Wash. Patient Sent 600 Miles for Hospital Care

Tri-City Herald 

One Tri-Cities area patient recently needed to be transferred to a hospital 600 miles away as the latest COVID-19 surge is filling hospitals and overwhelming emergency rooms.

In another case, Prosser Memorial Hospital had to call 20 hospitals to find one with an intensive care unit bed for a patient who needed more care than that hospital offers.

A week ago all three Tri-Cities hospitals were so busy that for a time they all asked that any emergency patients be taken to another hospital.

As the number of COVID-19 confirmed cases in Benton and Franklin counties skyrocket because of the more infectious delta variant and too few people vaccinated, health professionals were sharing increasing accounts of the stresses on area medical services.

On Friday, nearly one in five patients was being treated for COVID-19 at the four hospitals in Benton and Franklin counties.

The 70 patients were a near record for the number of COVID patients admitted, according to Tri-City Herald records that showed a day in late December when hospitals were treating 72 patients.

Those patients are in addition to an increase in other patients who delayed getting care earlier in the pandemic or whose conditions worsened to the point they needed to be hospitalized because they delayed care for fear of being exposed to the coronavirus, according to officials at Kadlec Regional Medical Center in Richland.

"Here at Prosser we admit a lot of patients locally, but at times we have patients who need to be transferred out for a higher level of care, whether it be the intensive care unit or specialized procedures, and we're finding it very difficult to transfer patients because of how full the hospitals are," said Dr. Robert Wenger, medical director of Prosser Memorial Health emergency department, at a news media briefing Friday.

When patients are transferred 600 miles — nearly a quarter of the way across the nation — for treatment, "that's hard for their families who are vising and hard for families getting the patient home once they are ready to be discharged," Wenger said.

And other local hospitals noted similar troubles finding a bed for intensive care unit patients as the Washington State Hospital Association says all hospitals in the state are quite full.

Highest Hospitalization Rates

Franklin County has the highest two-week hospitalization rate per population in the state and Benton is second, followed by Columbia and Walla Walla counties, according to the Washington state Department of Health.

Doctors say they are increasingly seeing younger patients admitted to hospitals for COVID-19 problems.

"About a year ago we thought that COVID only affected older patients with medical risk factors, but now we're seeing young, healthy patients testing positive for COVID," Wenger said.

The hospital has been admitting patients in their 20s, 30s and 40s, he said.

"So the way COVID is behaving is very different now than it was before," he said. "The only thing that patients testing positive and being very sick with COVID have in common is that they are mostly unvaccinated."

Close to 100% of those who need hospitalization for COVID treatment are unvaccinated, he said. The vaccine is "extremely effective" in preventing serious illness, hospitalization and death, he said.

The Prosser hospital is seeing twice as many patients coming into its emergency department as it did in late winter and early spring, Wenger said, adding the trend was being seen across Tri-Cities.

When space is not available to admit those emergency patients to the hospital immediately, they stay in the emergency room until a bed elsewhere in the hospital is available for them.

"That takes up a lot of beds in the emergency departments that we have less beds and less staff available to see new patients who are coming into the department," he said. "So in a lot of the departments throughout our area we're seeing delays to care because of that. We just don't have the rooms available and staff available to see the large volume of patients."

Tri-City ERs Divert Patients

The increase in COVID-19 in the Tri-Cities area also means hospitals are having to divert patients from their emergency departments more often.

On Saturday night a week ago all three Tri-Cities hospital emergency departments were too busy to take more patients, said Franklin County Fire Chief Bob Gear at the last Pasco City Council meeting.

Pasco emergency responders are transporting three to five very sick COVID patients a day, he said.

The high number of COVID patients in addition to other patients "has put a tremendous load on all three hospitals," he said.

"We are keeping our fingers crossed that we are still able to take people to the hospital and not have them sit in the ambulance" until a hospital can take them, Gear said.

When all hospitals are diverting patients, in effect, none are, said Dr. John Matheson, medical director of Kadlec emergency departments.

"(People) should not fear that they will be driving around in an ambulance with nowhere to go," he said.

When all hospitals are "on divert" patients would typically be taken to the nearest emergency department, even if they would prefer a different one, he said.

They would then have to stay in the waiting room, with patients triaged to get help for the sickest first, until they can be seen.

Hospitals across the Tri-Cities have had more times since the recent surge in COVID cases when they have asked to divert emergency patients to other hospitals, a situation seen across the nation, Matheson said.

Saturday night a week ago the hospitals were busy, presenting challenges to emergency responders "but there was never a time we were unable to get into a facility," said Kennewick Fire Chief Chad Michael.

The Tri-Cities area fire departments are working closely with each other, city managers, hospitals and the Benton Franklin Health District to determine how they can best collaborate, Michael said.

Already emergency responders may discuss options with people who are less seriously ill when first responders know hospital emergency departments are full or close to full and a long wait in the emergency department is likely, Michael said.

If hospitals continue to get busier there are other options that the community could consider for less seriously ill patients.

They include taking patients to clinics rather than hospitals or having a doctor assess a patient by phone or video as a first responder provides information to see if they need emergency care, Michael said.