Upstate New York Hospitals Overwhelmed by Rising Covid Cases

An increase in Covid cases and a shortage of healthcare workers are filling hospitals and nursing homes beyond capacity in upstate New York, creating a growing crisis in the healthcare system before even that the Omicron variant is not known to have spread in the area, according to hospital officials from Buffalo to Albany.

Covid hospitalizations in the region have more than tripled since August, when the Delta wave began to hit the state, Governor Kathy Hochul said this week. At the same time, tens of thousands of healthcare workers have quit their jobs in the healthcare sector, for reasons ranging from pandemic exhaustion to refusal to be vaccinated despite the state’s strict mandate for them. healthcare workers, and some systems have posted hundreds of available job openings.

The result was a decrease in upstate hospital capacity of about 10 percent. And a perfect storm of high patient volumes, reduced staff, and inability to refer patients to nursing homes – which are themselves full – has started to overwhelm some facilities, especially in western New York. York, the Finger Lakes region and the north of the country, hospital officials mentioned.

With Omicron now detected in New York and Long Island and the variant is expected to spread, and few hospital beds in the upstate are available for patients if Covid hospitalizations increase further, Ms Hochul said the ’emergency state.

On Wednesday, she announced that 120 National Guard soldiers would be deployed to support nursing home staff across the state. The governor’s office has so far announced nine facilities – nursing homes in Rochester, Buffalo, Long Island and elsewhere – where the soldiers will work. Other locations will be announced soon.

The governor also said that all hospitals above 90% of their capacity could be ordered to stop elective surgeries to deal with the outbreak. There were 56 hospitals in this category on Friday, including 10 in New York, some of which had already taken this step.

“Hospitalizations are on the rise, get that number, 150% in the upstate versus the lower state,” Hochul said on Monday of the Increase in hospitalizations linked to Covid since August. “It’s not that I’m trying to create a divide between the upstate and the upstate,” she added, “but these are the numbers that we are seeing and they are very disturbing. “

At Glens Falls Hospital in Warren County, about an hour north of Albany, patient volumes are at their highest level since the start of the pandemic. About a quarter of the beds are filled with Covid patients, the rest with patients with other illnesses, including some who could typically be released to nursing homes but cannot be released due to a lack of beds .

Covid-19 is prevalent in Warren County, where there are 93 cases per 100,000 residents, about 5 times the rate in New York City. The positive rate for virus tests is 12%, compared to 2% in New York.

Still, masking at local Glens Falls stores seemed rare, even as emergency care centers and hospitals fill up with patients seeking tests and appointments. The county’s vaccination rate for all residents is 72%, which is actually higher than the state average of 69%, but a combination of relaxed precautions, waning immunity, and increased infectivity. of Delta propels cases there, as elsewhere.

“It’s so bad in this area,” said Dr Jeremy Di Bari, a family doctor who works for the Hudson Headwaters Health Network and sees patients at Glens Falls Hospital and several nursing homes. emergency in rural Warren County. Dr Di Bari himself contracted the Covid when it spread in his family, despite being fully vaccinated. “I don’t think it’s going to get any better,” he said. “I hope it doesn’t get worse.”

Erie County, which includes Buffalo, has seen one of the largest increases in hospitalizations in the state in recent weeks. The Erie County Medical Center is full and patients are waiting in the ER to be admitted. At the same time, there are 500 job openings at the hospital, which currently employs around 3,600 people, hospital officials said.

Similarly to Glens Falls there are patients – 52 of them – who could be discharged if there were only nursing homes or group homes that had room for them. them. While the hospital does not refuse people seeking care, between 10% and 20% of people who go to the emergency room leave unseen because wait times are very long, officials said.

“The convergence of problems is the worst I have ever seen,” said Tom Quatroche, general manager of the medical center. “We had these high volumes before, but we could transfer them to other settings and we had the staff to manage the volume. We find ourselves in a situation where the understaffing in the wider community and in the hospital, only creates a perfect storm. “

Marty Boryszak is the senior vice president of acute care at Catholic Health, which operates five hospitals and a number of outpatient and inpatient treatment centers in Erie County. Last month he struck a contract after 2,500 workers went on strike. He said Buffalo hospitals are reaching critical juncture. “We are 100% touching, and it is not over,” he said.

