CORONAVIRUS

University of Iowa Hospitals and Clinics urges families to skip traditional holiday gatherings to spare state's hospital system from COVID-19 surge

'What we're entering is the danger zone'

Medical assistant Alex Abodeely holds a swab taken from a patient for a coronavirus test as she places it in a container
Medical assistant Alex Abodeely holds a swab taken from a patient for a coronavirus test as she places it in a container toe be transported for analysis at the University of Iowa Hospitals and Clinics Family Medicine Clinic in Iowa City on Monday, April 20, 2020. (Andy Abeyta/The Gazette)

IOWA CITY — On a day when Iowa reported its eighth straight record high of COVID-19 hospitalizations, the top executive of the University of Iowa Hospitals and Clinics urged Iowans to accept this as the year they forgo the traditional Thanksgiving and Christmas gatherings.

“This may be the year that, on top of everything else, 2020 took away our ability for families to get together in the manner that they did before for Thanksgiving and Christmas,” Chief Executive Officer Suresh Gunasekaran told reporters. “I think that these are the kinds of choices that Iowans are going to have to make.”

If they don’t, he said, hospitals across the state — including UIHC — might be forced to take extreme measures, like postponing routine and preventive appointments and scheduled surgeries, echoing steps taken in the spring that exacerbated patient illnesses and deprived health care facilities of tens of millions of income.

Hospitals also might again be forced to further curtail visitors — leaving patients alone during scary procedures in unfamiliar surroundings.

Late last week, in a statement to The Gazette, a spokesman for Gov. Kim Reynolds asserted that the percentage of COVID-19 patients in Iowa hospitals still is low, and that “new therapeutics such as Remdesivir and other treatments have helped reduce the severity of illness and shorten hospital stays for many patients.”

However, the 845-bed UIHC — regularly near capacity even without COVID-19 — could see its ability to accept transfer patients from other, smaller facilities in Iowa delayed or restricted. Gunasekaran said that already has happened sometimes — although for less-serious patients with other options.

“We have had to reject some transfers throughout this pandemic, and even recently,” he said. “But really what we’re entering is the danger zone. Because if it continues like this, it’ll be hard for us to continue to operate without modifying operations and without adding capacity, and then doing some of those restrictions.”

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From Saturday to Monday, Iowa added 7,122 new COVID-19 cases and 28 more deaths. Its continually-climbing hospitalized patient tally of 718 as of Monday morning is up 33 percent over eight days.

UIHC on Monday reported it was caring for 31 adult COVID-19 patients, up from 22 on Friday. It totaled 421 telehealth screenings for “influenza-like illnesses,” which was the highest in at least two weeks and up from 233 a week earlier.

As the state’s largest health care system and only academic medical center — on the front lines of coronavirus treatment and vaccine trials — UIHC has been preparing a surge plan.

“Absolutely right now at the top of my list, what my team is working on, is creating additional surge capacity for (intensive care unit) beds,” Gunasekaran said. “Those are the beds that most hospitals typically rely on the UIHC to provide.”

Administrators over the weekend pored over options, he said, including using its 190-bed Stead Family Children’s Hospital to take overflow non-virus adult patients.

“We considered it,” he said, but added, “There are a lot of reasons why that’s not option one and more like option four.”

For starters, he said, the hospital is tailored for pediatric patients.

“We did spend some time this weekend working through the scenarios of what it would take to convert Children’s or portions of Children’s into an adult area if we needed to,” he said. “But right now that’s not an option that we’re presently pursuing. But it’s certainly on the table. “

Thanks to UIHC’s expansive clinics infrastructure, Gunasekaran said, he doesn’t anticipate needing to set up tents and temporary treatment structures — like New York and now Wisconsin have done.

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And he’s not worried about personal protective equipment, ventilator supplies or even the budget — although that could take another hit if surgeries are scrapped and other care is delayed. What Gunasekaran worries about is staffing resources.

“Our bigger issue is going to be quality staff that are available, that are comfortable, delivering this care at the standard and level that folks expect the UIHC to be able to do,” he said.

Calling the recent surge in cases a seemingly third spike for Iowa, Gunasekaran said it’s different from the others for several reasons — including that it’s arriving at the start of cold and flu season, when winter weather is about to force many indoors and as the holidays arrive.

“This holiday season will likely have to be different,” he said. “I think it’s time for us to get prepared. I think it’s time for us to make some changes. I really think this is a question of personal responsibility and accountability and caring for one another.”

Many across the state and nation — fatigued by lockdowns and restrictions and yearning for a return to normalcy — have wrongly surmised, with news of vaccines on the horizon, the worst is over, Gunasekaran said.

“What the virus and the pandemic are showing us is we haven’t quite made it yet,” he said. “I think if we could get through this Christmas season, we might well have made it.”

But, he said, the notion that therapeutics and treatments are much better today so that individuals can stop worrying is a flawed take.

“There is not a miracle treatment or therapy for COVID. The mortality rate has stayed almost the same throughout the pandemic,” he said.

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The health care system has developed an orderly way to take care of COVID-19 patients, with standard protocols and standard therapies.

“But I certainly wouldn’t say it’s OK to get the virus because the therapeutics can make it go away,” Gunasekaran said. “We still don’t know the long-term effects of coronavirus and the treatments that we’re using. … I still think the best plan for Iowans is to go ahead and not get the virus.”

Comments: (319) 339-3158; vanessa.miller@thegazette.com

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