'It's critical.' COVID-19 is filling Wake hospitals and emergency departments

Aug. 25—RALEIGH — The explosion of coronavirus cases in recent weeks has helped fill hospitals in North Carolina's largest county to capacity, and hospital leaders are imploring residents to not only get vaccinated against the coronavirus but also avoid going to emergency rooms unless it's necessary.

The situation has grown critical, according to top doctors at WakeMed, Duke Raleigh Hospital, UNC Rex Healthcare and Wake County Emergency Medical Services. They held a joint press conference Wednesday to ask the public's understanding and help.

In particular, they said with hospital beds full, patients are getting backed up in emergency departments that are crowded with people seeking care for COVID-19 and other ailments. The lobbies at the emergency department at Duke Raleigh Hospital are full, said Dr. Timothy Plonk, the department's medical director.

"Our wait times are higher than they've ever been at Duke Raleigh. I'm sure other hospitals can agree to that as well," Plonk said. "And it's creating a great deal of stress and frustration. I think a lot of people are waiting in our lobby and other lobbies in our country longer than they ever thought they would have to wait for health care in this country."

Plonk and the other doctors urged people to consider alternatives to the emergency room, such as primary care physicians, urgent care centers or minute clinics. They said emergency departments prioritize the most critically sick or injured patients, and those with more routine problems are likely to wait many hours.

"When you're seeking care, and we know you will, if you can avoid the emergency department, it's a good thing to do that," said Dr. Seth Brody, the chief physician executive at WakeMed Health and Hospitals.

The number of people hospitalized with COVID-19 in North Carolina has still not reached its previous peak of just under 4,000 in mid January. As of Wednesday, 3,503 people were hospitalized with with disease statewide, according to the state Department of Health and Human Services, including 856 who were sick enough to require intensive care.

But hospitals say that unlike last winter, the summer surge in COVID-19 came at a time when they were already busy with patients with other ailments and injuries, including chronic problems such as diabetes and heart disease that had gone untreated during the worst of the pandemic.

"It's the effects of an 18-month pandemic that we're seeing," Plonk said. "It's folks that have chronic conditions who haven't been able to care for themselves as well as they might have otherwise. We're seeing folks who've lost their job, who've lost their insurance, who've had changes in their family situation, who maybe have lost folks in their family who might have been primary caregivers or had changes to their primary care. All of these things have created gaps in people's resources that would otherwise keep them healthy."

As a result, Brody said, WakeMed and other hospitals are seeing sicker patients who remain in the hospital longer. He said WakeMed has added spaces to its emergency departments to hold patients while they wait for beds to open up in the hospital, but they just fill up.

"As the hospital's full and you have long lengths of stay and you can't discharge folks, that backs up the whole pipeline," Brody said. "So it's hard to get people admitted. Even to get people seen and treated and released is hard. So those wait times are long."

Rex hospital exceeds capacity

Someone coming to the emergency department at UNC Rex hospital may wait as long as a full day to be seen, said Linda Butler, the chief medical officer. Butler said Rex, with 439 inpatient beds, had 520 patients in the hospital on Wednesday, in part because so many were housed in the emergency department and other temporary areas.

"There are several days during the week when our largest inpatient unit is actually our emergency department," Butler said.

She said the situation has gotten to the point that emergency medical services crews have had to wait for up to two hours for a space to open up for a patient.

"EMS has never had to wait in our ED before," she said. "That just speaks to the volume challenges that we have."

As with hospital emergency rooms, Wake County EMS is seeing unprecedented demand for its services, said Dr. Jose Cabañas, the chief medical officer. Some increase in demand is expected as the population grows, Cabañas said, but this summer's spike has been unusual.

Cabañas said Wake EMS is answering 355 calls a day on average this summer and some days more than 400, compared to an average of 330 a day before the pandemic. The agency had never answered more than 10,000 calls in a month until recently and is on pace to top 11,000 in August, he said.

"We triage calls to make sure that life-threatening emergency conditions are getting the resources rapidly when they need it," he said. "If you need us, we will be there, but the system is stressed."

The doctors at Wednesday's press conference also kept coming back to the need for people to get vaccinated against COVID-19. They said the surge in COVID-19 patients remains largely among the unvaccinated, who account for more than 90% of patients hospitalized with the disease.

As of Wednesday, 57% of North Carolina residents 12 and older have received the vaccine, meaning hundreds of thousands who qualify have still not gotten it.

"Please get vaccinated so you do not end up a patient in one of our hospitals," Butler said. "We don't want your business; we want you to be healthy."

___

(c)2021 The News & Observer (Raleigh, N.C.)

Visit The News & Observer (Raleigh, N.C.) at www.newsobserver.com

Distributed by Tribune Content Agency, LLC.