Cancer patients pushed aside by the unvaccinated
Dr. Megan Frost is making hard phone calls to tell people with cancer that the surgeries they need are being delayed by weeks and perhaps months while Rogue Valley hospitals struggle with an overwhelming surge of COVID-19 patients.
She said she tells them, “I know you have cancer. We can’t take care of it right now, and I’m not sure when we’re going to be able to get you in.”
Frost said patients won’t die immediately, but the delays give their cancer time to spread and could potentially shorten their lives.
With prompt surgery, a patient might get 20 more years of life, but a delay could cut survival time to five years, she said.
Frost, a surgeon, said the delayed care is putting a heavy burden on cancer patients, who are sad, scared, frustrated and angry.
“To say my patient with cancer isn’t as important right now as a patient in a hospital with COVID doesn’t feel right. It doesn’t sit with us very well,” she said of surgeons in Southern Oregon who can’t perform vital surgeries.
As of Wednesday, 179 people were hospitalized with COVID-19 in Asante’s three hospitals in Medford, Ashland and Grants Pass. Of those, 94% were unvaccinated, Asante reported.
Rogue Valley medical workers held an online press conference Tuesday to spell out the dire situation facing COVID-19 patients and anyone else needing advanced medical care.
Jackson and Josephine counties weren’t hard hit by previous COVID-19 surges that swept other parts of the country. But low vaccination rates here, high numbers of people who hadn’t yet had the virus and the rise of the highly contagious delta variant are now taking their toll, said Dr. Estin Yang, a surgeon with Asante Physician Partners.
Hospitals are canceling a broad range of elective surgeries.
The term “elective surgery” sounds frivolous, like a nose job.
But to medical professionals, an elective surgery is simply a scheduled surgery. Surgeons are meeting every day to decide which surgeries are most critical and must be performed, but they have to decline the vast majority of cases, Frost said.
“That’s including patients that have cancer. It’s including patients that are at risk of stroke, at risk of heart attack, at risk of losing a limb. It’s patients with conditions that I feel are urgent, but right now we don’t have the space or staff to take care of them in the operating room — and we definitely don’t have the space or staff to take care of those patients after their operations in the hospital,” Frost said.
Hospitals have turned operating rooms, emergency departments and any other available space into places to care for patients. Basically, if a room has electricity and can be used to administer oxygen, it’s being put to use, hospital workers said.
The Asante Three Rivers Medical Center in Grants Pass has turned two of its three idled surgery units into COVID-19 wards, with non-COVID-19 patients overflowing into the third surgery unit, said Laura Magstadt, a registered nurse and vice president of nursing for the hospital.
Every day, 10-20 people who are ill enough to be admitted into a hospital bed are boarding in the Grants Pass emergency department due to a lack of space. The post-surgery recovery area, the outpatient surgery area and a cardiovascular area are packed with patients, and the ultrasound area is being prepped to hold more, Magstadt said.
Surgeons, doctors, nurses and other workers have all teamed up to take care of patients, said Dr. Scott Nelson, a surgeon with Asante Physician Partners.
Out in the community, Dr. Steven Marshak, a pediatrician with Siskiyou Pediatric Clinic, said kids are being diagnosed with COVID-19 every day.
They’re suffering from vomiting, diarrhea, respiratory problems and low oxygen levels. Some have had to be hospitalized, including a one-month-old baby, Marshak said.
Kids are at risk from long-term impacts from COVID-19, including heart problems.
They can develop multisystem inflammatory syndrome, in which their hearts, brains, kidneys, eyes and other body parts become inflamed. The condition can be deadly.
Marshak said the COVID-19 pandemic has triggered a drastic increase in depression and anxiety among kids, largely because of a lack of social interaction through school and other activities.
“I think children deserve to have full-time, in-person, safe learning. The path to get us to that is that all eligible people, including children 12 and up, get vaccinated and that everyone wears masks,” he said.
Without people taking those steps, Marshak said, he fears more cases among kids and teachers, plus school shutdowns.
Over the past weekend, Marshak said, the ventilator supply dipped so low in Grants Pass that doctors considered taking a ventilator designed for a newborn baby and using it on an adult.
“Luckily, we did not have to do that, but it just shows the dire situation that we’re in that we’re out of personnel and equipment to handle the caseload that we’re seeing,” he said.
Although the Asante hospital system has been preparing for 18 months for a potential COVID-19 surge and brought in more ventilators, the need for ventilators can jump in just a few hours if a large number of people need to be intubated at the same time, hospital workers said.
Obstetricians are keeping a worried eye on their pregnant patients.
“It’s a tenuous time to be a health care provider, particularly an obstetrician, because usually I’m used to dealing with young, healthy patients expecting to bring new life into the world,” said Dr. Justin Shelton, an obstetrician with Women’s Health Center of Southern Oregon.
Pregnancy naturally weakens women’s immune systems, making them less able to fight off viruses, he said.
A study published in the Journal of the American Medical Association looked at 870,000 pregnancies, including 18,000 in which women caught the COVID-19 virus.
“If you were pregnant and you were diagnosed with COVID-19, you were five times more likely to need ICU care. You were 14 times more likely to require intubation and care with a ventilator, and 15 times more likely to die from complications of COVID,” Shelton said.
Respiratory illnesses, including COVID-19, increase the risk that babies will be born prematurely, he said.
“But there is a way to avoid these complications and mitigate the risks in pregnancy, and that is vaccination. Vaccination is safe during pregnancy. A lot of folks have commented, ‘This hasn’t been studied well in pregnancy. We don’t know the adverse effects to the baby or unborn baby.’ And that’s simply not true,” Shelton said.
More than 178,000 pregnant patients have been followed so far in a giant COVID-19 vaccination study. By contrast, a solid medical study often includes about 30,000 to 40,000 patients, he said.
He said there is no increased risk to the baby, no increased risk of premature labor and no impact on future fertility from getting vaccinated.
“Any claims that have been made that the vaccine affects your fertility or ability to become pregnant in the future are false and not founded in science,” Shelton said. “And another benefit of vaccination is that you’re also protecting your baby as well. When you do get vaccinated, the antibodies that you create during pregnancy actually pass through the placenta and the baby holds on to them for the first couple months of life.”
Those antibodies are especially important given that newborn babies have vulnerable lungs and lack a developed immune system of their own to protect themselves, he said.
“By getting vaccinated as a pregnant patient, you’re actually doing one of the best things you can for your newborn child to protect them,” Shelton said.
As medical workers both inside and outside hospitals continue to fight against COVID-19, Oregon National Guard soldiers have joined the battle.
About 116 soldiers are spread out across the Asante health care system in the Rogue Valley, doing everything from cleaning rooms to answering phones to ferrying much-needed supplies. They’re doing nonmedical tasks because National Guard members with medical skills can’t be spared from their civilian jobs in health care.
“We are absolutely grateful. They are doing so many different types of things,” Magstadt said.
The state government is helping to bring 110 out-of-state nurses this week to join Asante nurses, she said.
“It’s just a tremendous help to our existing staff who have been working unbelievable amounts of shifts and doing heroic measures to care for our patients,” Magstadt said.
The state is also taking steps to ease a bottleneck of patients who are well enough to leave hospitals, but still need care in a nursing home or other facility. Asante hospitals were caring for 60 patients who had nowhere to go, but that number has dipped to 45, Magstadt said.