CORONAVIRUS

As surge continues, UIHC considers further steps to meet COVID-19 demand

New cases may affect ability to perform 'essential' surgical procedures

Medical assistant Shannon Jensen (right) carries a swab for a coronavirus test taken from a patient to her colleague Kat
Medical assistant Shannon Jensen (right) carries a swab for a coronavirus test taken from a patient to her colleague Katrina Rogers, to be bagged and sealed at the Family Medicine Clinic of the University of Iowa Hospitals and Clinics in Iowa City in April. (Andy Abeyta/The Gazette)
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If Iowa continues on its trend of unprecedented growth in COVID-19 cases, the state’s largest hospital is preparing to reduce more scheduled procedures — even those that are considered essential — to alleviate the stress being felt by the health care system, an official said Monday.

Monday not only brought the largest single day increase of hospitalized patients with the novel coronavirus at the University of Iowa Hospitals and Clinics, but across the state.

Hospitalizations of COVID-19 patients have more than doubled since Nov. 1, reaching 1,392 total patients in Iowa, according to The Gazette analysis of Iowa Department of Public Health coronavirus data.

The state had 676 COVID-19 patients on Nov. 1.

Monday brought the largest single-day increase of hospitalized patients, with 113 admissions over a 24-hour period.

UIHC reported more than 90 inpatient admissions as of Monday afternoon — the highest COVID-19 patient count since the start of the pandemic — said chief medical officer Dr. Theresa Brennan.

On Nov. 10, UIHC reported 59 adults and three children among their COVID-19 inpatients.

“We are in a surge. That’s the easiest way to put it,” Brennan said during a Facebook Live event. “We have entered into the first phase of our surge plan and we have the next phase planned so that we will be able to respond as the need arises.”

UIHC has opened 10 additional ICU beds as a part of the hospital’s first phase of its surge plan, moving certain providers from other areas of the health care system to alleviate the staffing needs in critical care areas, Brennan said.

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UIHC, along with other hospitals across the state, have reduced the number of elective surgeries that would require an inpatient bed in an effort to conserve the bed count. Both Cedar Rapids hospitals, for example, announced this past week it would reduce these procedures until Nov. 20.

However, as the number of new cases continues to trend upward, Brennan said it is beginning to affect hospitals’ ability to do surgeries “that are even considered essential.”

“Many of us have decreased those that are elective that are in need of beds so we can conserve those for patients in need of a hospital bed, whether it’s for COVID-19 or not,” she said. “But gradually increasing that threshold means we won’t be doing surgeries we would have done in a timely way.

“That is on the horizon. Many of us have done that already and are considering being more aggressive about that.”

However, patients should have a conversation with their health care provider before deciding whether to delay routine care, she said.

Brennan noted it is important for Iowans to recognize the surge in cases presents a potential for more shutdowns across the state. Particularly as health care resources continue to be stressed, officials will have to take steps to reduce the risk of more people becoming infected with the novel coronavirus, and thus reduce the need for more hospital beds.

Iowa currently has the third-worst state in the nation in terms of number of cases per 100,000, falling behind both North and South Dakota, according to national databases, including those maintained by the New York Times and Washington Post.

Among those nearly 1,400 COVID-19 patients across the state, it also includes 271 patients in intensive-care units.

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During an emergency meeting among Johnson County officials and local health care leaders on Thursday evening, Mercy Iowa City’s chief medical officer Dr. Steve Scheckel reported that among the 17 hospitals surveyed in the southeast region, 15 lacked ICU capacity.

The number of COVID-19 patients on ventilators also increased to 123 total patients on Monday, which is tied to the rampant spread of the virus, according to Dr. Gregory Schmidt, UIHC director of critical care programs.

“Many infections leads to many hospitalizations, leads to many ICU admissions, leads to many ventilated patients,” he said to The Gazette. “And this will worsen dramatically in the next month in Iowa.”

He also noted COVID-19 patients often recover slowly — meaning they remain on a ventilator in a hospital’s ICU for an unusually long time. However, these patients’ outcomes aren’t abnormal from other patients with lung failure, and their potential for recovery isn’t dismissed.

“Of course, for very frail or elderly patients, the outcome from critical illness and mechanical ventilation, including COVID-19, may be poor,” he said.

“In appropriate patients, we consider the alternative of non-invasive therapies or treatments directed at comfort.”

Brennan urged Iowans to practice public health safety measures to prevent further spread of COVID-19, including wearing a mask, washing hands frequently and maintaining social distance.

She also emphasized the importance of limiting gatherings with those outside the household, including immediate family and friends, particularly as the Thanksgiving holiday draws closer.

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Though a COVID-19 vaccine may be on the horizon, Brennan said it is important for individuals to remember to not relax on these safety standards.

Comments: (319) 398-8469; michaela.ramm@thegazette.com

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