Commentary: Hospitals still facing significant challenges due to the COVID-19 pandemic

November 4, 2021 5:50 am
Exterior of hospital

Hospitals in New Hampshire came together to partner with one another to ensure that every patient was able to get the care they needed. (Dave Cummings | New Hampshire Bulletin)

Since those very first days of the pandemic over a year and a half ago, one of the overriding goals has been to ensure our hospitals have the capacity to care for a surge of COVID-19 patients. As we experience an ongoing increase of patients in need of hospital-level care here in New Hampshire, both those with and without COVID-19, that goal continues to challenge hospitals, state leaders, and the incredible women and men on the front lines of this pandemic.

I recall that we all watched with horror the images coming from overseas in the early days of the pandemic of hospitals being overrun by patients with COVID-19. The response was swift: In addition to lockdowns, stay-at-home orders, and more, hospitals across the country canceled all non-urgent, elective procedures to preserve the personal protective equipment and bed capacity to ensure that they could serve patients with COVID-19. In addition, much of the health care system outside of hospitals moved to virtual models of care to keep people safe and socially distant.

Hospitals in New Hampshire came together to partner with one another to ensure that every patient was able to get the care they needed. During the surge in COVID-19 cases, hospitalizations, and deaths last fall and winter, clinical leaders from every hospital and health system in New Hampshire met daily to manage hospital capacity so that if any hospital was at or near their bed capacity to care for their patients, other hospitals were able to step in and share resources, transfer patients, or offer assistance so that every patient received the highest quality of care. Having witnessed this collaboration and partnership firsthand, I could not be more proud of our hospitals and their health care heroes for everything that they do to fulfill the mission behind the blue and white H we see in our communities.

So, what is different now? Why are hospitals as challenged today as they have been at any time during the pandemic?

Hospital bed capacity has been at its highest levels over the past few months. While COVID-19 hospitalizations are increasing, and at levels we haven’t seen since earlier this year during the winter surge, hospitals are also seeing more seriously ill non-COVID patients in need of care. Many of those patients may have delayed screenings or other preventive care during the pandemic, and now their illnesses are much more serious. Finding an intensive care unit bed has become one of the greatest challenges facing hospitals across New Hampshire and the country. It’s not uncommon for some of our largest hospitals, who would normally be able to accept transfers from smaller hospitals in New Hampshire and across the region, to say that they were unable to accept those patients. That means those patients in need of a transfer may have to be transferred to hospitals far from home – Connecticut, New York, and beyond.

A workforce shortage that was challenging before the pandemic has only been made more so because of it. We often talk about those on the front lines of this pandemic as heroes – and they are, in every sense of the word. But they are not superhuman, and they are tired. Like everyone, they want to get back to normal, but normal for them means taking care of everyone who needs their care. And this surge is making that so much more challenging. Patients often experience longer wait times for service, whether that’s in an emergency room, urgent care center, or even your doctor’s office. They understand that you are frustrated by this because they are as well.

Hospitals are not the only part of the health care system challenged by the pandemic. Those in long-term care, home care, and behavioral health, just to name a few, are also facing significant challenges.  When a nursing home or home health agency is unable to accept a patient who is ready to be discharged from the hospital, that patient remains in the hospital until they can be safely discharged. When those in an acute psychiatric crisis are unable to be transferred to the appropriate facility to receive the care they need, they are forced to stay in a busy hospital emergency room until an appropriate bed opens up for them. One hospital reported recently that over 20 patients, practically an entire unit in the hospital, were ready for discharge but remained in the hospital because of a lack of treatment capacity at a lower level of care, or because of delays in insurance approvals.

All of these things are converging in a way that makes the job of hospitals and their caregivers more difficult. We continue to do everything we can to ensure that the capacity is there for every patient who needs our care, whether that’s someone with COVID-19, a crash victim, or someone suffering a heart attack.  That is why it is so important that we do everything we can to ensure that a hospital bed is there should we or one of our loved ones need it. That means getting a COVID-19 vaccine to help protect yourself and your loved ones.

If you still have questions, please talk to your doctor or other trusted health care professional. The science and data are overwhelmingly clear: The vaccines that are approved for use are safe and effective at preventing infection, serious illness, hospitalization, and death. It is what is going to help us all get back to doing what we want to do when COVID-19 isn’t calling the shots.

The women and men of New Hampshire’s hospitals are here for you now as they have been throughout the pandemic. We are all in this together, and it is going to take all of us, working together, to get through it. If you see one of those health care heroes, please tell them how much you appreciate all that they have done and continue to do to keep us healthy and safe.

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