Just two months ago, Columbus Regional Healthcare System was admitting one or two patients a week due to COVID-19 infection. Now, with cases surging due to the more transmissible delta variant, the Whiteville hospital now has 26 COVID-19 patients and expects this number to climb even higher.
“The first time, it was a slow burn,” said Jason Beck, chief operating officer. “Now, it’s just every time you turn around there are more people coming into the emergency department.”
People from outside of Columbus are coming because their hospitals have already closed to the general public. Sick people, regardless of their counties of origin, are staying in the emergency department for longer periods of time.
“We just don’t have beds for them,” said spokesperson Stephanie Miller.
In response to the uptick in hospitalizations, CRHS is reinstituting its overflow tent, expanding into the fourth floor and pausing cardio-pulmonary rehabilitation for the next two weeks. It’s also considering a moratorium on elective surgeries.
“Obviously, there’s a breaking point when you’re beyond the threshold of being able to care for things,” Beck said. “The forecasts are not looking favorable.”
In January, CRHS expected to see an uptick in hospitalizations a month after an increase in county cases. Now, due to the more transmissible delta variant, it’s expecting more admissions just two weeks after recent surges.
“The number of cases probably isn’t as high, but offsetting that and making it worse is the pace,” Beck said. “We’re facing a grim reality.”
Refusing vaccine is ‘huge gamble’
Most COVID-19 hospitalizations at CRHS are of unvaccinated individuals who are between the ages of 30 and 50. Currently, 36% of Columbus County has received at least one dose of a COVID-19 vaccine, according to the North Carolina Department of Health and Human Services.
“We have seen relatively healthy individuals for whatever reason having poor outcomes,” Beck said. “Seeing what we see on a daily basis, it’s a huge gamble to not take the vaccine.”
The rare vaccinated patients admitted with COVID-19 have a relatively benign course, according to Beck. “They’re discharged and back to their normal selves,” he said. “They’re not the people on high-flow oxygen; they probably won’t have long-term effects from COVID-19.”
Beck added that the vaccines do not erase individuals’ chances of contracting COVID-19. “We shouldn’t get hung up on positive [tests] versus negative [tests],” he said. “[Vaccines] are preventing hospitals from getting overrun and preventing people from dying.”
CRHS is already nearing capacity and understaffed, and the healthcare workers there are exhausted from working to help sick people for the last year and a half.
“It’s tough work being in that environment day in and day out and not seeing any relief in sight,” Beck said. “We were just getting over it, and now we’re back there again.”
The hospital has tried to hire more contact tracers and respiratory therapists, but they’re in high demand across the nation. CRHS has been cross training its staff, who were not laid off at the beginning of the pandemic, for months to prepare for this surge in hospitalizations.
“We’re doing everything in our power to adjust resources, add resources and provide for the community,” Beck said.
To further protect their workforces, other healthcare systems in the state have mandated vaccines for their employees, but CRHS has not made that decision. Approximately 55–66% of CRHS workers are vaccinated, according to Beck.
“Are we at where we want to be in terms of percentage vaccinated? We’re not, but we think we can get there through proper education and constructive dialogue without doing a mandate at this time,” Beck said.
Some staff members have threatened to leave over mandated vaccinations, which Beck said “weighs heavy” on an already short-staffed hospital. “It’s such a polarizing topic that people will leave the workforce over it,” he said. “If we lose one nurse, we feel that.”
At the end of the day, Beck is hopeful that CRHS staff and the rest of Columbus County will make the choice to vaccinate.
“We could stop this from mutating into something else that’s worse than the delta variant,” he said. “It’s a safe vaccine.”
Encouraging masks for all
Regardless of vaccination status, the hospital is asking everyone to wear masks in public. The statewide mask mandate, however, ended July 31.
Beck said that he understands people’s confusion over the changing guidance, but added that the pandemic was a “fluid event” with quick turnarounds.
“You’re not managing month to month; you’re managing hour to hour a lot of times on what’s the best decision,” he said. “What’s appropriate for today is probably not going to be weeks from now.”
As a result, Beck thinks that Columbus County hasn’t realized how bad this recent surge in cases truly is. “I think the public at large is not grasping the severity,” he said.
Miller thinks that the public is also not grasping the effect this surge is having on healthcare workers. “I wish the community would get back involved, but they just don’t know what we’re going through here,” she said.
Now, the hospital is asking for that community involvement through vaccinations and face coverings. “We are doing everything we can to take care of our community here. In turn, we need them to do what they can do,” Miller said.
With the community’s help, Beck is optimistic about the hospital’s ability to address the recent surge in COVID-19 cases. “We’re going to get through it, but it’s going to be a challenge,” he said.