A small hospital in Michigan’s Upper Peninsula braces for COVID

War Memorial Hospital has served the Soo area for more than a century, but a surge in COVID cases could quickly overwhelm its six intensive care beds and small staff. (Bridge photo by Robin Erb)

SAULT STE. MARIE — As COVID-19 cases continue to surge eastward through Michigan’s Upper Peninsula, the reality at tiny War Memorial Hospital can be counted on the fingers of hospital CEO David Jahn.

 

Six. That’s the number of intensive care beds at War Memorial. On Thursday, five of those beds were filled; one with a COVID patient.

Ten. That’s how many patients could receive the COVID drug Remdesivir based on current supplies.

Related stories:

Six months. That’s how long the hospital waited for backordered disposable gloves, which finally arrived this week. 

Ninety miles. That’s the drive — south across the Mackinac Bridge, then west to McLaren Northern Michigan Hospital in Petoskey — should patients with COVID overwhelm capacity at War Memorial and need more critical care. 

“People choose to live in a rural area for a lot of benefits,” Jahn said of life in the U.P. “You don't have to lock your doors; there's not a lot of crime and all those things.” 

But “when it comes to health care, you're making that choice, knowing that if you had something really critical, you're probably going to die here.”

War Memorial Hospital David Jahn said the hospital’s personnel are smart, compassionate and well-trained, but there’s just not enough of them if serious COVID cases surge. (Bridge photo by Robin Erb)

'You can call the doctor at home’

War Memorial and hospitals like it are sprinkled across more than 300 miles, east to west, of the Upper Peninsula, some with a dozen or so beds. The peninsula overall has 15 hospitals and 750 beds — with just 58 set aside for intensive care, according to state data.

 

By Thursday, 46 of those beds were occupied, with the worst of an anticipated coronavirus surge yet to arrive. 

While U.P. hospitals have emergency plans to make more beds available, an overflow of COVID-19 patients may mean less room for the usual flow of stroke and heart attack victims, surgical patients or those in car accidents. 

“The ERs see the first of the surge, too, and the more time they spend on flu and COVID, the less time they have for other emergencies,” said Mike Grisdale, spokesman for the 15-bed Mackinac Straits Hospital in St. Ignace.

COVID cases are surging across Michigan at record levels, with 5,700 new coronavirus infections reported Thursday — the highest daily tally since the pandemic hit the state in March.  

Which makes emergency COVID planning no longer just a theoretical exercise in places like Sault Ste. Marie.  

In the four-county region of Luce, Mackinac, Alger and Schoolcraft, COVID-19 has surged fourfold since the beginning of October from 111 reported cases to 453 on Thursday, according to state data. Those four counties each have their own hospital, none of which have intensive care beds, according to Kerry Ott, spokeswoman for the LMAS Health Department.   

The wave of infections prompted Jahn of 82-bed War Memorial and administrators at eight other hospitals to issue a joint statement on Monday warning the public that they are “at risk of a capacity crisis.”

That likely won’t surprise many residents, who accept Jahn’s blunt warnings of the area’s emergency capabilities, said Jill Rambo, a long-time Soo resident.

Several years ago, Rambo’s teenage son had to be airlifted to Helen DeVos Children’s Hospital in Grand Rapids after he grew listless from a serious flu infection.

Stories from the front  

Bridge Magazine, Detroit Free Press and Michigan Radio are teaming up to report on Michigan hospitals during the coronavirus pandemic. We will be sharing accounts of the challenges doctors, nurses and other hospital personnel face as they work to treat patients and save lives. If you work in a Michigan hospital, we would love to hear from you. You can contact reporters Robin Erb rerb@bridgemi.com at Bridge, Kristen Jordan Shamus kshamus@freepress.com at the Free Press and Kate Wells katwells@umich.edu at Michigan Radio.

The fact that patients may need to travel for hours for the most critical treatment “isn’t news to anyone here,” Rambo said from The Little Gift Shop, which she opened in 2018.

But it’s a trade-off many folks are willing to accept to live in this less crowded land. 

Small local hospitals can’t always afford the most sought-after specialists or most cutting-edge technology. Nor can they easily “load-balance” with other hospitals, transferring patients among hospitals to ease pressure on the most overwhelmed locations.

