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Hospitals warn they may have to ration care

Hospitals in the Rogue Valley are warning they may have to ration care if COVID-19 cases keep rising.

Both Providence and Asante are reviewing their plans for handling such a dire scenario, hospital officials said Tuesday during a video conference briefing with Jackson County commissioners.

“If we run out of resources, we will be embracing something called crisis standards of care, which means that we have to decide who’s going to get the limited resources that we have left. It’s not an exaggeration to say that we may very well be in that situation within the coming weeks to months if things don’t change,” said Dr. Courtney Wilson, vice president of medical affairs for Asante Rogue Regional Medical Center and a practicing emergency room physician.

Asante’s health care network includes the Rogue Regional Medical Center in Medford, Ashland Community Hospital and Three Rivers Medical Center in Grants Pass.

Providence is also reviewing how to allocate resources if COVID-19 hospitalizations surge to levels that require rationing, said Dr. Jason Kuhl, chief medical officer for Providence Medford Medical Center.

He said there is a “very real potential” rationing could occur in the community if cases keep rising.

On Tuesday, 49 of 57 staffed adult intensive care unit beds in Jackson and Josephine counties were full. Of those filled beds, 17 were occupied by COVID-19 patients, according to the Oregon Health Authority.

The two counties had 390 of their 445 staffed adult non-ICU beds occupied Tuesday. COVID-19 patients were in 44 of those beds, the OHA said.

Hospitals are straining to meet staffing needs, especially as health care workers fall ill from COVID-19 and the traditional cold and flu season, local hospital officials said.

With outbreaks hitting local nursing homes and assisted living centers, hospitals are unable to discharge patients who need follow-up care to those settings — meaning patients have to stay longer in hospital beds, officials said.

During the early days of the COVID-19 pandemic last spring, the United States saw hotspots of virus infections. But places like Oregon were still able to lend ventilators and other resources to the hardest-hit parts of the country, Wilson said.

“We’re in a very different state of affairs now,” she said. “The entire country is dealing with an outbreak of COVID. And unfortunately, we’re not going to be able to count on getting resources from outside our community.”

Portland hospitals are already bursting at the seams and canceling elective surgeries to deal with the rush of COVID-19 patients, said Chris Rizzi, chief executive officer of Providence Medford Medical Center.

“This situation is happening everywhere. So if our hospitals fill up, we won’t be able to transfer patients outside of our region, which is really concerning,” Wilson said.

She said health care professionals are struggling to convince some residents that they should take COVID-19 seriously and protect themselves and others by wearing face masks, social distancing and washing their hands.

Wilson compared the current situation to a red flag warning day in which widespread emergency alerts have gone out warning the public about extreme fire danger and high winds.

Wilson said imagine being a firefighter who rushes out to a report of a fire, only to find dozens and even hundreds of people starting fires.

“You look around bewildered, pleading with them to please practice fire safety, but they refuse and tell you that the red flag warnings and even the forest fires themselves are a hoax, that they have a right to start fires. Well, I’m afraid that that’s what it’s like to work in health care right now,” Wilson said.

With vaccines on the horizon, Dr. Bruce Van Zee, a retired physician, said the public needs to hold on for a few more months.

“It is so unfortunate that the public health measures have become so politicized,” he said. “They shouldn’t be. They are not red or blue. They are scientific conclusions about how to handle a pandemic.”

Regardless of their political beliefs, Van Zee said, most people share common ground in wanting kids back in school, businesses reopened and an end to the pandemic with the least loss of life and health as possible.

He encouraged elected leaders to support COVID-19 vaccination.

The first vaccinations for health care workers and nursing home residents could begin later this month. Widening pools of people will be able to get vaccines as availability increases.

Jackson County Commissioner Rick Dyer said he backs mask-wearing, social-distancing, hand-washing, remote-working and any other measures that could slow the spread of the virus without devastating the economy.

”I’m all for that,” Dyer said.

Jackson County Commissioner Bob Strosser said he also supports measures that include mask wearing and social distancing.

Dyer, Strosser and Jackson County Commissioner Colleen Roberts said they are concerned restrictions imposed by Gov. Kate Brown target restaurants, gyms and schools when those aren’t significant sources of COVID-19 outbreaks locally.

Instead, the commissioners said nursing home outbreaks and informal social gatherings are driving most of the spread.

They plan more discussions later this week about asking the governor to change her COVID-19 restrictions so Jackson County can adopt an approach more tailored to local conditions.

At least 25 nursing home residents have died from COVID-19, according to information from Jackson County that was updated Monday.

Jackson County reported four new deaths Tuesday, bringing total COVID-19 deaths to 35 as of Tuesday. Information wasn’t immediately available about whether any of those four people who passed away lived in nursing homes.

Reach Mail Tribune reporter Vickie Aldous at valdous@rosebudmedia.com. Follow her on Twitter @VickieAldous.

Asante Rogue Regional Medical Center is among the local hospitals reviewing their plans for the possible rationing of care if COVID-19 cases keep rising. Jamie Lusch / Mail Tribune