upper Peninsula hospitals are approaching their peak, according to state hospital COVID-19 data analyzed by Bridge Michigan.

In metro Detroit, the state’s most populous region, health officials say they are approaching the point where they’ll have to ask for help or start making decisions about whether to curtail care options.

 

“We do not have any plans right now to make any sweeping changes to scheduling, but we implore the community to help us keep the full spectrum of services open that you all need,” said Bob Riney, CEO of Henry Ford Health System.

Riney and others again called upon residents to get one of three, U.S.-approved COVID vaccines or boosters if they haven’t already and honor the state’s recommendation to wear masks indoors in public spaces. At the Henry Ford facility in Macomb County, Riney said all 21 COVID patients in the ICU are unvaccinated.

Statewide, just over 5.2 million people are fully vaccinated against COVID, or 56 percent of those ages 5 and older who are eligible. That’s well below the national rate. Across the U.S., 63.5 percent of the eligible population is fully vaccinated, according to the Centers for Disease Control and Prevention.

Michigan currently leads the nation with the highest rate of hospitalizations per 1 million residents and is among the highest in rates of new infections.

By getting more people vaccinated, Riney said the public can help reduce pressure on the health care system. “We can get through this, but we need help,” he said.

Leaders representing a half-dozen large hospitals and health care systems in west and southeast Michigan took to news conferences and social media Friday, painting once again a grim portrait of exhausted staffs, nurses with dangerously high patient loads, and — with the spectre of the December holidays and a new variant spreading — no end in sight. Some hospitals already have canceled nonurgent care and, at times, have turned away patients with acute care needs.

“That's happening not just here; that’s happening across the state,” said Spectrum’s Elmouchi. 

In less than two months, Spectrum Health hospitals in West Michigan have turned down requests from other hospitals to tranfer care for 700 patients — unable to treat them because Spectrum facilities are at or over capacity.

“So you could be in the (Upper Peninsula), you can be somewhere Up North or anywhere else, get in a car accident, have a heart attack, and — even if it's not COVID-related — because of the strain COVID is putting on health care system, you could potentially not get care,” Elmouchi said.

Spectrum also has canceled 1,100 non-emergency procedures, he said. Its Grand Rapids-based intensive care unit, he said, is “beyond capacity.”

And while the procedures might not be urgent, they are certainly necessary, said Mercy Health’s Biersack: “These are joint replacements. These are back surgeries. These are bariatric procedures. These really present a substantial impact on people and their families.” 

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Spectrum’s Elmouchi said he wishes he could offer a personal tour to every vaccine-hesitant Michigander to his hospital’s ICU “for five minutes, (and) introduce you to pregnant women that are on the ventilator, introduce you to young people with kids there that are on a ventilator, potentially dying.”

The trio of Michigan news conferences Friday followed more than two months of swelling COVID case numbers, climbing hospitalizations and deaths, and increasing calls for the public’s help from hospital leaders. 

They acknowledged that bed “capacity” is a fluid number, changing with fluctuations in available staff. 

Additionally, there are capacity demands beyond those measured by patients who are admitted, noted Dr. Peter Hahn, president and CEO of University of Michigan Health-West in Wyoming near Grand Rapids.

Monoclonal antibodies appear to be highly effective in curbing serious illnesses among those recently infected. But most of those treatments are given by infusion — a process that can take 90 minutes or more from hospital staff, he said, stretching the limits of staff capacity.

Registered Nurse Xuerong Mu
In addition to caring for critically ill COVID patients, hospitals also are offering outpatient treatments of monoclonal antibodies, an effective but time-consuming infusion in most cases. Registered Nurse Xuerong Mu gets ready to treat a patient in Ann Arbor in October. (Bridge file photo by Erin Kirkland)

Currently, four of the state’s eight emergency preparedness regions have their highest numbers of COVID-19 patients, including the northern Lower Peninsula, west Michigan, southwest Michigan and southern-central Michigan, according to state data.

Although the hospitals in the two regions of metro Detroit are experiencing an increase in patients, they are still well below their highest counts, when they combined for over 2,600 patients; they currently have just over 2,200 COVID-19 patients. 

Hospital leaders, however, have repeatedly said that they have far fewer staff to care for patients than earlier in the pandemic.

On Wednesday, eight nurses at rural Schoolcraft Memorial Hospital in the Upper Peninsula took to YouTube in front of a brightly lit Christmas tree, saying they’ve been unable to transfer some of the sickest patients to larger health systems that, like Schoolcraft, are operating near or at capacity. 

And on Thursday, the state announced that a third federal team of health care workers is headed to Michigan to ease staff shortages, this time to Covenant HealthCare in Saginaw.

Two other teams — each with 22 registered nurses, doctors and respiratory therapists — were earlier deployed at Beaumont Hospital in Dearborn and Spectrum Health in Grand Rapids. They are expected to support local staff for 30 days, according to the Michigan Department of Health and Human Services.

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