Current COVID-19 surge causing worst delays of pandemic, Iowa hospital leaders say

IOWA CITY — The dire situation at the University of Iowa Hospitals and Clinics is the worst it has ever been throughout the COVID-19 pandemic, with infected patient counts at an all-time high while more staff are out sick than before, the health care system’s leader said Thursday.

The system — along with other hospitals across the state — are straining under the load, meaning patients are facing even longer wait times for their medical care than ever before.

“People are still getting their emergency needs met, they are still getting the treatment that they need, but it’s not the same as it was before,” UIHC Chief Executive Officer Suresh Gunasekaran told reporters. “There are more delays today for the average Iowan than there were at any other time during the pandemic.”

This week, the Iowa Department of Public Health reported the highest coronavirus hospitalization rate seen statewide in this current surge, with 923 patients hospitalized for COVID-19 as of Wednesday. It’s the highest total admissions for the virus seen in Iowa since December 2020, according to state data.

As of Wednesday, the state reported that almost 73 percent of COVID-19 patients being cared for in Iowa hospitals had not been fully vaccinated.

‘System is under stress’

New infections across the state have reached near-record levels this week, driven by the highly transmissible omicron variant. Federal health officials reported it had become the predominant coronavirus strain in Iowa last month.

As a result, UIHC providers are seeing a rising number of infected patients both in outpatient and inpatient settings that is “causing health care to be modified and delayed as we have to shift our operations to take care of COVID-19 patients,” Gunasekaran said.

Some research has indicated an infection with omicron is less likely to cause severe disease, reducing the risk of hospitalization and mortality. However, the variant is much more contagious than other strains — meaning that even if it causes more mild illness, a continued increase in hospitalization in the coming weeks is expected, local health care leaders says.

“As more and more resources flow to into taking care of COVID-19 patients, it restricts the number of resources that we have to do other care,” Gunasekaran said. “So what we see is that the entire health care system is under stress.”

That’s on top of an increase in individuals with other chronic medical conditions seeking care in recent months. Some doctors have said it's a result of individuals delaying their health care in the early months of the pandemic.

The high level of infection has also resulted in significant workforce shortages at UIHC. Gunasekaran said hospital officials have never seen so many staff call in sick or stay home to care for others, a challenge that is exacerbating current delays in care.

The strain on health care system also comes as the nation faces a shortage in COVID-19 treatment options, including monoclonal antibody therapies and an oral antiviral pill that are effective in reducing severity of illness in infected patients.

UIHC and other health care systems are currently prioritizing treatments for the highest risk patients, such as those of advanced age or those who have medical conditions that put them at risk for severe disease.

Testing demands surge

As the novel coronavirus spreads rapidly throughout the community, demand for COVID-19 testing is at an all-time high.

“We have never seen this kind of demand for COVID testing during the entire pandemic,” Gunasekaran said.

It’s difficult for health care providers to keep up with the demand, he said. In recent weeks, it has taken multiple days for some individuals to access UIHC’s same-day test program because of that demand. UIHC officials are taking steps to adjust staff to help address the influx of phone calls the system is receiving from individuals seeking out testing, Gunasekaran said.

State public health officials have reported similar high demand for the state’s free coronavirus testing program, Test Iowa, which has slowed down the State Hygienic Lab’s turnaround on results. The spike in demand “could affect Test Iowa kit availability for brief periods of time” in the coming days and weeks, state public health department spokeswoman Sarah Ekstrand said this week.

These tests don’t account for the number of individuals testing positive through rapid tests and other at-home testing kits, which are not reported in state coronavirus databases. Given the high level of infection reported — currently about 20 percent positivity rate in Iowa — the number of infections is likely higher.

Health care experts have previously stated the current surge will likely peak in Iowa sometime in late January or early February.

The head of the state’s largest hospital said if Iowans can recommit to mitigation strategies — such as diligent mask wearing and avoiding gatherings — for the next three to four weeks, the surge won’t last as long and won’t have as high a peak.

If they don’t, health care systems will continue to be strained.

“Our actions as a community end up disadvantaging the health care needs of everyone,” Gunasekaran said. “The choices that we're making as individuals are having repercussions not just on people that are seeking COVID-19 care, but on all of us.”

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