Cody Regional Health saw a surge of COVID patients last week, some admitted and some seen and sent home with treatments.
And unlike in the early days of the pandemic, Dr. Elise Lowe, a Hospitalist at CRH, said more patients were in their 30s, 40s and 50s, many with no serious health issues. She said with younger patients some of the top issues that can lead to a more serious case of COVID include being overweight and suffering from hypertension or diabetes, which could lead to needing breathing support.
Cody Regional Health is dealing with an influx of new COVID patients and larger hospitals in surrounding states don’t have the capacity to accept intensive care patients. Now, the hospital is preparing to implement the Wyoming Department of Health Crisis Standards of Care and has initiated their internal Incident Command System to manage the load of COVID patients in addition to normally elevated summer patient volumes.
Over the last several weeks there has been an increase of COVID patients at Cody Regional Health’s Emergency Department, Walk-in Clinic and Acute Care/Critical Care units.
“We’ve seen quite a spike in cases, even just in the last three days. More cases in the last few days than we’ve seen before,” Lowe said. “A lot of our patients are surprised they’re the ones who got sick.”
Tuesday-Thursday the hospital saw 87 patients, 17 of those with COVID. Spurred on by the Delta variant, the virus is exacerbating an already busy time at the hospital.
As of Friday afternoon, the number of active confirmed cases of COVID in Park County was at 163. Hospitalizations actually dropped some by Sunday after being as high as 10 patients at CRH and seven at Powell Valley Regional. Neither hospital reported an open ICU bed.
As of Monday morning, CRH had dropped to five COVID patients hospitalized, with six at Powell Valley. Cody reported two open ICU beds.
Lowe said the surge in cases hasn’t changed the hospital’s messaging, just the urgency of it.
“Now is the time for masking when appropriate, social distancing,” she said. “We see people going to work, the grocery store with symptoms. If you have symptoms you really should stay home and take care of yourself, don’t go out and spread this, take this seriously.
“In the end, the vaccine is the cure for this, and unfortunately it’s been politicized, but vaccines have been known to work for more than 100 years. This vaccine is incredibly safe and effective.”
CRH CEO Doug McMillan said while there has been plenty of disinformation going around, the stats tell the clear story.
Last Thursday, Yellowstone County, Mont., reported 99 COVID patients, 91 unvaccinated, while eight were fully vaccinated. Of those, 36 were in the ICU, 23 on ventilators.
Park County Public Health Officer Dr. Aaron Billin on Wednesday shared the state’s county metrics, which put Park County in the most severe zone for transmission levels at a rate of 1,062 cases per 100,000 people and in the second-to-worst zone for test positivity at 12.7% over the last two weeks.
It’s put all area hospitals in a bind, even as they’ve worked to pool resources and ensure they are doing as much as they can to treat people, Lowe said. She said they have worked to treat and send home people that don’t need to be hospitalized, and can provide approved treatments such as an infusion of antibodies, or can even send people home with oxygen.
She cautioned against using unapproved treatments, such as the drug Ivermectin, noting that even the manufacturer, which could stand to make a lot of money from it being used to treat COVID, has said it is not effective for that purpose and has advised against it.
McMillan said the hospital is committed to working through the surge and is set to abide by the new vaccination requirements for heath care facilities dealing with Medicare and Medicaid.
“We expect increased vaccination will assist in preventing further widespread transmission of COVID-19 we are experiencing,” McMillan said. “Additionally, increased COVID-19 testing, that is readily available and affordable at home and in the community will assist, as well as increased supply of monoclonal antibody treatment availability, and additional support provided to schools that provide additional protections to students.”
Crisis Standards of Care
The principle of Crisis Standards of Care is to do the greatest good for the greatest number of persons and is defined as a major change in usual healthcare operations.
This can affect the level of care provided, which is made necessary by some pervasive or catastrophic disaster, in this case COVID-19.
“We are possibly going to a different standard of care soon, due to this major change in our health care operations in order to meet patient needs,”Lowe said. “This could mean double occupancy in our ACU/CCU units. We have communicated our situation with the Big Horn Basin Healthcare Coalition, Park County Public Health, the Wyoming Department of Health and Homeland Security.”
The decision comes after discussions with staff.
“Cody Regional Health leadership has come together to discuss how various departments throughout our system can assist with the increased volumes and staffing needs,” said Keith Ungrund, chief clinical officer. “We want people to know they can come to us for help, but we also need help from our communities. Please social distance, wear a mask and stay home if you are experiencing COVID symptoms.”
CRH elective surgeries are at risk of being canceled depending on resources such as staffing availability, bed capacity and supply chains. Only emergency surgeries will be considered moving forward if COVID cases continue to increase.
Reduced visitation hours are currently in place at CRH, limiting visitors to one per patient between the hours of 2-6 p.m. for non-COVID patients at this time. This may change as community COVID numbers change.
To be tested for COVID, hospital staff ask people to order a COVID test online through the Wyoming Department of Health, make an appointment with Walgreens if available, or if you believe you need to be seen by a provider due to the below respiratory symptoms, visit the Walk-in Clinic. If you are experiencing shortness of breath, visit your closest emergency room.
• Loss of taste/sense of smell
• Sore throat
In order to preserve Personal Protective Equipment, Cody Regional Health’s Walk-in Clinic team, located within Cathcart Health Center, are asking patients with respiratory related issues to use their walk-in clinic during the first two hours of opening, Monday-Friday, 8-10 a.m. and Saturday-Sunday, 9-11 a.m.
Walk-in Clinic Hours for non-respiratory patients are Monday-Friday, 8-6:30 p.m., Saturday, 9 a.m.-5:30 p.m. and Sunday, 9 a.m.-3:30 p.m.
For any questions related to school exposures or returning to school that do not require urgent evaluation by a provider, contact your school nurse. CRH cannot provide any guidance or testing related to school policies.
For further information about COVID-19, call (307) 527-1870 or visit cdc.gov/coronavirus/2019-nCoV/index.html