FARGO — Sanford Health is preparing for an expected peak in the surge of COVID-19 hospital patients in the next two or three weeks while dealing with a critical shortage of more than 200 nurses and other caregivers.
The surge of COVID-19 patients, driven by the highly contagious delta variant of the coronavirus, is coinciding with already high volumes of hospital patients, Dr. Doug Griffin, Sanford vice president and medical officer, said Tuesday, Sept. 14.
“We really are in a crisis,” he said. “Hospitals across the region are full of COVID and non-COVID cases.”
The daily census at Sanford’s three Fargo campuses was at 500 to 530 over the last few weeks and climbed as high as 550 as the pandemic overlaps with the many other illnesses and trauma cases requiring hospital care, Griffin said.
As of Tuesday, Sanford had 37 hospital patients with COVID-19 and expected that number to double or more, reaching 80 or 90 when the expected peak arrives, he said. During the peak last November, Sanford’s COVID-19 census spiked to 116 — but hospitals were dealing with many fewer admissions for other causes, unlike now, he said.
“We’re already at capacity and have been for a few weeks now due to our COVID and non-COVID cases being very high. So now is the time to take action,” Griffin said.
Sanford reduced elective surgery cases by 30%, shifted some staff to clinical roles and moved some physicians from clinics to hospitals to deal with the crunch.
“We really feel we have no other choice,” Griffin said.
Urgent cases will be handled without delay, he said.
“We’ll get you in,” Griffin said. “We’ll get it done. … It’s really all about staffing. That’s the issue. It’s day to day.”
The staffing challenge confronting Sanford at all levels is the most dire the health system has faced, Griffin said. He said Sanford in Fargo could use at least 150 travel nurses and another 200 or 300 nurses overall.
Sanford recently hired 100 additional nurses, but they won’t start until later in the year, too late for the current surge, Griffin said.
The availability of staffed ICU beds is especially critical. During Griffin’s briefing Tuesday morning, he said Sanford had no open ICU beds in Fargo, but said the situation can change hourly.
As of Monday, the most recent bed figures reported to North Dakota health officials, North Dakota had 105 available beds, including seven ICU beds, 77 non-ICU beds, 5 pediatric ICU beds and 16 pediatric non-ICU beds.
Many of the available beds are in rural hospitals in locations including Fort Yates, Belcourt, Crosby and Cavalier. Hospitals across Fargo had 30 available beds as of Monday, including seven ICU beds, nine non-ICU beds, four pediatric ICU beds and 10 pediatric non-ICU beds.
Most of the COVID-19 inpatients in Sanford’s Fargo hospitals are from the Fargo-Moorhead area, but the hospitals have taken transfer patients from western North Dakota, far into northwest Minnesota, southern Minnesota and South Dakota, Griffin said.
Sanford hasn’t been able to accept all the patients seeking beds from western North Dakota, where vaccination rates are low, he said.
To help ease the burden on hospitals, people should get vaccinated, Griffin said. “I understand peoples’ rights, but I think it’s a personal responsibility to get vaccinated for your communities.”
As of Tuesday, 84% of Sanford employees were vaccinated under a mandate with a Nov. 1 deadline, when Griffin expects the level to be 100%.
The vast majority of Sanford’s COVID-19 hospital patients are unvaccinated. As of Tuesday, 22 Sanford hospitals were treating 141 inpatients with COVID-19, 128 of whom are unvaccinated. Forty-four of 48 COVID-19 patients in intensive care units are unvaccinated, and 28 of 30 COVID-19 patients on ventilators are unvaccinated.
The actual number of patients who were hospitalized for COVID-19 is higher, because after 21 days they are no longer contagious and move into other units. COVID-19 patients, especially those who were placed on ventilators, have extended hospital stays.
Also, the demands of caring for COVID-19 hospital patients are high, requiring more nurses and other caregivers. Proning COVID-19 patients to help them breathe, for example, can take two, three or more staff members, Griffin said.
“It’s very labor intensive,” he said, often requiring one nurse for every hospital patient. Also, nurses and others caring for COVID-19 patients must take time to doff and don protective clothing and equipment before and after entering a COVID-19 patient’s room.
“They are very taxing,” Griffin said, referring to COVID-19 patients.
To increase staffing, Griffin said, Sanford is offering a number of “significant” incentives, including referral bonuses, sign-on bonuses and pay increases for certain positions.
Because COVID-19 patients who are hospitalized are overwhelmingly unvaccinated, caregivers are frustrated by the current surge of admissions. The number of patients was greater during the November peak, but that was before the availability of safe and effective vaccines, Griffin said.
“That is not that long ago, so it remains fresh in many people’s minds,” he said, referring to the extraordinary demands of last November’s COVID-19 admissions peak. Many caregivers worked long hours for an extended period of time and still need to recover mentally and physically, he said.
“There is a large level of frustration,” he said. “This could have been prevented.”
Essentia is dealing with similar pressures as hospital admissions climb while the current COVID-19 surge builds.
“At Essentia Health in Fargo, our resources are being stretched to capacity by COVID-19 patients and non-COVID patients alike,” spokesman Louis St. George said in a statement Tuesday. “Today, we have 15 COVID patients overall, including four in the intensive care unit. Those numbers continue to increase. We often have limited ICU-bed availability and our emergency department is very busy, as well.”
He added: “This increased need for acute medical services presents a risk to our communities, and it highlights the importance of taking preventive measures against COVID such as vaccination and masking. We are extremely grateful to our dedicated staff who are working tirelessly to meet the needs of our patients and communities.”