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COVID patient count steady, but hospitals busy with acute care

Medical wards and intensive care units are filling up in the region’s two hospitals, but officials say that’s caused by more and sicker patients seeking medical care and not a result of a spike in COVID-19 cases.

Officials with the University of Virginia Medical Center and Sentara Martha Jefferson Hospital say they have seen a spike in people seeking care for chronic health issues — care that was delayed during the first few months of the pandemic.

Those patients are also sicker, most likely because of the delayed care, official said.

“Overall, our ICU numbers have been low and steady and our COVID unit has patients but we haven’t been overflowing,” said Andrea Chapman, infection control practitioner at Martha Jefferson. “What we’re really seeing is an increase in the medical unit and the acuity of cases. The increased acuity and raw numbers of patients in the medical units has impacted our capacity way more than COVID.”

“We’re busy now, busier than I anticipated, but a lot of that is patients from all over the region being sent to UVa for treatment of serious non-COVID medical issues,” said Dr. Craig Kent, executive vice president for health affairs at UVa. “The number of those patients in the last two months has grown significantly.”

In March, Gov. Ralph Northam ordered a halt to elective surgeries and non-critical treatment at hospitals, dentist offices and veterinarian offices as part of a statewide lockdown designed to keep COVID-19 cases from overwhelming hospitals, as happened in New York City in the early days of the pandemic.

Lifesaving medical procedures, trauma treatment and other emergency care were not affected by the order.

In May, Northam rescinded the order and allowed medical offices to resume routine care. But some patients were reluctant to make appointments because of the fear that COVID-19 could be caught at the facilities.

“We don’t really know why there has been an increase in the number of people coming in who seem to have more acute medical problems than before the pandemic, but it could be that people were staying away from medical offices,” Kent said. “We are a teaching hospital and provide care on a level that many local hospitals cannot, and they refer those patients to us. We’re seeing more.”

The officials said both hospitals have in place prevention protocols and policies to protect patients from contracting COVID-19.

“We don’t want patients to ignore significant medical problems because they’re worried about the possibility of contracting COVID in the hospital,” said Dr. Paul J. Tesoriere, vice president of medical affairs at Sentara Martha Jefferson. “We have procedures in place to keep them safe.”

Kent said the university hospital has the ability to handle increased COVID cases, should a spike occur. Although recent figures from the Thomas Jefferson Health District showed that UVa’s COVID care ICU was full, Kent said that information was misleading.

He said the figure represented only one of many intensive care units at the hospital and that the hospital has the flexibility to turn regular beds into intensive care beds, if needed.

“We have 700 beds at UVa and we have multiple medical intensive care units. We have some units that are now closed and can be reopened, if needed,” Kent said. “We are in a great position because we have the new tower that we opened just after pandemic and that has 84 beds, all of which are ICU compatible.”

Kent said the hospital is seeing about the same population of COVID-19 patients recently that it saw at the beginning of the pandemic. He said the population sometimes spikes as outbreaks occur in nursing homes or other locations and then drops back down as those outbreaks are resolved.

Tesoriere echoed Kent.

“We certainly had a fair amount of COVID patients early in April and we saw some spiking around Memorial Day in June, and the whole country is seeing a spike as things open up,” Tesoriere said.

“When it first hit, probably 50% of our patients were going into ICU and on respirators but we’ve done a good job of avoiding that as many of the newer patients are younger and the research has shown that it’s better to avoid using respirators, if possible,” he said.

“We’ve developed some different treatment protocols as a result. We’ve been dealing with this virus for months and things are changing so fast. I’ve never seen research come out so quickly and changes come so fast. Everyone is working hard on this,” he said.

Officials from both hospitals said that should a surge of COVID cases occur, they currently have the capacity and capability to handle it.

“I’m concerned that if, as a community, we don’t follow social distancing and those precautions, that our numbers will go up. All we have to do is look around the nation to see that,” Kent said. “If that happens, we would do a few things. First, we shut down the elective surgeries again, limit the number of transfers from other hospitals and convert staff and facilities to handle the increase. We have that flexibility.”

Sentara Martha Jefferson staff members have continuously reviewed the hospital’s plan for COVID care, officials said. They believe they will have staff and facilities ready should a spike occur.

“We realize COVID-19 is going to be with us a long time,” Chapman said.


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