The state estimates that 33,000 healthcare workers, or just 3% of the overall healthcare workforce in New York City, have quit their jobs due to the immunization mandate, which does not allow testing instead. vaccination or religious exemptions. But because the sector as a whole was already understaffed, additional job losses hit hard. Ms Hochul is cautious about imposing additional mandates in other areas in light of the experience, she told a press conference on Thursday.

At FF Thompson Hospital, a rural hospital on the shores of Lake Canandaigua in the Finger Lakes, 15 people spent the night in the emergency room one night this week because there were no beds available, Stapleton said. , general manager of the hospital. At the start of this week, less than a quarter of the hospital’s 115 patients had Covid, but that was enough to overload an already taxed facility.

For weeks, the hospital had tried to return 17 stable patients to nursing homes, but could not find a place. A patient was recently taken by ambulance 300 miles to a nursing home bed in New York City, said Stapleton, the nearest facility that had an opening. The patient, who suffered from several chronic illnesses, had been in the hospital for three months.

About 150 staff have left rather than complying with the state’s vaccine mandate, including people with decades of institutional knowledge, Stapleton said. Things got so bad that the week before Thanksgiving, the hospital diverted ambulances for two days to other hospitals just to relieve some of the pressure.

“It’s the status quo now,” Stapleton said. “This is what we are dealing with. It’s just an incredible number of patients.

Kathy Parrinello, executive director of UR Medicine, the health system affiliated with the University of Rochester, said the six hospitals in the system in the Finger Lakes region, including FF Thompson, are operating above their authorized capacity. .

Fewer staff are working now than at this time last year, due to hundreds of vacancies, but patient volumes are higher. Those who work, said Ms Parrinello, feel “a combination of exhaustion and ‘I can’t believe we’re here again’.”

In Syracuse, the Northern University Hospital recently closed nearly 20% of its beds and stopped performing elective surgeries because it has around 400 vacant nursing positions, a spokesperson said. More than 100 staff have left rather than complying with the immunization mandate.

“The most pressing issue for Upstate right now is staffing,” said Darryl Geddes, the spokesperson. The hospital has increased overtime pay and “continues to aggressively advertise new staff” in an attempt to find more people to work.

Several counties have declared states of emergency, including Ulster County in the Hudson Valley and Wyoming County in western New York City, as cases of the virus have increased.

But except for Erie County, which reinstated a mask mandate for indoor public places regardless of vaccination status, no local county appears to have instituted additional virus-related restrictions for the public.

New York City remains the only state jurisdiction that requires people to have received at least one dose of the vaccine to access indoor bars and restaurants.

Ms Hochul has so far resisted any further statewide restrictions, saying it is up to local authorities to put them in place.

The contrast between the brewing crisis inside hospitals and the relatively regular pace of life outside can be stark. In Buffalo, the resurgence of cases did not appear to slow down shopping after Black Friday at busy malls, although most shoppers appeared to be complying with the new mask mandate.

And at Aviation Mall in Queensbury, County Warren, where the state just opened a new testing and vaccination center, few shoppers wore masks inside stores on Wednesday.

“It’s hard to ignore what’s going on with the cases, but the social determination of the population to keep up the good fight with mitigation measures is a bit shattered,” said Dr Thomas A. Russo, chief of staff. infectious diseases at the Jacobs School of Medicine and Biomedical Sciences at the University of Buffalo.

Concerned about the public’s lack of urgency, some medical workers began to try to warn people directly.

“Let me be frank,” wrote Dr. Howard Fritz, chief medical officer at Glens Falls hospital, in a press release issued by area doctors. just before Thanksgiving. “If you are not vaccinated, get vaccinated immediately.”

He added, “Your life, the life of your loved one and the lives of your friends and neighbors depend on it. “

Jane Gottlieb has contributed reporting from Glens Falls, NY, and Daniel Higgins from Buffalo.

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