Two weeks after an alarming news conference where hospital officials essentially said the state was heading to a very bad place with COVID hospitalizations, the situation has not improved much.
On Monday, hospital officials told reporters that while hospitalizations were perhaps plateauing, it's a long way from getting back to normal operations.
Taya Briley, executive vice president of the Washington State Hospital Association, said, "Things are still very bad. This week we have 16,173, COVID hospitalizations compared to last week's number of 16,174. We are in the midst of the worst peak of COVID cases that we have experienced since the beginning."
For comparison, "before this highly contagious Delta variant arrived ... we were averaging just about 350 cases in June and in early July," Briley said.
About 260 patients statewide were on ventilators as of Monday, she added, up from 251 last week.
"All of these hospitalizations, and the misery of the patients and the hospital staff that are caring for them, could have been prevented," Briley said. "More than 95% of those that are hospitalized are unvaccinated; that is a staggering number."
Some health systems have reported a higher percentage, with MultiCare telling The News Tribune on Friday that 96 to 98 percent of COVID patients across its system were not vaccinated.
Briley noted that those vaccinated and hospitalized with COVID typically have underlying conditions or are immune compromised from cancer treatment or organ transplants.
The problem, the officials in attendance noted, is that while the outside world is essentially moving on with fairs, sports events and more, the health systems continue to struggle with no let-up in patient flow.
"When you walk down a hall that is full of COVID patients, it becomes very real," Briley said. "These patients cannot catch their breath, they literally cannot get enough air. They are in effect, drowning, and it's horrible for the patients. It's also something that causes horrible anguish for our staff who, day after day, are working to position patients to get them the oxygen that they need to try and make sure that they stay off the ventilators if they possibly can.
"This is a huge level of human suffering that is occurring in our hospitals, day after day," Briley added.
Surgery cancellations are now common, along with longer wait time for emergency surgeries. The officials also noted that while they are not at Idaho-level of crisis standards of care, the ripple effect is bad enough.
"We are actively canceling surgeries that are surgeries that people need to be able to function at a very basic level of life," Briley said, everything from eye surgeries to joint replacements and more.
Worker shortages and strain
The news conference came on the same day that a group of health-care unions representing 71,000 nurses and other health workers released a statement "urging hospitals to use the tools they have available to mitigate this crisis by retaining and adequately compensating current staff and filling under-staffed departments to ensure patient safety and access to care."
"We're losing overworked nurses to overwhelming burnout, the distress of working short-staffed, better-paying traveler nurse jobs and even for signing bonuses of up to $20,000 to move to a different hospital," said Julia Barcott, chair of the Washington State Nurses Association Cabinet and an ICU nurse at Astria Toppenish Hospital. "We're worried for our patients and the impact of the staffing crisis on the care they receive."
The joint statement, issued by WSNA, SEIU Healthcare 1199NW, and UFCW 21, said that the current staffing shortages had nothing to do with vaccine requirements for health care workers, and existed before any mandates were issued.
Monday was the last day health care workers could be immunized against COVID-19 with the Pfizer-BioNTech two-shot treatment in order to comply by a statewide deadline of Oct. 18. Those seeking Johnson & Johnson single dose have until Oct. 4.
The officials noted the Biden Administration's own mandate nationwide should help limit the number of workers who do not want the vaccine to move to other states.
According to Briley: "The state has stood up its emergency volunteer data bank. And we are relying on that to the extent that we can. Hospitals are pulling in volunteers from their communities. We do not think that we will have much relief coming from the National Guard. We have made inquiries about that with the state, and they really feel like those resources are deployed elsewhere and will not be available to us."
Other federal resources are stretched with COVID and natural disaster relief elsewhere nationwide, she added.
What hospitals are seeing
Dr. Christopher Baliga, infectious disease specialist with Virginia Mason Franciscan Health, told reporters that last week was the peak for that health system in terms of number of COVID admissions.
"I will say that the majority of our patients are not vaccinated, the majority of our patients who expire, are not vaccinated," he said. "You do almost suffer PTSD from seeing this over and over again, especially knowing that you know if only they had been vaccinated perhaps it would have been a different outcome."
And, some patients who'd rejected vaccines previously are still using or seeking unproven medication along with the parasite medication Ivermectin, Baliga said.
"We've been asked and we're not doing it," Baliga said. "I have seen patients who are taking veterinary forms (of Ivermectin), and they end up in the hospital anyway. I've seen some people taking and trying to treat their COVID. I've seen others taking it to try to prevent it, along with hydroxychloroquine, another medication that really has no role in the prevention or treatment of COVID.
"What is ironic is that a lot of these patients that are asking for this refuse to get vaccinated," he added. "ivermectin is not your answer. The vaccine is the best thing that you can do to try to keep from getting sick with COVID."
Darin Goss, chief executive for Providence Health and Services Southwest said that like other hospitals, his system had had to expand access to the emergency departments with "alternative care spaces both in conference rooms and classrooms and hallways."
Diane Blake, CEO of Cascade Medical Center in Leavenworth, said that transfers for higher-need patients and some surgerical patients have been challenging, with even air transport having to come into play when ground transport isn't available.
"You think about the additional transport time and just the risk of potentially not finding a place, and that highlights how close we are I think to, to having some not-great outcomes for patients in our state, which is devastating to think about."
With such a drain on hospitals coming from those not vaccinated, the officials were asked if there's a scenario where the vaccinated could take priority in matters of crisis-allocated care, which Washington state, for all the patient load, has not reached.
A state-level panel actually oversees crisis level of care standards, should hospitals have to move to that level, more typically applied to disaster settings such as earthquakes.
"These protocols have been developed over a period of time and they really don't pass judgment on a patient's choices in terms of have they received this preventative care or another preventative type of treatment," Briley said.
"For example, if somebody is a smoker and has not great lungs because they were a smoker for years, we don't take that to account but we do actively look at the patient's condition and likelihood to be able to survive as decisions are being made about what lifesaving treatment they are able to receive."