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Missouri hospitals sound alarm over latest COVID wave

St. Louis area hospitals are getting “crushed” by the highest number of COVID patients they’ve seen yet in the pandemic, hospital leaders said in a press conference Wednesday afternoon.

And those patients are on track to double in the next couple weeks, according to projections from the St. Louis Metropolitan Pandemic Task Force, which includes the area’s four largest healthcare systems.

Adding to their panic are unprecedented staffing shortages, limited access to antiviral therapies and the fact that communities are facing intense pushback against mitigation measures, such as masking and vaccines, despite the omicron variant being more transmissible than previous strains of COVID-19.

“Behind the scenes, we’re quite frightened about what we’re experiencing and what we’re seeing,” said Dr. Alex Garza, SSM’s chief community health officer. “Don’t let this cool demeanor fool you.”

The St. Louis hospital leaders echoed the panic that their counterparts in Kansas City and western Missouri hospitals expressed in a press conference earlier Wednesday. 

Kimberly Megow, chief medical officer at HCA Midwest Health System, which serves the Kansas City metro area, said the hospital is nearing the point of “crisis standard of care,” meaning doctors will start determining who gets care and who is left to die.

“That’s how bad it could get if we are completely overwhelmed, and we’re at that point already and we suddenly have an onslaught of additional patients,” Megow said. “There have to be tough decisions made and no one on this call wants to be faced with making those decisions.”

HCA Midwest has postponed all elective procedures. And starting on Thursday, all elective procedures at BJC Healthcare center will also be postponed. 

Garza said the other healthcare systems in St. Louis will not be “far behind.”

Staffing is the main factor in making these decisions, hospital leaders said. St. Louis hospitals are seeing an alarming number of staff members calling in sick.

“There is no rescue bus full of labor coming,” said Dr. Aamina Akhtar, an infectious disease specialist and chief medical officer of Mercy Hospital South in St. Louis. “So we were all having to look internally and understand how we can use the people who we have and redeploy them in acute clinical situations.”

Other countries, such as South Africa, have faced a spike in cases due to the variant, but they saw a drop after they put stringent mitigation measures in place, including a shutdown, Garza said. 

However in Missouri, public health departments’ “hands have been tied” because of legislation and recent lawsuits, said Dr. Clay Dunagan, BJC HealthCare’s chief clinical officer. 

That, combined with Gov. Mike Parson’s ending Missouri’s state of emergency recently, has left hospital leaders “panicked.” 

“There really are no hospitals left untouched,” Dunagan said. “There’s no place for us to go for respite. We don’t have a place that we can send patients if we run out of room. There’s no safe harbor.”

On Wednesday, the state reported 12,264 COVID cases, tripling the number of daily cases from a month ago. In November, the St. Louis task force sounded the alarm when the hospital admissions were at fewer than 300 COVID inpatients, Dunagan said. 

As of Wednesday, there were 1,114.

“We have almost four times as many patients in hospitals as we did at that initial moment,” Dunagan said, speaking of COVID patients. “And it would be easy for us to hit double the current number within the next couple of weeks.”

Hospital and public health leaders on both sides of the state have urged Parson to put the state’s emergency order back in place. 

Garza said the governor’s recent decision to end the emergency order has taken away some of their vital tools, including extending waivers for telemedicine to increase hospital capacity, being able to move caregivers across state lines quickly and deploying the National Guard to perform COVID-related missions such as testing.

Donald Kauerauf, director of the Missouri Department of Health and Senior Services, told The Independent Wednesday that his team has been talking with hospitals about the current rules that would allow for expanded bed use and staff. 

“We’ve provided what the current law allows us to do or provide variances upon request from a hospital,” he said.

Dunagan said many people have been forgoing vaccination because they believe antiviral therapies are readily available. But the hospitals currently  have such a limited supply that they will be almost exclusively used for people who have significant risk factors. 

“If you’re the average person on the street, you’re unlikely to be able to get an effective monoclonal antibody at this point,” he said.

The St. Louis area hospitals have seen children hospital admissions more than double in just a week. Dunagan said schools that have been able to implement mask mandates and other mitigation measures have been more successful in preventing outbreaks among students. 

The St. Louis County Council voted Tuesday to put an indoor mask mandate back in place. The county had abandoned its effort to maintain a mask mandate last month, in the wake of Attorney General Eric Schmitt’s push to crush out all such orders statewide.

On Wednesday afternoon, Schmitt announced that he will file a lawsuit seeking to halt the county’s mask requirement.

Jennifer Watts, chief emergency medical officer at Children’s Mercy in Kansas City, said that masks worked.

“It is hard to look at a child that is sick and to have that thought in your mind: If we would have worn masks in school, could this have been prevented?” Watts said. “And to have that conversation with a parent is heart-wrenching. So yeah, we are devastated that kids are not wearing masks in school.”

Allison Kite of The Missouri Independent and Sherman Smith of the Kansas Reflector contributed to this report, which is published by permission.

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