Flathead County is now experiencing COVID-19 hospitalizations on par with the pandemic’s peak in November, contributing to Logan Health exceeding its adult acute-care bed capacity last week and leading the health system to examine contingency plans in preparation for potential operational adjustments.
As is the case nationally, the vast majority of local hospitalizations are unvaccinated patients, prompting health officials to amplify their plea for eligible people to get a COVID-19 vaccine as the highly contagious Delta variant continues spreading.
“We’re all concerned about what’s happening with the current surge,” Dr. Doug Nelson, Logan Health’s chief medical officer, said. “None of us knows the future, but I think it’s very likely that we haven’t reached the peak of this surge yet. We’re monitoring the situation literally on an hourly basis regarding which of our contingency plans we might need to initiate.”
“I think it’s clear that vaccination is the most important thing we can do to stop or in any way end this pandemic,” Nelson added. “I would strongly encourage anyone who is not vaccinated to become vaccinated. It’s been demonstrated repeatedly that the vaccine is remarkably safe and remarkably effective.”
The county has been consistently hovering above 25 COVID-19 patients for most of August, with the number shooting up to 36 on Aug. 12 and remaining there through yesterday, with 30 county residents and six out-of-county residents hospitalized. Most are receiving care at Logan Health Medical Center, but North Valley Hospital has also been treating COVID patients.
Thirty-six is just shy of the county’s single-day pandemic record of 39 hospitalizations on Nov. 30, according to local health department data, and accounted for nearly one-fifth of the 191 active hospitalizations statewide on Monday. The county also led the state in active cases that day with 560.
Nelson said the hospital exceeded its 126-bed adult acute-care capacity on multiple days last week due to a combination of COVID-19 hospitalizations and skyrocketing emergency room visits. Logan Health has briefly exceeded acute-care capacity during busy summers before, but Nelson said last week was longer and more pronounced.
“It’s been exacerbated this summer because of all the patients we’ve had with COVID,” Nelson said.
Nelson said the hospital hasn’t turned away any patients and has been able to make use of other hospital space to accommodate those needing acute care, including by “boarding” patients in the emergency room. If the surge worsens, Logan Health has contingency plans to expand into other parts of the health system if necessary.
The alternate-care facility constructed last year on the vacant third floor of the Logan Health Children’s medical center still has cubicles and beds, but Nelson said the supplies that would be used in patient care were sent back to the state when Montana’s state of emergency ended.
“But if we needed, we would potentially have the ability to get that equipment again and open that,” he said.
Nelson said staffing is likely a bigger concern than bed capacity, although he noted that the hospital has managed thus far through a combination of regular employees and traveling workers.
“I think staff is being stretched,” Nelson said. “But we still have staffing ratios that are safe, and we feel good about the safety and quality of care that’s being provided.”
North Valley Hospital (NVH) has been similarly busy and last month saw its highest number of emergency department visits in the last six years. NVH spokesperson Riley Polumbus said the hospital closed its cafeteria seating to create an overflow waiting area for COVID-symptomatic patients who come into the emergency department.
NVH has also prepared COVID kits for patients who don’t require hospitalization. The take-home kits come with instructions and help patients manage and monitor their symptoms as they recover at home. The kits include a blood pressure cuff, finger oximeter, thermometer, electrolyte powder, hand sanitizer and masks.
The surge in cases has also forced the Flathead City-County Health Department to alter its operations by redirecting resources and hiring temporary staff for contact tracing investigations. Health Officer Joe Russell said contact tracing investigators continue to run into difficulties with cooperation and compliance from community members, but he’s happy to have additional help on staff.
Russell is also pleased to see an uptick in local first dose vaccine administration, meaning people who had previously not received a shot are now deciding to get it amid the surge in cases.
During the week of July 4-10, Russell said the county saw 283 first doses administered across all sources, including the health department, pharmacies and hospitals. For the week of July 25-31, that number swelled to 612 and was near 500 for the first week of August.
“We’re going in the right direction,” Russell said on Monday, adding that his staff had been fielding calls that day from “a lot of people” saying they planned to walk into the department’s weekly vaccine clinic the following day.
Flathead County still has the lowest full vaccination rate among Montana’s largest counties at 41%, but the numbers have been slowly ticking upward.
The Centers for Disease Control and Prevention (CDC) considers an area to have “substantial” COVID-19 transmission if there are 50-100 cases per 100,000 people or a testing positivity rate between 8-10%. A “high” transmission rate is 100 or more cases per 100,000 people or a positivity rate of 10% or higher.
As of Monday, Flathead County had 342.95 cases per 100,000 people, according to the CDC, the most among the state’s population centers. Its testing positivity rate of 16.1% is also the highest of Montana’s most populated counties, although that number has fallen from well above 20% two weeks ago as testing volume has increased.
Local COVID-19 hospitalization numbers reflect a specific day’s census, counting both newly admitted patients and those who have been there for weeks, which means the fluctuating figure isn’t necessarily the best method of gauging trends. But Russell said the health department has now started tracking hospital admissions, which he hopes will provide more useful public-health data.
“It’s a better indicator, and it’s way better for looking at trends,” he said.
Nelson said Logan Health has seen a greater number of younger patients — residents in their 40s, as well as some in their 20s and 30s — than earlier in the pandemic. The hospital has also cared for a handful of pediatric patients but has avoided the high numbers seen in states such as Texas and Florida, which have often been the result of co-infection with another pathogen.
“We haven’t experienced pediatric patients in significant numbers, but we’re preparing for that possibility, too,” Nelson said.
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