Health officials in Washington are worried the state's nearly fully hospitals could be hit even harder because of the omicron variant of the coronavirus.
The occupancy rate in intensive care units statewide is 90%, and for acute care beds it's at 92%.
"We have a math problem," Taya Briley, executive vice president of the Washington State Hospital Association, told reporters Thursday.
If omicron infects a large number of people as it is predicted to do, some will need hospitalization .
"This could mean a huge number of people getting sick enough to need hospitalization in a system that's already maxxed out," Briley said.
Some hospitals statewide are currently operating at or over 100%.
In Wenatchee, there were just seven open adult acute care beds on Thursday, said Dr. Jason Lake, chief medical officer at Confluence Health there. The hospital is licensed for 176 beds and has just 15 COVID patients, indicating how tight capacity is for patients seeking all kinds of care, not just for the virus.
Hospitals are facing capacity challenges for myriad reasons.
Many hospitals have patients who they could discharge but have nowhere to go. These patients need to be transferred to nursing homes, adult family homes or get care in their own homes, but they wait in the hospitals.
At Providence Regional Medical Center in Everett, 100 of the 600 hospital beds are full with patients who don't need to be there, said Dr. George Diaz, the division chief of medicine there.
Briley said the problem has become exacerbated with the pandemic, and the hospital association is advocating for changes to state law.
At the same time, there are still 702 patients being treated for COVID-19 statewide, though this number has decreased significantly since the delta variant swept through the state earlier this year.
Hospital occupancy rose when the delta variant arrived in the state, from about 80% in August to more than 91% by September.
The occupancy rate has remained consistent since then, despite the number of COVID hospitalizations decreasing.
Hospital leaders said Thursday that this in part due to the number of patients returning to the hospital for procedures and surgeries that had been delayed, including some that require staying there to recover.
"We're trying to get those patients now taken care of, some of whom need hospitalization, which is why we're not seeing that capacity decline," said Dr. Michael Myint, population health physician executive at MultiCare.
In Spokane, these procedures have been scheduled into the first quarter of 2022.
Statewide, there were no early indications of COVID hospitalizations beginning to increase with omicron — except in south King County and Pierce County. With case counts escalating there, hospital leaders asked residents to take multiple precautions during the holidays.
The rise on the West Side " absolutely could be the beginning of impact from the new variant," Mark Taylor, operations director of the Washington Medical Coordination Center, told reporters Thursday.
The coordination center is a large part of why Washington hospitals never entered crisis standards of care in the pandemic, where certain types of care is rationed. Hospitals in the state have made a commitment to not let any one hospital go into crisis standards, sending patients across facilities and regions.
The hospital association recently rolled out new guidelines with the Department of Health for implementing crisis standards of care, Briley said.
"We're doing everything we can to avoid it, but we're getting ready," she said.
