The COVID-19 pandemic continues to challenge healthcare providers around the country, including St. Lawrence Health. As we enter now the 21st month of the pandemic, it may seem the current surge in COVID cases is simply more of the same, that it will be managed by healthcare providers as it has in the past and then subside. That’s not the case. We are in a different situation now and both the healthcare system and the community should be prepared to adjust to these new realities.
So what is it that makes the surge of December of 2021 different than previous COVID spikes? Never have we seen such a continuously high percentage of inpatient bed capacity filled by COVID-positive patients. Unlike most routine inpatient cases, COVID patients require a substantially greater amount of staff resources at a time of our greatest staffing shortage. Not only do COVID-positive patients require more intense resource deployment, their lengths of stay run longer.
Never before has access to nursing home placement been more difficult as our region’s skilled nursing facilities struggle with similar staffing challenges. The result is that COVID-recovered patients remain in hospital beds long after their acute illness has resolved. Never before has transferring high acuity patients in need of tertiary care been harder, as our tertiary hospital partners experience this same gridlock. Patients normally placed in larger centers remain here.
We are experiencing longer than average wait times in our emergency rooms. There are a number of factors that contribute to this. All patients presenting to an emergency department are potentially COVID-positive. As a result, waiting room space is limited. Many patients presenting for emergency treatment exhibit COVID-like symptoms, requiring they be tested and treated separately. Emergency room patients needing inpatient admission are often unable to be promptly placed on the floors due to a lack of available beds, thus causing further congestion.
In times of crisis, everyone experiences stress. We understand that delays in care and restricted visitation can lead to heightened levels of frustration. Please understand we are doing everything possible to provide access to needed services. Please also understand that this continued escalation in the number of COVID patients requiring ever-greater inpatient bed capacity cannot be accommodated.
Our staff work countless hours each day under enormous pressure. They continue to find ways to manage through the most demanding of days, but there are limits to the number of overtime hours the nurses and providers and support staff can continuously work. We have reached that limit.
This week we will be postponing virtually all elective inpatient surgeries. We will be tightly managing outpatient elective cases to see that they occur within specific limited daytime hours. We will this week be temporarily suspending cardiac rehabilitation services at Canton-Potsdam Hospital (CPH) to repurpose that space to emergency department use. We hope to resume the CPH cardiac rehabilitation services at Massena Hospital in January of 2022. The laboratory service at the St. Lawrence Health System Medical Campus in Canton is closed due to staffing shortages. Laboratory services remain open in Canton at the EJ Noble building. As we continue to progress into this current COVID surge, we will adjust to the changing needs of our patients as well as our available resources.
What is most dramatically different between the COVID surge of December of 2020 and December of 2021? Last December we were dealing with the Alpha COVID variant and the vaccine was just becoming available. This December, with 56% of County residents fully vaccinated we have the Delta COVID variant, which spreads more quickly and reaches higher acuity more rapidly. Fortunately, over 80% of St. Lawrence County residents age 55 and older are vaccinated. Alarmingly, the rates of vaccination of those 54 and younger is far below state averages. In 2021 we see greater numbers of this younger population being hospitalized.
With each passing week it becomes increasingly clearer that this December 2021 crisis is being driven overwhelmingly by unvaccinated patients. Breakthrough hospitalizations do occur in those fully vaccinated, most frequently in patients with other significant underlying health conditions, but let’s not succumb to the false narrative that breakthrough cases prove the vaccine doesn’t work. Ten days ago at CPH on a floor full of COVID patients, we had one unvaccinated patient. Since that time, of all the COVID patients admitted, 80% were unvaccinated.
St. Lawrence Health employees and their families live in every corner of this county. They are members of the community and patients of SLH as well. It is our purpose to be here for all, to provide the best care that can be provided, no matter how difficult the times. We will remain true to that mission, but we need your help to provide that care. Please get vaccinated. It’s the single most important thing that can turn this tide.
We greatly appreciate all of the assistance and understanding the community has provided.
