Area hospitals say they continue to try to provide care safely and effectively even as the number of Covid-19 patients continues to increase rapidly. With the highly contagious Omicron variant continuing to spread at an unprecedented pace across the area, the U.S. and the world, case counts continued to reach new records in Ulster County. Healthcare workers are not immune to contagion, and staffing problems have been a problem in many facilities.
On January 8, the state health information system reported that Ulster County had recorded 471 new Covid cases in one day, a record number.
Dr. William Begg, vice-president of medical affairs and an ER doctor at Nuvance Health’s Vassar Brothers Medical Center in Poughkeepsie, reported the middle of last week that the hospital was seeing Covid-19 hospitalization numbers on a par with the first wave of the pandemic in spring 2020. Begg said Covid-19-related hospitalizations have increased substantially. Before the holiday season, there were just a handful of patients with the virus in the hospital. It was the respite time between the Delta wave and the current Omicron wave.
Begg estimated last week that Covid-19 patients now made up approximately 20 percent of all patients hospitalized at Vassar Brothers.
What’s different this time than during the first wave back in spring 2020, said Begg, was that Vassar Brothers was better prepared to deal with patients, It has implemented improved procedures like cohorting patients in certain areas and opening additional floors to accommodate Covid patients
“The reason for this is many of them are getting similar treatment, and that makes it easier to staff,” he said. “Those staff have to have certain protective equipment, which makes it quite useful to have the same units with the same patients.”
The first wave of the pandemic taught the hospital to be able to expand this wing rapidly based on the number of patients and align staffing accordingly. Begg said the hospital has also changed procedures in the ER to help reduce the number of patients who come to the ER and then leave before getting treatment out of frustration over long waits. The hospital now stages a team of doctors and nurses in a triage area that sees patients and determines the seriousness of their illness before they register.
Vaccines, antibodies and pills
Vaccines have made a huge difference since the first wave. The patients who have been hospitalized and have ended up in the ICU or even died were overwhelmingly unvaccinated.
Begg urged everyone eligible to get a booster shot. “If you’re a healthy person and you get a booster shot, you don’t have a bad outcome,” Begg said.
The Omicron variant presents an unique challenge to the medical providers because it’s far more transmissible than previous variants.
Monoclonal antibody treatments are reserved only for those patients with serious symptoms. The older Regeneron treatment is not working well with Omicron. The availability of new treatments specifically targeting this latest variant has been quite limited, Begg confirmed.
Vassar Brothers has had to prioritize the most ill patients first, then the less ill, and lastly those considering elective surgery.
Cautious optimism
Begg remains cautiously optimistic about the future. New York State may be reaching the peak of its Omicron wave right now, he said last week, while Connecticut might not reach its peak for another week. Even when the number of cases decrease, a lot of people will have “long Covid,” symptoms that may last weeks and months.
Begg said that Pfizer’s recently approved Covid-19 pills will start to be more regularly available in the next month or two. The drugmaker is trying to accelerate mass production. They will not be available at the hospital, but instead by prescription at pharmacies.
The world will continue to deal with waves of Covid-19, Begg believes. “Hopefully it will burn itself out and not be as strong,” he said. “The best-case scenario is everyone gets vaccinated and gets a booster and Covid goes away”.
Northern Dutchess sees a spike
Northern Dutchess Hospital in Rhinebeck, also operated by Nuvance, has seen an increase in Covid-19 cases following the holidays. Many of the hospital’s beds are occupied by patients, according to Sarah Colomello the hospital’s public and community affairs manager.
“Our staff are fatigued, and this is not how they wanted to start off their New Year,” Colomello said. “We also have staff out with Covid-19 and other illnesses, adding another challenge.”
While the hospital’s ER typically sees a lot of serious winter illnesses, Colomello said, they are seeing an atypical number of acutely ill Covid-19 patients in the hospital’s emergency department.
She said the hospital has implemented part of a surge plan allowing it to expand capacity and to transfer patients to one of the other Nuvance-operated hospitals depending on the level of care needed as well as capacity.
Colomello said the hospital has also postponed some elective surgeries. Urgent elective procedures are being evaluated on a case-by-case basis. Colomello urged patients with minor symptoms to visit Nuvance Health’s website to schedule a telehealth visit with their primary-care doctor to arrange for testing
“Nuvance Health primary-care doctors had hundreds of appointments available at the start of today for people with Covid-19 symptoms,” she said. Patients should not come to the emergency room for testing unless they need emergency care. The public should follow CDC guidelines.
With such wide community exposure, Colomello said, there’s a good chance someone within a household has Covid-19. “If you were exposed and weren’t recently boosted,” she warned, “you are at risk and be diligent about isolation, symptom monitoring and testing.”
Colomello, like Begg, emphasized the importance of vaccinated individuals getting their booster shots. “They aren’t perfect, but they may make the difference between you needing to be hospitalized if you do get infected,” Colomello said.
Don’t delay seeking care, WMCHealth urges
Westchester Medical Center Health Network’s northern division operates Mid-Hudson Regional Hospital in Poughkeepsie, HealthAlliance Hospital’s Broadway and Mary’s Avenue campuses in Kingston, and Margaretville Hospital. WMC issued this statement when asked about the current status of hospitalizations in its area hospitals:
“Like elsewhere in New York State and around the country, WMCHealth hospitals have seen an increase in patients with Covid-19 infection,” WMCHealth said. “Current staffing levels at WMCHealth hospitals, skilled nursing facilities and provider practices are appropriate, and our workforce continues to provide care in safe and comfortable environments.”
WMC Health officials said community members should not delay seeking care if they have Covid symptoms or another illness or injury. WMC Health is offering testing services at WMCHealth Physicians at 28 Grand Street in Kingston and at 241 North Road in Poughkeepsie. Community members can schedule appointments for both locations by calling 914-202-4530.