With Omicron’s Arrival, What Will Healthcare Look Like in 2022?

The Governor’s Coronavirus Task Force announced in a Jan. 3 update that the omicron variant has been detected in Flathead County, which is now one of 17 Montana counties in which 64 cases involving the variant have been confirmed.

The variant is believed to be significantly more contagious than the delta variant, but there are indications that it tends to cause less severe illness.

Case numbers have begun to increase again in Flathead County, after falling through mid-December from an October peak of 1,000 active cases.

As of Jan. 3, Flathead County had 261 active cases compared to 153 on Dec. 15. Those are based on cases that have been reported, and may not include the results of some positive rapid tests that people do not disclose to the health department.

Health Officer Joe Russell said he tries not to be a “doomsayer,” but with the recent uptick in cases, the new year should bring more infections, deaths and hospitalizations from COVID-19. So far, 21,539 cases and 225 COVID-19 deaths have been confirmed in Flathead County.

The health officer said the severity of illness continues to be something his department is watching closely, and as of late last week hospitalizations remained relatively low in the county. The county closed out last week with 17 COVID-19 hospitalizations, compared to an October peak of around 60 patients a day receiving care for COVID-19.

With the continued spread of COVID-19, the expectation is that the same trends that have been seen in the county for months will continue.

“We’re no different than the rest of the world. The higher acuity patients are unvaccinated,” Russell said.

He added that older members of the population, and those with underlying medical issues, will also continue to face a higher risk.

Russell said one data point he is keeping an eye on is cases per 100,000 population in Gallatin County. Monday Gallatin County had the highest amount in the state with 61 cases per 100,000 population, compared to 28 per 100,000 in Flathead County.

“What we see in Gallatin County tends to happen in Flathead County within two to three weeks,” Russell said.

The county vaccination rate continues to “trickle” upward, according to Russell. About 50% of the county population has at least one shot, and 44% of eligible residents are considered fully vaccinated.

“I wouldn’t expect a huge, dramatic change in that,” said Dr. Cory Short, a Logan Health hospitalist and the executive physician for the hospital’s acute service care line. “Obviously I’d love to see it, but I don’t think we can bank on that happening.”

Short said medical professionals at Logan are continuing to have honest, transparent conversations with people about getting vaccinated. People have changed their minds, in some cases because of loved ones or friends with firsthand experience. In other instances it takes a trip to the hospital for people to decide they need to become vaccinated.

“People who are sick enough to come into the hospital, boy, they feel pretty ill. Usually when they’re coming it’s because they’re short of breath and they can’t breathe,” Short said. “I think when people realize just how sick they can get from this, that’s been an eye-opener.”

Short said that time will tell what omicron will mean in terms of severity of illness and hospitalization, but that he anticipates another wave of COVID-19 hitting Flathead County.

“We have been, historically, kind of late with our surge arrivals, compared to the rest of the country,” he said. There’s “always a chance” the hospital will need to request help from the Montana National Guard to deal with the surge, but Short said a lot of work has gone into balancing resources to try and avoid a situation in which extra help is absolutely needed.

 Alongside the expectation of more COVID-19 cases, Short said that he is also expecting people without COVID-19 to generally be more sick when they arrive at Logan. It’s a continuation of a trend he attributed to the earlier months of the pandemic when many people deferred or avoided seeking medical treatment.

“I think there’s less of a fear factor now, maybe compared to when this whole pandemic started, but there are still a lot of people delaying their checkups, their primary care visits, their specialty visits.”

That means chronic disease processes “have had a little more time to go unchecked,” Short said. Cancer screenings have been missed and colonoscopies have gone unscheduled. “What that’s leading to is a lot of late diagnoses of cancers that really should be preventable just based on the screening programs we have in place.”

Logan Health is also continuing to see people dealing with complications of COVID-19 or lingering symptoms including fatigue and heart issues.

COVID-19 infections have caused blood clots, embolisms in the lungs and lung scarring in some people seen at the hospital.

With delta variant cases, Short said there have been increased instances of stiffness in the lungs that can cause ruptures leading to air in the chest outside the lung which has to be evacuated using a chest tube.

Logan Health has been relying on traveling nurses to help supplement its staff. Like many other hospitals across the nation, the hospital heads into the new year hoping to bring in more staff nurses, but shortages are not restricted to nurses.

“It is even beyond nursing,” said Cindy Morrison, the hospital’s chief transformation officer who added the hospital is not alone in facing a “workforce challenge.”

Going into the new year among the top priorities for Logan Health is improving employee recruitment and retention.

“We are labor intensive. It’s people caring for people,” Morrison said.

Other priorities heading into the new year include improving the patient experience. The hospital began surveying staff in December, and will look at a range of patient experience issues including access to appointments, wait times and communication with patients. The hospital is also launching a new human resources information system called Workday, to improve HR functions. Morrison also noted ongoing efforts to update and streamline electronic medical records, with Logan Health Whitefish’s new system going live in the spring, and Logan Health Conrad’s going live in 2023.

The hospital will also be finishing up the rollout of new wayfinding signage on campus brought about by its 2021 rebranding from Kalispell Regional Medical Center.

Another priority, according to Morrison, is to continue evaluating how telehealth services are provided. That means looking at how competitors are offering telehealth, assessing vendors and even looking into telehealth related apps.