Hospitals across the state remain very busy, even as Vermont boasts one of the lowest COVID hospitalization rates in the country.
More surgical procedures are taking place, Vermonters are seeing shorter waits for care, and it’s generally easier to transfer patients from the hospital. “We’re not stretched as thin,” one health care provider summarized.
Still, hospitals are not functioning as normal. Nurses and paramedics contracted through the federal government and troops with Vermont’s National Guard continue to provide assistance. Blood supplies are at critical levels. And available hospital beds remain low.
For the fifth, and final, week, VPR’s Lexi Krupp spoke separately with Dr. Trey Dobson, the chief medical officer at Southwestern Vermont Medical Center in Bennington; Meg Oakes, a nurse leader and senior director of quality and safety at Rutland Regional Medical Center; and Dr. Stephen Leffler, the chief operating officer at the University of Vermont Medical Center in Burlington. Their responses are below and have been edited for clarity.
Lexi Krupp: Has capacity improved and how are you feeling now?
Meg Oakes: We’re back from the edge. So that feels good. But it's funny how quickly you get used to the new normal, because the number of COVID positive patients we have today – three months ago, I would have thought this was a really high number.
Trey Dobson: It's not like the hospital’s empty. It's definitely high capacity, lots of activity. But there is that sense, almost of accomplishment, that we've gotten through this rough time, and that we haven't had to reduce our services or lower the care standards that we all strive for.
Stephen Leffler: There's still a lot of challenges right now. It's everybody, all the other illnesses in Vermont, are really playing as much of an impact on how busy we are as COVID.
That sense of normalcy is not there. But that's okay.Trey Dobson, Southwestern Vermont Medical Center
How is the hospital different than before this recent surge?
Stephen Leffler: In lots and lots of ways. We're still using our boardroom today for monoclonal antibody infusions. We’re using our gift shop for blood donations. We're using our first-floor lobby for psych overflow space. We're not doing all the scheduled surgeries that we wish we could do. We're still doing a lot of testing of COVID.
Meg Oakes: We still have FEMA staffing. The paramedics have been extended into early March, and the nurses are here through February, unless we hear otherwise. We definitely still need them. It's making a big difference that they're here. We still have our special COVID unit open. So we have part of what otherwise would be a medical unit walled off, and it's still pretty fully occupied.
Trey Dobson: We still have a morning report where we have to talk about staff shortage: Who's out with COVID? And how are we going to cover a particular department? We still have those patients in the hospital, and we still have all of the mitigation measures. I think that sense of normalcy is not there. But that's okay.
Last week, there were problems discharging patients to nursing homes and long-term care facilities in some parts of the state. What’s happening now?
Stephen Leffler: We have 49 people waiting for nursing home placement. So that's down a little bit from last week. That's still well above our normal, but slightly improved.
Meg Oakes: That's gotten a little better. They're not closed to admissions. They're taking patients when they can.
Trey Dobson: They haven’t gotten worse. The ability to transfer patients to tertiary care (a hospital that provides specialized care), the ability to discharge patients to long term care facilities or assisted living has not gotten worse, and has slightly improved.
It's funny how quickly you get used to the new normal. Because the number of COVID positive patients we have today – three months ago, I would have thought this was a really high number.Meg Oakes, Rutland Regional Medical Center
What about patients needing psychiatric care?
Meg Oakes: The biggest strain on our system, from a patient demand and need for care perspective, really has to do with making sure that patients who need psychiatric care somewhere in the state are able to get it.
Stephen Leffler: Our psychiatric crisis for this last couple days has been a little bit better. We're down to 15 total psych patients waiting for beds in our emergency department. That’s down significantly.
Have blood supply levels changed at all?
Trey Dobson: It is the same, or worse. It is really a critical situation. Blood is obviously vital and life saving in so many situations – in a bad traumatic accident, but there’s also medical reasons people need blood. They may have cancer and be undergoing chemotherapy, which may require that they get transfused. With the supply so extremely low, it is very plausible that a patient could die – in our country, in our system – because blood was not available. And that is not something most of us in healthcare have experienced in the past.
Meg Oakes: It's not impacting surgery at all. We're keeping track of it, looking at it, organization-wide, at least daily. It’s now part of our daily safety huddle to talk about blood supply, when, until recently, it wasn't.
Stephen Leffler: We are still, every day, just barely getting by. But we are taking some action. We're going to start augmenting the Red Cross Blood Drive donations with another process in our gift shop, to try to do additional blood donations. So we’re hoping that will ease things up a little bit.
Lexi Krupp is a corps member for Report for America, a nonprofit national service program that places journalists in local newsrooms to report on under-covered issues and regions.
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