LAWTON – With a rising infection rate in Oklahoma, Dr. Scott Michener, chief medical officer at Comanche County Memorial Hospital, knew the hospital was scarce for lifesaving equipment and at some point would run out.
Nov. 10 was nearing that breaking point as Michener saw CCMH had just one ventilator not being used.
As COVID-19 cases continue to climb and hospitals fill up with patients, Michener was preparing to make difficult decisions.
“We have an allocation protocol that I actually wrote it based on New York’s protocol, said Michener. “You take emotion out of the equation. You can’t be emotional.
“The way it’s written, if you have to decide, you take names and personal information off the table and have three physicians review the case. If you’re 90 and you’re going to die anyway, you’re not getting a ventilator. If you’re 30 and it’s likely you’re going to recover without a ventilator, you’re not getting a ventilator. That’s everyone’s logic. Try to close down both ends; those at the end of life and those that will probably get by without one.”
Statewide, hospitals like CCMH find themselves in similar situations after infection rates spiked to record highs this month. The influx of hospitalizations has created an environment with limited resources and staff.
“If we’re full and you need COVID care, you could be sent from here to Alva or here to Woodward or here to Enid,” Michener said. “That’s the governor’s plan of trying to even out the workforce, but once they all get full, then there’s nowhere to go.”
Michener said CCMH had four deaths in one day over the weekend. They were between the ages of 60-72.
“The problem is we went on emergency room divert (Monday), which means telling the ambulance ‘don’t come here’. However, Southwestern is on ER divert, too, so there’s nowhere for people to go,” Michener said. “Obviously, we would not turn someone away. We have 34 ER rooms and we had 20 of them taken up with patients. Fourteen of them are critical care patients. Our ER is down to 10 rooms. That makes it extremely difficult to provide good care. On the trajectory we’re on, it’s a bad trajectory. If we don’t do something to change the course, I don’t think it’s going to be well.”
Michener said nurses and doctors are doing everything they can to provide the type of care patients need. Yet, the numbers are unrelenting and staffs who were already stretched thin are being pushed even further.
“Healthcare providers are being infected as well with COVID or they’re being quarantined because they have a family member that has a direct contact,” said Brandie Combs, the District 5 Regional Director for the Oklahoma Health Department. “So you may have more hospital beds available in a particular hospital, but if you don’t have the nurses to work those beds, then you can’t allow an admission of a patient.”
According to Combs, the strain the healthcare workers have been under as the COVID-19 threat continues to grow is immense.
“Our public health workforce, the nurses that are doing all of the testing and the case investigations and trying to track people down to let them know that they have tested positive and working with the schools,” Combs said. “Some of our nurses haven't had a day off in months and they are fatigued.
“The whole system, our healthcare system, our public health system is stretched and it’s just about at capacity as far as workforce, as far as being able to handle the demand.”
With the holiday season approaching, Michener fears those numbers will skyrocket and the healthcare system won’t be able to handle the influx of cases.
“We have limited ventilators; we have limited nurses,” Michener said. But “there’s going to be a point there where we can’t. It’s not that we’re going to not want to, it’s that we can’t.”
He is asking residents to wear masks and socially distance if they haven’t been doing so and says there is still time to turn things around, but it’s up to the public to make it happen.
“We need a month or six weeks to try to get our numbers down because the trajectory we’re on is not good,” said Michener.