Hospital limits elective surgeries amid surge

COLDWATER - Mercer County Community Hospital officials believe the omicron COVID-19 variant is in the county and starting today are limiting elective surgeries to one per day in light of soaring hospitalizations and the near impossible task of transferring patients.

Vice president of patient care services Susan Miller gave an update on the virus during Wednesday's hospital board of governors meeting.

Dr. John Terpstra offered some hope, reporting U.S. health regulators on Wednesday authorized the first pill against COVID-19, a Pfizer drug Americans will be able to take at home to head off the worst effects of the virus.

Miller said the number of local and regional hospitalizations is concerning and reported area hospitals are denying patient transfers.

The closest hospital to even offer a waitlist for patient transfers is Lutheran Hospital in Fort Wayne, Indiana - more than an hour-long drive from Community Hospital.

"It's not just COVID that we're seeing," Miller said. "We actually do have an increase in cardiac patients that we're seeing. Without being able to get patients out (transferred) … it bedlocks you."

Without the ability to transfer, patients end up staying longer, Miller said, exacerbating the strain on the hospital and its staff. The average patient stay is usually two to three days before a transfer, she said. Now, patients have to ride out the entirety of their stay at the hospital. Some current patients have been at the hospital for two weeks, Miller said.

The hospital has a 33-bed capacity and used to average about 14 patients per day. However, over the past two weeks the hospital has seen upwards of 28-30 patients per day. The intensive care unit has five beds, all of which are occupied, Miller said.

The omicron variant is undoubtedly playing a role in the increase in cases, Miller continued. The variant was first detected in the state earlier this month. Terpstra said the Centers for Disease Control and Prevention on Wednesday estimated the omicron variant accounts for 90% of new COVID-19 cases in some parts of the country.

The variant made up more than 73% of new cases as of Saturday, according to the CDC. It's a significant increase from last week, when U.S. health officials estimated omicron accounted for 12.6% of new COVID-19 cases.

CEO Lisa Klenke noted the flu also is more active this year, especially when compared to last year when the hospital saw few, if any, flu hospitalizations.

"The flu is compounding things," Klenke said.

The situation statewide has become so dire that Gov. Mike DeWine has deployed more than 1,000 Ohio National Guard members into local hospitals to help address staffing shortages, Klenke said.

"At the state level, they are concerned right now with the volumes (of patients) because the whole system has a backlog," Klenke said. "Early on in the pandemic we still were able to transfer (patients) to a higher level of care … now bed availability is a real issue."

Klenke said the state also is working with a staffing agency to open up eight to 10 sites throughout the state that hopefully will relieve some of the pressure and capacity issues hospitals are facing.

On a positive note, Terpstra said the new Pfizer oral medication appears to be highly effective, more so than the monoclonal antibody treatment the hospital offers.

Although effective, the monoclonal antibody treatment is given through an IV, takes roughly two hours to complete and requires a nurse and space for the treatment. Meanwhile, the Pfizer drug, Paxlovid, is a treatment that can be used at home. The treatment consists of three pills taken twice daily for five days, Terpstra said. The treatment is most effective when taken within three days of symptoms, but is still effective up to five days after symptoms first appear, he said.

A trial of about 3,000 patients showed the pill cut hospitalizations and deaths by 89% when given to people with mild to moderate COVID-19 within three days of symptoms, Terpstra said.

"It's incredibly effective in reducing hospitalizations, more effective than the IV monoclonal antibody treatment," he said.

Terpstra said officials do not yet know when or how much of the Pfizer treatment the hospital will receive. In the meantime, the monoclonal antibody treatment is still available for adults at risk of severe complications, he said. The IV treatment is most effective when taken within a few days of symptom onset, he said.

Terpstra stressed any adult over age 40 is likely eligible for the monoclonal antibody treatment, and the sooner they consult with their physician about treatment options the better.

Terpstra said he's heard of several middle-aged patients who test positive, don't contact their doctor and wait until seven to eight days have passed before going to the hospital. If those patients had contacted their doctor right away, the IV treatment could have helped prevent hospitalization, he said.

Board members also,

• appointed Dr. Megan Core as chief of staff. Terpstra had served in the term-limited role for two or three years, he said.

• established the next board of governors meeting for 6:30 p.m. Jan. 26 in the Sanderell room at the hospital.