“But,” Rambo noted, “if you live in a place like this, you can call the principal at home. You can call the doctor at home.” 

“Yooper life!” a shopper added as she meandered by.

A hunt for nurses 

Inside War Memorial, numbers are on Joe Cohee’s mind. Among them: Five.

Cohee heads emergency services. He largely depends on five contingent nurses who cross the bridge from Canada when staffing levels fell too low in the emergency department.

While War Memorial Hospital’s emergency department was more recently updated, other sections of the aging building were built in the early 1900s, making it difficult to configure enough private, isolation rooms for a sudden surge in seriously ill COVID patients, said CEO David Jahn. (Bridge photo by Robin Erb)

But COVID has forced medical personnel on both sides of the international border here to choose which side they'll work in.

The five nurses are staying put on the Canadian side for now, said Cohee, sitting at a desk covered with papers and files. That’s a problem, made worse by the challenge of getting traveling nurses in Michigan to take temporary assignments in Sault Ste. Marie in the dead of winter.  

With COVID cases on the uptick, “my staff will get sick, that's a given,” Cohee said. 

“What resources do I have to replace them? There's not many to be found.”

Large-scale community COVID testing has further stretched staff. 

A day before Bridge Michigan visited last week, War Memorial lab workers — responsible for routine lab work — ran nearly 300 COVID tests as well. That’s 4,333 minutes of processing samples from the three different kinds of tests War Memorial uses, said Jennifer Kabat, co-director of the laboratory.

War Memorial Hospital provides community COVID testing — an effort that may help contain cases, but also means more staff and lab time. Here, medical technologist Don Brunner runs a Sofia SARS Antigen test. (Bridge photo by Robin Erb)

Standing outside on this windy day, a Jeep pulled up at a converted newspaper box that now serves as War Memorial’s test kit pick-up spot. Stephanie Pins, the hospital’s director of quality management, said War Memorial has enough testing supplies for now. 

“The limitation right now is the manpower to run the tests,” she said.

A northbound virus?

A desire to escape this fever dream of a pandemic year has drawn a flood of non-Yooper tourists to the Upper Peninsula; most recently, to watch as autumn repaints the miles and miles of forests and hulking lake freighters thread through the famous Soo Locks.

As they pass through Rambo’s gift shop, visitors snap up pieces of handcrafted Soo charm, home decor, candles, clothing and accessories from her shelves, driving up sales to some 40 percent over last year.

Sault Ste. Marie gift shop owner Jill Rambo said business is up by about 40 percent this year as tourists flooded into the town in search of peace in a tumultuous year. (Bridge photo by Robin Erb)

But in Sault Ste. Marie, a town with little wiggle room for crisis, some see peril in the river of tourists drifting in and out of its shops and restaurants.

On the Friday before Labor Day, Chippewa County reported 43 confirmed cases of COVID. That number climbed to 118 by Monday, with 54 cases reported in the last two weeks.

Audrey Jones and several fellow retirees recently shared laughter over morning coffee at Penny’s Kitchen, across Spruce Street from War Memorial.

The talk, as it often does, turned to COVID.

Jones, a retired prison bookkeeper, said she grew more worried about the virus when she saw webcam images of backed-up, northbound traffic on the Mackinac Bridge on Labor Day weekend.

It seemed as though “there’s six cars going south for every 600 coming north,” she said.

Then over three October weekends, the “Boo in the Soo” hockey tournament drew young hockey players and their families to the Soo area. A stream of hunters, snowmobilers and other outdoor enthusiasts will follow, residents told Bridge.

There are also three nearby prisons that house some 4,000 inmates in tight quarters nearby — prime real estate for the wildfire-like spread of the virus among inmates, as well as guards and staffers who then return home after their shifts.

As the women chatted above the clatter of a restaurant gearing up for lunch, two inmates from the Newberry Correctional Facility were being treated for COVID by War Memorial staff.

The uncertainty of the months ahead is grinding, said Jones’ companion at the coffee shop, Deb Piche, 68, of Brimley.

“There’s no ‘this-will-be-the-end-of-it-on-this-date.’ That’s what’s frustrating,” Piche said.

Time to prepare

Earlier this week, snow had already dusted the miles of evergreens and tamarack trees here — now gold in late autumn.

