MOUNT VERNON – Every day, Knox County residents see numbers describing the toll of the COVID-19 pandemic.
Cases, hospitalizations, deaths. Lately, those numbers have been increasing at alarming rates.
But numbers have limitations – while they may effectively portray quantitative trends, they often fail to represent the true, human toll of the pandemic.
On Thursday, during Gov. Mike DeWine’s weekly coronavirus press briefing, Knox Community Hospital CEO Bruce White described that toll for a statewide audience.
“I don’t work on the front line, but I have the privilege of working with people who do,” said White, calling in virtually from his Mount Vernon office. “This morning I was talking to one of my nurse leaders in our intensive care area. She told me a couple quick stories that I’d like to share.”
The first was positive, about a local man in his early 70s who was hospitalized with COVID-19 and survived. He was able to go home to his wife, and is now heading towards a full recovery.
“He was one of the lucky ones,” White said.
The second story was quite different.
A man in his mid-60s came into KCH recently, White said, and quickly began exhibiting severe symptoms. Over the course of a week, the man’s condition progressively worsened. He eventually was placed on a ventilator.
“The nurse explained to me that she was in that room, sitting with that patient, in her PPE, as he passed,” White said, pausing to collect himself.
“This is what our nurses do. A gentleman who had no family, alone in a hospital room, and here’s the nurse, taking care of him for his last moments on earth.”
This is reality right now for nurses at Knox Community Hospital, as coronavirus numbers continue to rise. Knox County has seen 464 confirmed cases in the last two weeks – roughly 42 percent of the county’s eight-month pandemic caseload – and 729 in the last month (67 percent).
Twelve Knox County residents have died from COVID-19 complications in the last month, according to Knox Public Health. All were ages 68-92. Hospitalizations have also risen in recent weeks, with KCH treating 16 coronavirus patients as of Friday morning.
White told DeWine on Thursday that KCH is becoming increasingly concerned with the number of COVID-19 patients it’s receiving.
“We are seeing an influx here,” White said. “You know, early on in this experience, the urban centers were hit. It’s now moved into the rural areas – and in fact, rural hospitals like ours are seeing it more and more.”
KCH is a 99-bed hospital, with a 12-bed Intensive Care Unit and a 19-bed Progressive Care Unit. Two months ago, White said, just five percent of Knox Community Hospital’s patients were COVID-positive. Recently, that number has risen to 30 percent.
“That has moved extremely quickly,” White said.
Additionally, White said half of Knox Community Hospital’s ICU is now occupied by COVID-19 patients. Two months ago, it had none.
“We’re flirting every day with the maximum number of intensive care beds we have and the number of progressive care/monitor-assist beds that we have,” White said.
Even the hospital’s standard-care section, containing roughly 65 beds, is nearing capacity.
“We’re bumping up against that every day,” he said.
If the current COVID-19 surge continues at this pace, White worries it could overwhelm the local healthcare system. KCH, Knox County’s only hospital, could run out of resources (beds, equipment, staffing) to care for patients. It could force the hospital to reduce or eliminate standard procedures in order to preserve resources.
“It impacts all patients, not just the COVID-positive …” White said. “As we see an influx of COVID patients and that intensity and acuity-of-care need going up, we pull from other areas.
“What that means is that those really important healthcare concerns that are going on every day in every one of our communities – high blood pressure, COPD, congestive heart failure, diabetes, chronic conditions that impact people – we don’t have the staff, we don’t have the services to be able to continue to focus on them the way they should be focused on, because we’re focused on the surge that we’re seeing.”
This influx of COVID-19 cases could ultimately suffocate Ohio's healthcare system, White added. Hospitals like KCH depend on nearby partners (referred to as “lateral transfers”) to take care of patients when it nears capacity. If every hospital is full, those transfer options will run dry.
“We rely on being able to transfer laterally, to our colleague hospitals in the area, and then on to the academic medical centers and tertiary facilities. When those facilities get full – and they’re getting there, some already are – the ability to transfer is not there,” White said.
“And so we have to buckle down as a state, because over the entire state, it’s a system. We’re all partners in this, and we have to be able to rely on each other.”
White and Knox Community Hospital aren’t alone in these concerns. Hospitals across the state are facing similar realities, as the latest COVID-19 surge has seemingly reached every corner of Ohio, with 72 of its 88 counties deemed “red” in the Public Health Advisory System this week.
There were 3,829 Ohioans hospitalized with COVID-19 on Thursday – a new state record.
Cheryl Herbert, the senior vice president of regional operations at OhioHealth in Mansfield, described the current surge as a “tsunami.”
“The forecasters have told us that it’s coming, and we’re feeling the early wave,” she told DeWine Thursday. “If you knew that a storm surge of epic proportions was headed in your direction, you would evacuate. You would leave the area, you would run away. Healthcare workers cannot evacuate.”
Erin Russo, the director of clinical education at Memorial Health in Marysville, shared similar thoughts.
“We’re seeing our highest volumes to-date for COVID patients, coming through our ER and then requiring in-patient admissions … It’s reflective of the data that you speak to,” Russo said. “And I think the unfortunate piece is, to kind of compound the issue, we’re also in our high-tide period in the Midwest, where hospital census is typically high and is expected to be high without the effects of COVID, without that population also marching into the buildings.”
Herbert, Russo and White all described in heartbreaking detail the exhaustion of their staff. Nurses, doctors and healthcare workers have served on the front lines of the pandemic since it began in March. According to White, this prolonged stress is beginning to take a physical and mental toll.
“Earlier in the experience, we were worried about PPE and supplies. That’s not the issue now, it is manpower. It is the skilled resources,” he said.
“People are tired, just as they said. I have the privilege of working with some amazingly dedicated people, but they can only do so much. Every day, they do miracles. But they can’t perform magic. They’re tired, and they’re doing a great job, but they do need the support of our state. They need folks to do the right thing, so that we don’t overwhelm our hospital resources.”
White concluded Thursday with a plea for resilience. As the U.S. comes closer and closer to producing a viable vaccine, White said there is now a light at the end of the tunnel. He compared this phase of the pandemic to the moment before the fourth quarter of any high school football game, where players will hold up four fingers to signal the final push.
“What were they indicating to each other? They were indicating to their teammates that this is the fourth quarter,” White said. “This is when it’s the most important. This is when you may be tired or hurting, but this is when you buckle down. Because this is when it’s the most significant.”
At this point, White said, following the gameplan – wearing masks, practicing social distancing, and avoiding large gatherings – will be crucial to saving lives and keeping the healthcare system from becoming overwhelmed.
“I feel like in Ohio, we should all be going around with four fingers held up in the air, saying ‘We’re in the fourth quarter,’” White said. “Let’s hang on for the coming months until we get those vaccines out, until we get them deployed, and then we can start turning this around.”