Yves here. This piece describes is what is coming to pretty much everywhere in the US soon. Hospitals and medical providers are effectively rationing care in Colorado, which is merely in the midst of s Delta wave. It is also sadly presenting vaccines as the only defense against Covid, and ignoring wearing protective masks (N95/KN95), limiting interactions, and ventilation.
By John Daley, Colorado Public Radio. Originally published at Kaiser Health News
Harold Burch’s home has a spectacular view in Paonia, a rural part of Colorado’s Western Slope at the foot of Mount Lamborn. But the landscape has been little consolation to the 60-year-old as he has battled a cascade of health problems during the pandemic.
“It’s been a real rodeo,” Burch said. “It’s been a lot of ups and downs and lately it’s been mostly just downers.”
Burch has battled chronic osteoarthritis and rheumatoid arthritis and has had two major intestinal surgeries. One specialist he was seeing left her practice last year. Another wouldn’t accept his insurance. Then, Nov. 1, he started experiencing major stomach pain.
“When we talk terrible problems, I can’t leave the house,” he said. He hasn’t eaten anything substantial in three weeks, he added.
Burch had to wait that long to be seen by a primary care doctor. He said the doctor told him, “‘If things were different, I would tell you to go to the hospital and be diagnosed, have some tests run and see what’s going on with you.’ But he says, ‘As of today, Delta County hospital is clear full. There are no beds available.’”
The covid variant delta has overwhelmed the Colorado county of the same name. Hospitals on the Western Slope have been slammed for weeks, and the statewide picture is similarly grim. As of Monday, the state’s coronavirus website reported 1,294 patients hospitalized with covid-19. Half of the state’s hospitals said they anticipated a staffing shortage in mid-December; more than a third of them anticipated bed shortages in their intensive care units at the same time.
And behind those numbers, patients are feeling the impact.
Burch’s doctor told him he might have to wait hours in the emergency room, perhaps with people who have flu or covid symptoms. So Burch stayed home.
“It’s really frustrating because I did the right thing and like so many other people have, and we’re being just kind of like told, ‘Unless you have a really serious problem, like a heart attack, a stroke, you’re going to have a baby or something like that, we really don’t have time to mess with you,’” Burch said. “I mean, it’s just wrong.”
Burch’s situation is not uncommon this fall, as the state faces its second-worst covid surge for hospitalizations and deaths. Hospitals are under tremendous strain and that means delays and changes from normal care, as strapped providers do more with less.
“Hospitals across Colorado are in critical condition. We have been at 90%-plus capacity in our ICU and acute care beds for weeks now. And unfortunately, there doesn’t appear to be an end to that situation in the near future,” said Cara Welch, a spokesperson for the Colorado Hospital Association.
Diann Cullen, 72, a retiree in Broomfield, Colorado, was told by her doctor that her hernia surgery would have to be postponed for weeks. Her reaction: “Frustration, extreme frustration, actually anger, because I said a bad word. … He flat-out told me we can’t even do it because of too many covid patients.”
The combination of too many covid patients, the need to treat those who delayed care and staff shortages have pushed hospitals into crisis, said Robin Wittenstein, CEO of Denver Health, which runs one of the state’s biggest hospital and clinic systems.
“They’re coming into hospitals now sicker than ever before. And they’re coming in larger numbers than we’ve ever seen before,” Wittenstein said on the day when most metro-area counties announced they were enacting a new indoor, public mask mandate. “Our system is on the brink of collapse.”
At the academic medical center UCHealth, Dr. Abbey Lara said the crush of unvaccinated patients in the ICU means patients face longer waits or they don’t get much-needed diagnostic tests. In the worst-case scenario, “patients who could have survived something had their life cut short because they weren’t able to access care,” she said.
And when there are too many patients being treated by too few staffers, Lara said, that ratchets up the difficulty for providers.
“I just worry that there’s going to be not only a lot of turnover in the near future,” Lara said. “But I think that access to health care is just going to get even worse in the future.”
Lara predicted the effects of the pandemic will be felt long after the emergency ends: “The sky isn’t falling, but the sky is going to turn a very different color.”
In Longmont, Colorado, about 50 miles north of Denver, nearly a third of Longmont United Hospital’s registered nurses have left since the start of July and many have not been replaced, said Kris Kloster, who has been a nurse for 32 years. She is backing an effort by nurses to unionize there.
The stress nurses and doctors feel is compounded when they feel powerless to take what they regard as an ethically correct action in treating a patient.
There’s a term for that, “moral distress,” said Dr. Barbara Statland, a hospitalist at Denver Health. The tension comes “because you can’t do what you feel is ethically proper. And I’d say that health care workers have been riddled with this.”
Despite the stress and distress, many front-line providers are hanging in there, continuing to care for patients every day. That made the difference for at least one covid patient who said he was appreciative he was able to get care — just in time.
“They saved my life. I do feel grateful for everything they did,” said 58-year-old Rob Blessin, of Fort Collins.
He caught the virus this fall and spent 30 days in an ICU ward with pneumonia at North Colorado Medical Center in Greeley. He described the efforts of his doctors and nurses as heroic, some working nine or 10 days in a row, many taking overtime. And others, Blessin said, were filling in.
“So often you’d have people from different departments being trained on the fly,” Blessin said. “So there’s a lot of pressure on people. They’re just trying to get warm bodies in there.”
Respiratory therapists are in short supply in hospitals, and Blessin said as more coronavirus patients were admitted, the staff struggled to keep up.
Blessin said he landed in the hospital because he was swayed by internet misinformation and didn’t get vaccinated. It’s a decision he came to regret.
“I guess my recommendation would be to get vaxed, you know, even if you’re totally against it; don’t fall into the internet hype,” Blessin said.
After his experience being hospitalized for a month due to the coronavirus, and having talked with his physicians there, he now plans to get vaccinated.