‘The numbers just keep jumping every single day’: Many Wisconsin hospitals fear breaking point is near

“All the hospitals locally are at capacity, and the numbers just keep jumping every single day,” said Jen Drayton, the chief nursing officer at HSHS Sacred Heart and St. Joseph’s Hospitals in Wisconsin.

Coronavirus hospitalizations have reached levels not previously seen in the pandemic. Hospitals in the Midwest, a region of the United States that was spared early on, are straining to keep up with the rapid rate at which patients are newly diagnosed. According to Wisconsin state health authorities, about 89% of all staffed hospital beds and 90% of ICU beds are occupied. The Mayo Clinic Health System, one of the world’s leading hospital systems, reported that 100% of its hospital beds are full in northwestern Wisconsin, with 50% of intensive care units being occupied by patients diagnosed with COVID-19.

HSHS Sacred Heart Hospital has hit capacity, Drayton told the Washington Examiner.

“The biggest problem is the numbers of colleagues that are contracting the illness from the community,” Drayton said. “I’ve been a nurse for 35 plus years and have never seen anything like this.”

More than 2,000 COVID-19 positive people are hospitalized in Wisconsin, an increase of more than 500% from the rate of hospitalizations in early September when the surge in the Midwest was first becoming apparent. The current rate of transmission in Wisconsin also indicates that increases in hospitalizations will continue. State health officials report that more than 16% of coronavirus tests in Wisconsin are coming back positive. As cases continue to climb, hospitalization rates will follow.

Many healthcare providers in Wisconsin thought they saw the worst of the pandemic in the spring, only to realize months later that the worst was yet to come. Dr. Jeff Pothof, an emergency room doctor and chief quality officer for UW Health in Madison, Wisconsin, said the hospitals were initially able to confine all COVID-19 patients in a special pathogen unit established as a precautionary measure to prevent the spread of Ebola in 2014.

“And then, that all started to change and change pretty rapidly, I’d say about three weeks ago,” Pothof said. “Within a matter of days, instead of using one wing of our COVID unit, we filled up all of them. We had three wings filled up. We quickly filled up that whole wing of our ICU level care.”

From there, they filled half of another ICU with coronavirus patients, which still was not enough. They then looked back at original plans to open a specialized unit for neurosurgery patients later in November.

“We saw the writing on the wall, and I think it was a week ago we opened that unit a month ahead of schedule, but not for neurosurgical patients. We opened that for COVID ICU patients,” Pothof said. “And even with that, we’re still having daily struggles with the managing of COVID ICU volume.”

The state recently erected a field hospital in Milwaukee on the state fairgrounds where hospitals can send patients who still need care but are not in critical condition. The facility can handle more than 500 patients, and 14 have already been transferred there since it opened last month.

New York City hospitals faced a similar threat in the spring when the first coronavirus surge threatened to overwhelm the city’s healthcare systems. The state government erected two overflow care facilities, the Javits Center in Manhattan and the USNS Comfort, a U.S. Navy hospital ship, to prepare for hospital overflow. The facilities were built to hold over a thousand patients, but only a fraction of the additional beds were used in the end.

The Javits Center, which could accommodate 1,900 staffed hospital beds, held slighly fewer than 1,100 patients. Likewise, by the time the Navy ship left New York City about a month after docking there, the approximately 1,200-person crew and 1,000-bed hospital had treated just 182 patients, of whom roughly 70% had COVID-19.

New York City was the first coronavirus epicenter on the East Coast. At the outbreak’s peak in early April, more than 1,800 patients were receiving care in a city hospital. It was not until mid-May that daily hospitalizations fell below 200. At that point, cases began ticking up in Sun Belt states. By July, Southern states had become virus epicenters. Texas, for example, recorded its peak hospitalizations in the third week of July with more than 10,800 hospitalized COVID-19 patients at once. The rate of new hospital admissions started to slow soon after that in late July, and hospitals were able to avoid the nightmare scenario in which care must be rationed and some patients turned away, which a Texas A&M public health professor credited to increased public awareness of the troubling surge and cooperation with social distancing guidelines.

“On the flip side, what we’re finding especially in Wisconsin, is that we’re having a very difficult time doing the mitigation strategies,” Pothof said. “We’re not masking or not social distancing, or we’re gathering, and we’re taking our mask off and having a good time.”

Gov. Tony Evers made a rare primetime public address this week to announce an executive order advising Wisconsinites to stay home but stopping short of imposing any new COVID-19 restrictions. The order, which carries no legal weight, does not include any penalties for noncompliance with the advisory, probably because Evers has faced numerous roadblocks in court from Republicans when he has tried to impose restrictions. Evers has, however, successfully issued a mask mandate.

Wisconsin hospitalizations have not shown signs of slowing down, Drayton said. In fact, conditions will probably worsen, given the high rate of transmission in the state.

“I think we haven’t seen the worst of it yet,” she cautioned. “It’s very concerning to me, as a longtime nurse and now a nursing leader of an organization, that we can’t convince people that this is real.”