Aspirus CEO says they can’t take another COVID-19 surge

Published: Nov. 18, 2020 at 7:28 PM CST
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WAUSAU, Wis. (WSAW) - The president and CEO of Aspirus said in a press conference Wednesday that they cannot take another surge in COVID-19 cases.

Systemwide during the summer, Matt Heywood said they had about 30 COVID-19 patients in their hospitals on any given day. Now, that number is 130. Having enough beds and staff are both a problem. Pre-pandemic, Aspirus would have enough staff to manage 300-350 hospitalized patients around its system. They have a total of 500 beds for hospitalized patients throughout all of the hospitals. Heywood said they staffed up due to the pandemic, allowing for as many as 450 beds to be staffed, which is needed with the additional 130 COVID-19 patients. However, they also have about 300 staff members who are either quarantining or isolating due to COVID-19.

“We can’t take another pop as a state,” he said.

Heywood urged that if people do not change their typical holiday plans, they project that an additional 250 people will need in-patient care at Aspirus alone. If you do the math, that means they will go well beyond the 500 beds and necessary staff that they have, meaning they will not be able to save all patients, COVID and non-COVID, who come through their doors.

He also said they can no longer easily transfer patients amongst other hospital groups when needed anymore, a sign that this is not exclusively an Aspirus problem.

“We’ll discharge 40 or 50 in Wausau alone and they’re filling back up and again, that’s the same on the COVID side and the non-COVID side, so this has been a steady-state for probably the last month or so,” he stated.

Other states in the U.S. have been able to come down from their surges with help from resources in other states and now Wisconsin is in that spot. However, as the holiday season approaches, if people stick with their normal holiday traditions, the whole country could see an uptick in cases and it will be hard for Wisconsin hospitals to get help.

“If the country has this challenge, there’s going to be limited resources from staffing, supplies, etc. because there’s going to be a lot of people who all need the same thing,” he stated.

In the meantime, they are trying to get creative to help free up bed space. That includes sending people home to work with the Aspirus At Home care team if they do not need the most intensive care and equipment at the hospitals. They are also rescheduling elective surgeries. They set up a skilled nursing facility in Medford. They are repurposing staff where they can and borrowing staffing resources from other states.

The Wisconsin Department of Health Services announced earlier this month that Bamlanivimab is now available in limited supply for Wisconsin hospitals. It is a treatment that received emergency use authorization from the FDA for particular types of COVID-19 patients, patients that have a high likelihood of having a severe reaction to the disease but who have not reached that point yet and do not require hospitalization. It helps to keep patients out of hospitals and recover faster. Heywood said they are hoping to get a supply of that as well, but have not been allotted any at this point.

Heywood noted, COVID-19 patients require a lot more attention and work compared to other patients’ needs, meaning more staffing resources are needed on COVID-19 patients.

“You may be here for weeks and weeks and weeks, which is one of the issues with COVID-19. The people who come in the hospital are very sick,” Dr. Stephen Phillipson, Aspirus Wausau Hospital Director of Medicine said.

Being a hospitalized patient with COVID-19

Dr. Phillipson described the typical experience of patients hospitalized with COVID-19.

“You’ll be in isolation. The people who see you will be wearing N95 masks, face shields, gowns, gloves and you’ll be very isolated and not be able to leave your room very much,” he began. “You will not be able to see your family, probably, unless you’re dying and in some situations when someone is dying we’ll make an exception and allow someone to come in, but otherwise you won’t see family except on a video interface or by telephone.”

He stated that if a patient ends up needing a ventilator, they have about a one in three chance that they will survive. He explained having those conversations with families over the phone is challenging.

A lot of patients who are at the hospital end up being on a high level of oxygen to do respiratory therapy. Specifically, Dr. Phillipson said there are a lot of patients who are put on BiPAP, which is a noninvasive breathing apparatus. He explained the BiPAP is uncomfortable, but patients are having to keep that on them longer than they would in most other circumstances in order to keep them breathing properly.

“There’s a myth out there that it’s just very old and infirm people who end up in our hospital and that’s not true. We see people who are in their 40s, 50s, extremely ill. We’ve had people in their 20s die. We’ve had patients who are in their mid-30s go from talking to us to passing away within 24-36 hours. This is a serious illness and it affects a broad swath of people,” he urged.

He noted the people who primarily land in the hospital, though, are older and have underlying conditions, but that does not mean they would have died anytime soon if COVID-19 did not exist.

“There’s also ‘oh, we’re just attributing this to people who were going to die anyway.’ Well, I would take issue with that and say that’s not really correct,” Dr. Phillipson stated. “We’re seeing many people who should have had many years of life with their families.... who will not because of the COVID-19 pandemic.”

The frontline workers

“In my specialty, we deal with death and dying not uncommonly, but my team is seeing volumes of people dying that they’ve never had to deal with before and that’s been emotionally draining on them,” Dr. Phillipson said.

He started his career in the medical field during the AIDS epidemic. He said all of his patients in his care died.

“For my younger physicians and younger staff... this may be one of the defining moments in their career and how they hold up through this is something they’re going to think about and recall for a long time,” he explained. “So we try to support each other and we talk about the losses. It’s very hard for my young physicians to lose five or six patients in 24 or 36 hours. They’re not used to that.”

“It’s basically talking it through and getting it up and doing it again the next day because we have a lot of people who do well and go home and you’ve got to focus on that aspect of it as well,” he noted.

“This is taxing,” Heywood said. “This is tough day after day for month after month and then you’ve got me telling you, and other people telling you, it’s going to be another three or four months. So, I would just ask our community to understand what our staff are going through and help them because the only way we can get through it is some of them are not going to have to have vacations to help out while their colleagues are sick.”

He noted a vaccine will not help get us through the winter due to the timeline and realities of distributing it to the public. Which is why they are begging people to plan their holidays around COVID-19 safety guidelines until there is a solution.

“I’ve heard us talked about as the frontline workers, but right now, the people in our community, they need to be the frontline workers by wearing masks, social distancing,” Dr. Phillipson stated.

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