Hospital officials around the state are watching Indiana’s COVID-19 numbers – and not liking what they’re seeing.
As of Tuesday, COVID hospitalizations in Indiana had crossed the 1,500 line for the first time since early February with no sign of a decrease in the future. That’s only slightly under half of the peak 3,441 hospitalizations that Indiana saw last winter.
More than 470 people are hospitalized in Central Indiana, about the same number as early November and early February. At the beginning of July, fewer than half that number were in the hospital for COVID treatment.
Space in intensive care units is growing uncomfortably thin for both COVID and non-COVID patients. About 24% of Marion County ICU beds are available, compared with about 28% statewide, according to the state dashboard.
Tuesday also saw the seven-day average for new COVID cases exceed 2,500. Less than two months ago, that number fell below 200.
The steep rise in patients here — just two weeks ago fewer than 1,000 people were hospitalized for COVID care in Indiana — combined with what other nearby states are experiencing prompted the Indiana Hospital Association to issue a warning and urge those who are unvaccinated to do so immediately to stave off an even greater surge.
“We’re still very much on the upswing and we just felt like this was a time to just remind people about how effective the vaccination is at reducing your chances of being hospitalized,” said Brian Tabor, the association’s president. “When we look at the strain that is on the system right now on some of states that are not too far away, like Alabama, we just felt like getting a message out so we don’t end up there is really important.”
Over the past few weeks, hospital leaders across the state have grown increasingly concerned, Tabor said. Some have started talking about whether they will need to postpone less urgent procedures.
Meanwhile, they’re watching with trepidation as the virus rampages through other states; Alabama Tuesday had more intensive care patients in its hospitals than it did staffed beds. The fear is that if COVID cases increase, hospitals will struggle to care not just for patients with the virus but also those with other conditions.
“Really what we want to do is make sure that’s enough beds for hospital care for everyone who needs it,” Tabor said.
Public health officials and hospital leaders say the one way to stave off overcrowded hospitals both in the immediate and long term is to increase vaccination, which offers protection against developing a severe COVID case.
In Indiana 51.5% of the eligible population has been vaccinated against COVID. As the highly transmissible delta variant has become dominant in the state, this percentage has not proven sufficient to prevent cases from rising again.
Community Health Network has 105 COVID patients
Community Health Network has seen its COVID patient numbers multiple about five times in recent weeks, said Dr. Robin Ledyard, chief medical officer.
Late last week, she had hoped the numbers would level off. Tuesday the hospital system admitted 16 new COVID patients, bringing the total to 105.
“It seems all of a sudden we are starting to escalate again,” she said. “We are managing day to day but we are also running at capacity.”
In some instances, non-urgent surgeries have been delayed.
IU Health and Franciscan see rising cases
Other Central Indiana hospitals are also seeing higher numbers of COVID patients. IU Health’s three Downtown hospitals had 73 COVID patients as of Monday, four of whom were pediatric patients at Riley Hospital for Children.
Franciscan Health has more than tripled its inpatient COVID volume, said hospital spokesman Joe Stuteville. About a month ago, the hospital was in the low single digits for COVID patients. Now the number is in the mid-30s.
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Many of the patients being treated are younger than 50 years old with severe disease and many, though not all, are unvaccinated.
Of the 766 people admitted to an Indiana hospital in the first week of August, 758 were unvaccinated, according to the Indiana Hospital Association. Of these, the 137 who required intensive care were all unvaccinated.
Smaller hospitals also feel crunch
Johnson Memorial Health in Franklin last week reached a total of 11 patients hospitalized with COVID, more than the facility had seen since vaccine became available. At the height of the pandemic, the hospital cared for 19 COVID patients at one time. Earlier this week, that number had fallen to eight patients — with one on a ventilator, said Dr. David Dunkle, president and CEO.
That’s out of a total of about 40 medical-surgical and intensive care units, Dunkle said. And, the hospital is not just treating COVID patients. Johnson is also caring for an unusually large volume of non-COVID patients, some of whom may have delayed getting care earlier in the pandemic, Dunkle said.
“If a quarter of our beds are taken up with COVID patients, that’s big. That’s a big number and that’s where the struggle is,” Dunkle said. “Our census is never this high in August.”
Staff shortage hurts hospitals
Compounding the high numbers of patients has been a staffing crunch, felt at hospitals across the nation. It’s not just nurses in short supply, Dunkle said, but also laboratory and ultrasound technicians, environmental services people, and others, who have been working without breaks.
Most of the time that Johnson Memorial has gone on diversion it has been for lack of staff rather than lack of space, Dunkle said.
In addition to having staffing issues, Major Hospital in Shelbyville has also been having some challenges securing supplies such as masks and other personal protective equipment, said Jack Horner, its president and CEO, as it, too, has weathered a rise in COVID patients. More than 20% — or eight out of 31 — of its patients are COVID positive, compared with none to 2 just a month ago.
And Horner said, hospital staff is even more worried about what will come as the outpatient offices and emergency clinics have seen a significant increase in cases, not that different from what they saw late last fall.
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“We’re not quite fully there yet but we’re getting close to that,” Horner said. “We’re very concerned about what’s going to happen over the next four to six weeks.”
At times in recent weeks, hospital staff have struggled to find a tertiary care hospital in the region that would accept a patient in need of more advanced treatment, Horner said, as these hospitals have been going on diversion more often.
Hospital officials also fear what the next weeks will bring not just in terms of COVID but other respiratory diseases. Last year masking and social distancing behavior tamped down the annual flu numbers. But as people are congregating more this year, often without masks, hospitals are bracing for what this year flu season could bring.
Johnson Memorial physicians have already diagnosed flu cases in their outpatient practices, Dunkle said. He can’t recall any at this time last year.
Preparing for a two-pronged surge of patients, Johnson Memorial recently converted some office space into overflow rooms and has been trying to hire nurses to staff those beds, Dunkle said.
“They’re contingency beds right now,” he said. “We had to be ready because we have no indication that things aren’t going to get worse.”
Some sick patients don’t regret skipping vaccination
Unlike during the previous two surges, health care workers can now be vaccinated against the virus, providing some protection. But the arrival of the vaccine has also brought unforeseen downsides.
Many of those who have fallen ill have opted against vaccination, may question whether the virus and the pandemic is real, and doubt the information hospitals and health care professionals are providing.
“When you’re in the ICU, there’s a lot of remorse but I am also surprised by the number of people who are in the hospital who don’t have remorse,” Dunkle said. “I’m really just astounded by how many people out there are digging their heels into the ground and not relying on facts… That’s a slap in the face to health care providers.”
To sign up to be vaccinated, visit ourshot.in.gov or call 211. While appointments are encouraged, most vaccine sites also offer shots on a walk-in basis.