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September 23, 2023

Inside a Seattle-area hospital, the Covid grind wears on staff

Inside a Seattle-area hospital, the Covid grind wears on staff

Responding to the surge, Washington Gov. Jay Inslee on Thursday ordered 100 National Guard members to deploy at hospital emergency departments and to run Covid testing sites, including one at Harborview Medical Center.  

Inslee also paused nonemergency procedures, like some surgeries, for a month throughout the state and encouraged retired health care workers to volunteer to help respond to the growing crisis. 

Harborview Medical Center is one of four hospitals in Seattle operated by UW Medicine, a university-affiliated medical system. Across its four campuses, the system counted 194 patients that were Covid-positive Thursday, which is 70 more than the previous high during the peak of the delta wave.  

Harborview, a Level I trauma hospital that typically operates at full capacity, was now stretched well beyond it. 

“This is a 413-bed hospital that has over 500 patients,” Lynch said.

The UW Medicine hospital system had begun to convert nonclinical spaces to accommodate the swell of Covid patients, adding beds in conference rooms, hallways and surgery clinics.

Some hospital workers were out sick, complicating matters further. 

Across the UW Medicine workforce, which numbers some 29,000 workers, about 600 were unable to work because they were isolating or quarantining because of omicron, Lynch said. 

Hospital staffing across Washington was concerning enough that he thought some facilities might soon ask staffers not to isolate after a Covid infection, but return to work as soon as they felt better.

Lynch was concerned patient care would begin to falter throughout the state. 

“I am worried that we’d go to crisis standards of care,” he said of Washington hospitals. 

Crisis standards are when hospitals are so overwhelmed they cannot provide the typical level of treatment, and organizations are left to triage resources and decide who will receive treatment and who will be left to suffer or even die. 

“The scarcest resources are staffed beds,” Lynch said. “The hands of a physician and a nurse and a therapist available for a patient who needs care in the hospital in a bed — that’s my biggest concern.”

So far, patients at Harborview Medical Center with Covid were faring better than during previous Covid waves. 

“We’re seeing less people with ICU Covid,” Lynch said. Patients often needed oxygen supplementation, but few required intubation or other drastic lifesaving measures. 

“Overwhelmingly, the patients are in acute care, and it’s a mix of people coming in with things like Covid-associated pneumonia and other respiratory problems,” Lynch said. 

About 40 percent of patients were asymptomatic for Covid and had been admitted to the hospital for something else, Lynch said. 

“Most of our patients with asymptomatic Covid are vaccinated folks,” Lynch said. “A lot of the folks that we see with symptomatic Covid, and certainly folks in critical care, are folks who are unvaccinated.” 

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