That seasonal change will drive residents inside, and holiday gatherings will follow — all good conditions for the virus’s spread, said Karen Senkus of the Chippewa County Health Department.

“It's not going to take much to put our hospital at capacity,” she said.

Still, there is good news too, she and others noted.

War Memorial staff are better prepared for COVID than in March and April, when the virus swept through southeast Michigan.

An surge in serious COVID-19 cases could quickly consume staff and resources at War Memorial Hospital in the Upper Peninsula’s Sault Ste. Marie. (Bridge photo by Robin Erb)

Hospital staffers took part in “conference calls where we were with Henry Ford [Health System] and Beaumont [Health] and they were seeing the massive surges,” said Pins, the director of quality management.

Like the state’s other hospitals last spring, War Memorial canceled all but emergency procedures. Then for weeks, it remained quiet — an almost eerie waiting game — as COVID cases remained low in the U.P.

“We were ready … and kind of sitting there. It was like an invisible thing, and we didn't know where it was,” Pins said.

Now, that invisible thing has taken some form. 

There's still no vaccine or sure-fire treatment, but the symptoms are better understood. Testing is more readily available. Treatment options are growing. Doctors know better how and when to use ventilators against the virus.

“There's still some nervousness and anxiety because it's an unknown virus, you know, but I think it's not as bad as it was,” Pins said.

Now, she added, “it’s ‘here it is. Let’s do this.’”

Bridge reporter Mike Wilkinson contributed to this report.

Facts matter. Trust matters. Journalism matters.

If you learned something from the story you're reading please consider supporting our work. Your donation allows us to keep our Michigan-focused reporting and analysis free and accessible to all. All donations are voluntary, but for as little as $1 you can become a member of Bridge Club and support freedom of the press in Michigan during a crucial election year.

Pay with VISA Pay with MasterCard Pay with American Express Donate now

Comment Form

Add new comment

Dear Reader: We value your thoughts and criticism on the articles, but insist on civility. Criticizing comments or ideas is welcome, but Bridge won’t tolerate comments that are false or defamatory or that demean, personally attack, spread hate or harmful stereotypes. Violating these standards could result in a ban.

Plain text

  • No HTML tags allowed.
  • Web page addresses and e-mail addresses turn into links automatically.
  • Lines and paragraphs break automatically.
CAPTCHA
This question is for testing whether or not you are a human visitor and to prevent automated spam submissions.

Comments

Leslie Watson
Sat, 11/07/2020 - 12:24am

"when it comes to health care, you're making that choice, knowing that if you had something really critical, you're probably going to die here.”

I nearly died due to a misdiagnosis at the Marquette hospital ER. Fortunately, a friend drove me to Lansing. I had a gangrened gallbladder! I had to sell my home in Gwinn and move to Grand Ledge to have dependable health care.

On Eagles' Wings
Mon, 11/09/2020 - 9:08am

Leslie, that is a very disturbing story. Glad you are okay, sorry you and your family have to go through so much grief.

Wake Up!
Sat, 11/07/2020 - 5:16am

It doesn't have to be this way. Take it seriously.

Anthony
Sat, 11/07/2020 - 8:18am

This is a story of lies and propaganda. I live here. No one testing positive is remotely sick. Why does everyone I know who has tested positive had a flu shot recently? Why are the zero cases of the flu this year? Did covod wipe out the flu ? Do we no longer need flu shots because there are zero reported flu cases. Everyone is tired of the communist governor. Suicides have killed more than covid-19. This is a hostile takeover by big pharma and sheep fall in line and follow.

JSK
Sun, 11/08/2020 - 7:58am

Anthony you sound like a disgruntled Trumper cult member. Covid-19 is not fake like the orange makeup on Donald your liar of a hero. No one is remotely sick, tell that to the survivors of those 240,000 plus who died from the virus in the USA. Communist governor perhaps you meant to say compassionate Governor. Gov. Whitmer has tried to save lives in spite the republicans/GOP Lansing gang who think wearing a mask is an infringement of their sacred rights. How selfish that is when you think about it. Big pharma business came directly from the deals and the profit for covid-19 warp speed done by none other than Trump. Anthony you are the sheep, who fell in line and followed the con-job of the greatest LIAR in the WH ever. The UP which is quite rural with exception of Marquette which voted for proven leader Joe Biden. Hopefully the UP will see their errors of their ways to a talking head Donald who promised all and delivered nada. ( unless you are rich 1-2 %) Good luck Anthony, hopefully Biden will save from the virus now.

