Aug. 13—WEST COLUMBIA, S.C. — Inside one of Lexington Medical Center’s COVID-19 wings, made up of more than 20 rooms, registered nurse Jenna Paul adjusts her hair net and places her transparent shield over her face.
She straps an air pack to her lower back, providing cooling to her head. She puts on the blue plastic gown and latex gloves — a rhythmic action before she slides open a door, enters the patient’s room and seals it from the rest of the hospital.
This time, the COVID-19 patient is in his 50s, sedated with a ventilator breathing for him.
The man is one of 149 COVID-19 patients in the hospital Wednesday, and one of 37 in the hospital’s intensive care units.
In the last two to three weeks, Lexington County’s main hospital has recorded a COVID-19 patient spike. Unlike in previous waves, the ramp up this time has been faster, according to hospital officials.
Dr. Brent Powers, the hospital’s chief medical officer, grew concerned almost two weeks ago when he saw admissions climbing.
Now, the hospital is close to capacity.
About 96% of its beds are taken, and, of the 149 COVID inpatients, 86% are not vaccinated.
Twenty-five percent of the hospitals COVID-19 patients are in the ICU, with 27% on ventilators — the highest number of patients in the hospital’s 50-year history, Powers said.
“The age at which patients were presenting, how sick they were when they were presented and the number of interventions to resuscitate them and stop the dying process was much more intense than what we have seen in previous waves,” Powers said.
The spike has forced Lexington Medical Center to rethink its strategy, and, in some instances, look at delaying non-emergent surgeries and procedures and even consider conserving personal protective equipment once again.
It has doctors and nurses pleading with the public — not the 45.4% of whom are fully vaccinated — to get vaccinated.
“I have never been as concerned about our capacity to care for patients as I am now,” Powers said. “We obviously have been through the COVID pandemic in the previous waves. What’s different about this wave is that the on ramp is a lot steeper. So the rate at which we’re admitting patients …. is at a higher pace and they seem sicker. We’re seeing younger patients, we’re seeing pregnant patients. We’re seeing patients that need more support.”
“We keep hitting high water marks,” Powers added. “I don’t think we’re done.”
Inside the COVID wing
The hustle and noise that can often be heard and seen in the hospital isn’t occurring in the COVID-19 wing.
Inside the wing, no visitors are allowed to cut down on the virus’ potential spread.
Almost all of the patients are on ventilators, usually used by surgical and cardiovascular patients, helping them to breath. Some are lying on their backs, while others are lying on their stomachs to help them breath and expand their lungs, said Donna Peterson, the director of nursing for critical care.
Those on ventilators are on paralytics to keep them sedated.
For the ones who need the ventilator longer, the hospital may cut a hole in the patients’ neck to connect a breathing tube.
“You don’t want them fighting,” Peterson said about keeping patients sedated. “Sometimes when you can’t breathe you’re your own worst enemy, … making that worse on yourself. Not intentionally, but you just can’t calm down, you can’t rest your body.”
Most patients have electrodes, some on their forehead, blood pressure cuffs around their arms and lines inserted into their bodies. In and out of the rooms, nurses monitor the patients’ heart rate, blood pressure, temperature, respiration rate and how much carbon dioxide they’re expelling. They place heated blankets around the sedated patients to keep them warm, similar to a bear hug.
Patients are fed through tubes that are inserted through their nose or into their stomach. Their feet are kept in boots to prevent muscle and nerve function loss.
Hospital officials say nurses and doctors are doing all they can to take care of the growing number of patients.
But with some in such bad condition, caregivers are feeling discouraged.
“You see the nurses who were the absolute best at what they do, and they take pride in what they do, feeling helpless when they can’t help somebody,” Peterson said.
Before seeing patients, caregivers put on protective gear, including masks, shields, gloves and gowns that looks like they’re handling hazardous materials. When they get inside, they put on an additional pair of gloves. Nurses will draw blood, administer medicine and take care of any tasks necessary to care for the patient to limit the amount of trips into the room.
When they’re done with their tasks, nurses will take the outer pair of gloves off and exit the room, rubbing their hands hard with sanitizer on the inner pair of gloves before seeing another patient.
This allows caregivers to wear multiple pairs of gloves, but conserve available protective equipment at the same time.
“Honestly I felt we were doing okay with PPE, but this surge seems to be a little bit worse in terms of how quick it’s going on, how many ICU patients there,” said Wendi Sowell, an infection control nurse. “So we’re back to conserving because we don’t know what tomorrow holds.”
A ripple effect in the system
The growing number of COVID-19 patients has made it harder for other patients to get care, creating a ripple effect throughout the health care system forcing some delays, hospital officials said.
“It’s not even the fear of getting COVID, it’s not being able to take care of people who are not COVID positive because this is so overwhelming to the system,” Peterson said.
Due to the inundation of patients, the hospital has delayed some procedures that can wait.
“This wave has come extremely fast, whereas in December we had this big wave. Now this wave, it’s like we’ve done the growth in a very short window versus where we were in January,” Peterson said.
Powers said the lack of rooms also results in clinicians making difficult decisions.
On Wednesday, 38 patients were in the emergency room instead of on a hospital bed, but no rooms were available. Some of those patients had been there for two days.
Ten patients who had surgeries that couldn’t wait were being held in a holding area because no rooms or staff were available.
Patients also are getting younger in the state’s current wave — dropping the average age of COVID patients from the 70s to the 50s to some in their 20s.
Patients also are staying longer in the hospital. Instead of eight- to nine-day stays, they’re staying more than 20 days.
“One hospitalized patient for COVID may take a bed now for two or three weeks, whereas before they only took a week. That’s the other distinct difference,” Dr. Powers said.
Luckily, younger people have a larger capacity to fight the disease, Powers said. But they’re staying longer, he added.
“It’s a two- to four-week hospitalizations compared to a one week. That means we need four times as many beds to care for all the same number of COVID patients,” he said. “That is a different story than before.”
Those long stays in ICUs can greatly affect a discharged patient’s quality of life, Powers said.
“What do you think happens to your lungs when they’re full fluid? They scar,” Powers said. “What do you think happens to your heart when it’s been inflamed? It doesn’t pump like it should. Patients leave this unit, if they survive, with pulmonary fibrosis and trouble breathing, … with heart failure. That’s what COVID’s done.”
Hospitals are urging the unvaccinated to consider getting the shot — dosages that significantly protect from serious illness.
And doctors, like Powers, said they’ll continue to reiterate that message, over and over again.
“I would encourage them to talk to nurses and doctors who work in a hospital, and ask them what they think. I would not get my source of truth from social media, or other outlets,” Powers said. “People who are in the trenches and…