Washington hospitals over capacity with rise in COVID cases, barrier patients

An increase in COVID-19 cases paired with an influx of barrier patients and other factors have pushed Washington hospitals past their capacity limits.

 

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Washington State Hospital Association CEO Cassie Sauer discussed state hospital conditions during a media briefing on Monday. She said hospitals across the state had nearly 600 COVID-positive patients at the end of last week.

“There were about 75 more people that were suspected of having COVID, but not yet confirmed,” Sauer said. “Their tests hadn’t gotten back yet, but their symptoms suggested they had COVID. That was an increase of about 10% from the prior week, which is a pretty big growth.”

The Washington State Department of Health’s COVID dashboard showed a 7-day rate of new COVID cases of 263.1 per 100,000 people from May 22-28. That was up from a rate of 170 new cases per 100,000 people from April 22-28.

Although case counts are increasing, those infected are experiencing less severe symptoms, Sauer said. That is largely because the BA.2 variant is currently the state’s dominant variant of the virus.

“The good news is that most people are not getting as sick on COVID as they were in the past,” Sauer said. “This variant seems to not make people quite as sick. There’s less than 1 death a day in Washington state right now. There’s about 20-25 people on ventilators per day. This is still more than we want, but it’s also much less than prior surges when we had hundreds of people on ventilators.”

But the state’s hospitals are quite full for a variety of reasons, Sauer said. 

“We have among the fewest hospital beds per capita in the country,” she said. “Even in normal times, we don’t have a lot of extra capacity. We continue to see people [who have] delayed care. They need a longer stay in the hospital so that takes up more room.”

Dr. David CarlsonChief Physician Officer for MultiCare Health System—said MultiCare’s hospital capacity across the Puget Sound is currently at about 120% of its normal capacity. 

“Only a fraction of that is due to COVID,” Carlson said. “A lot of it is pent-up demand from people who got sicker when they didn’t get care. So making sure you keep up with your routine medical care, making sure you’re taking care of the chronic conditions you have, is super important.”

Hospitals are also under pressure from the presence of barrier patients, Carlson said. 

“A barrier patient is someone who does not have a medical necessity to be in a hospital, and they’ve been with us for more than 10 days,” he said. “At Good Samaritan Hospital, we have over 60 barrier patients. Tacoma General has around 50.” 

The top three reasons barrier patients are stuck in hospitals include a lack of availability in skilled nursing facilities, delays in authorization processes, and wait times for assessments needed to transfer people to other facilities, Carlson said.

Dr. Steven MitchellMedical Director of the Emergency Department at Seattle’s Harborview Medical Center—said the inability to transfer patients to other facilities after they no longer need to be in a hospital remains a significant issue for Harborview as well.

The No. 1 issue facing our health care system now remains the inability of our patients to be able to transition into that post-acute care setting, such as a skilled nursing facility or a nursing home once their need for a hospital has ended,” Mitchell said. “That part of our health care continuum remains remarkably strained.”

Dr. Christopher Baliga—an Infectious Disease Specialist at Virginia Mason Franciscan Health—said COVID has played a role in that issue as well.

“We are still seeing people that are being denied transfer to other facilities because of not being vaccinated against COVID,” Baliga said. “Unless you want to stay in the hospital for a long period of time this is yet another reason why being vaccinated is a good thing to do.”