Jake D
Mon, 11/09/2020 - 9:17am

Your post is so full of anecdotes and conspiracies that it is difficult to know if you are being serious. You think people who got a flu shot contracted covid? That is complete nonsense. I work in a hospital and we are all required to get the flu shot. No one I know has contracted covid as a result of the flu shot. There is way too much misinformation and disinformation to address in your post. If I were Bridge, I would seriously consider removing your post, but on the other hand, it is very interesting to read your perspective and mindset no matter how radical it is, if it reflects a prevailing UP view. In the end, covid doesn't care about conspiracies. Look at filling hospital capacities and deaths. When it hits close to home you might change your views, maybe not. Instead of admitting your reckless behavior is spreading covid, you will continue to scapegoat and blame things like the flu shot. Your comments are truly despicable. Please stop spreading conspiracies.

Be honest
Mon, 11/09/2020 - 1:37pm

A lot of depression and suicides were caused by four years of Trump, the bully president who ignored covid-19 and our economic problems, not necessarily from covid-19 itself. It's time to face reality and help heal our country. Let's stop spreading conspiracy theories and work to unite our country.

Annonomus North...
Sat, 11/07/2020 - 12:16pm

My sister moved to the UP about a year ago before the pandemic.
As of now she is frustrated to see packed bars in the UP and hardly any social distancing. No offense but what was said is it seems like the small town communities in the UP believe they are superior beings in not getting this illness. As many visitors from the south as you have. A lot of the UP communities travel down south as well.
Prepare yourselves. Social distance and good luck because you never know who is going to contact this virus or how dangerously it will affect you.

I live here
Sat, 11/07/2020 - 12:37pm

I live in the area served by War Memorial hospital. Everyone here knows that one should not go to War Memorial Hospital for anything serious. War having 6 ICU beds is not really an issue because people with a life threatening illness will go down state. The hospital administration knows this and accepts this.

UP Shame
Mon, 11/09/2020 - 9:24am

So it's like relying on the rest of the state for "social medicine" while pretending to hate "socialism". Got it.

Now we have to guard against them spreading the virus here where they will get ICU care while they cry and scream about our "tyrannical" governor who is trying to protect us from such recklessness.

It's so sad.

https://www.youtube.com/watch?v=2Ufw0TYfmRk

Mark Dobias
Sat, 11/07/2020 - 1:07pm

The Soo, with its four ice rinks, has an endless capacity for those who cannot get into the ICU in time.

Beverly Smith
Sun, 11/08/2020 - 11:44am

Not that you'll find this info online, but Chippewa Correctional Facility is running wild with Covid-19. PLEASE hospital people: order as much of Remdesivir as you can! The prison(s) does not have the room, the proper equipment nor the trained staff to deal with this kind of nightmare. I just hope the officials at the prison(s) realize when a person is going to need more than Tylenol and a vitamin D pill!

Beverly Smith
Mon, 11/09/2020 - 6:20am

Not that you'll find this info online, but Chippewa Correctional Facility is running wild with Covid-19. PLEASE hospital people: order as much of Remdesivir as you can! The prison(s) does not have the room, the proper equipment nor the trained staff to deal with this kind of nightmare. I just hope the officials at the prison(s) realize when a person is going to need more than Tylenol and a vitamin D pill!

Good luck!
Mon, 11/09/2020 - 10:24am

"The peninsula overall has 15 hospitals and 750 beds — with just 58 set aside for intensive care, according to state data.

By Thursday, 46 of those beds were occupied, with the worst of an anticipated coronavirus surge yet to arrive.

While U.P. hospitals have emergency plans to make more beds available, an overflow of COVID-19 patients may mean less room for the usual flow of stroke and heart attack victims, surgical patients or those in car accidents."

It's a shame some people are still in denial, but such is life.

Richard M
Sat, 11/28/2020 - 2:24pm

Everybody blames someone in authority, Trump, Whitmer, whoever. In the end the spread of Covid boils down to selfish individuals making selfish choices.