Arizona hospitals strained with unvaccinated COVID-19 patients, health care workers call out for help

By

Soraya Marashi

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As the Omicron variant continues to surge across Arizona, hospitalizations remain at an all-time high, and positivity for COVID-19 testing has reached a record 63%, indicating significantly high community transmission, according to the Arizona Department of Health Services

As of Jan. 20, 39% of the state’s 8,763 general ward beds were occupied by COVID-19 patients, representing a 16% increase from the previous week, and 38% of the 1,652 ICU beds in the state were occupied by COVID-19 patients. Nearly 90% of these COVID-19 patients in Arizona hospital beds are unvaccinated.

Approximately 40% of hospitals in the state are currently reporting a staff shortage, with many reporting high staff turnover rates and an increased number of vacancies for a number of reasons. These include burnout, COVID-19 infection, and travel nurse positions, which tend to pay much higher wages. This has forced hospital systems to prioritize the resources that they do have available. 

Will Humble, executive director of the Arizona Public Health Association (AzPHA), explained how these staffing shortages are causing many medical procedures to be deferred:

“Most hospital systems are not doing elective procedures. Things like heart valves that are not life-threatening, slow grind prostate surgeries aren’t happening, hip and knee replacements … Basically none of that is happening in our state right now because they just don’t have the staff for it …

They’re really all in contingency standards of care, which means they’re admitting people with different criteria. In other words, they’re not admitting people that they would normally admit under regular circumstances. They’re discharging people earlier, they’re using different staffing ratios …”

Humble said a combination of insufficient COVID-19 vaccination rates (58.5% of all Arizonans are fully vaccinated, compared to 69.7% of the entire country), coupled with staff shortages and a lack of proper mitigation measures, are ultimately responsible for the state’s hospital crisis. 

Humble added that rural hospitals are undergoing the most hardships in the midst of this Omicron surge. 

“Our rural hospitals are not part of these big systems like Banner, Dignity, Honor Health or Abrazo. So, they don’t have a system where they can move and transfer patients. They can’t move hospital staff around to help staffing problems … you’re just a small, non-profit hospital. You’re not part of any big system. So they’re at a huge disadvantage …

The urban hospitals are crowded and busy and they don’t want any more patients either. If you’re in Cochise County [for example], and you’re past capacity and you can’t handle the patients you’ve got, and ambulances are continuing to come in and you really need to transfer patients, no one will take them …”

Humble explained that a year ago, there was a surge line in place to move patients around from facility to facility and transfer patients to large urban hospitals when necessary that is not available anymore. 

In the huge surge over the winter of 2020-2021, about a year ago, there was a surge line in place at that time, and the surge line was available to move patients around from place to place, and big urban hospitals were [taking transfers]. Well, that’s not happening anymore.”

Amid Gov. Ducey and many legislators’ efforts to ban mask and vaccination mandates, health care workers from across the state have been urging lawmakers to enact proactive COVID-19 mitigation measures, such as mask mandates in classrooms and more testing sites.

In an open letter addressed to the governor, the Arizona Hospital Association (AzHHA), the Arizona Legislature, and leaders of other government agencies, over 1,000 health care workers from across the state have called for more action to implement measures to prevent the spread of COVID-19 that will ease the burden on hospitals. 

The letter states that health system leaders and elected officials should take measures such as requiring N95 masking, adjusting and enforcing consistent hospital visitation policies, supporting mandatory vaccination policies for health care workers and state employees, making vaccinations and boosters more accessible, mandating mask use in all indoor public spaces, increasing testing access, and providing access to free rapid home testing kits and high quality masks.

As the 2022 legislative session continues, Humble said he expects the legislature to reintroduce bills meant to prohibit mask and vaccination mandates that were shot down by the Arizona Supreme Court last year.