As Hospitals Strain, Washington DOH Prepares For The Worst

OLYMPIA, WA — Washington's recent COVID-19 hospitalization boom is stretching resources thin across the state, and even has some health leaders mulling worst-case scenarios to prevent the state's health care system from being totally overwhelmed — including potentially rationing health care.

According to a statement released by the Washington State Department of Health Wednesday, state hospitals have already undergone "a number of strategies to stretch resources and mitigate current challenges" but they still may not be enough to handle the influx of new COVID-19 patients.

At a conference Tuesday, the Washington State Hospital Association reported that hospitalizations in Washington had grown 7 percent over the Labor Day weekend, with 1,674 Washingtonians hospitalized for COVID-19 treatment, the Seattle Times reported. At the WSHA's briefing the week before, doctors confirmed that several rural hospitals had been so full of COVID-19 patients that they had had to deny service to patients with other diseases or illnesses.

Denial of service may become more severe as the hospitalization rate continues to grow, warns the DOH. In its statement Tuesday, the DOH confirmed that it had "adopted and plans to use the ethical framework developed by the National Academy of Medicine, which stresses the importance of an ethically grounded system to guide decision-making in a crisis standards of care situation".

To a layperson, that may not mean much, but the sticking point is the reference to a potential "crisis standards of care situation" — it means that state health leaders are considering a situation in which hospitals become so overwhelmed by COVID-19 patients that they have to begin rationing health care, and have taken the steps to outline how health care would be rationed in that situation.

Earlier this week, a "crisis standards of care situation" was activated at 10 hospitals in Idaho. As the Associated Press reports, the declaration allows those hospitals to allot their resources and ICU space to patients who are more likely to survive. Other patients still receive care, but may be placed in hospital classrooms or conference rooms and go without life-saving medical equipment. Patients in need of critical aid but with lower chances of surviving will be given "comfort care" to keep them pain free.

While Washington's current situation is dire, it is not there yet — and hopefully never will be, the DOH says. Though it has now adopted guidelines in case it needs to implement a "crisis standards of care situation", the Washington State Department of Health says before that happens, hospitals are working to spread the stress equally, shifting resources and volunteers to the hospitals with the greatest need.

"DOH is working with state, federal, and private partners to mitigate Washington’s health care surge by accessing additional volunteer and contracted resources, coordinating information sharing, and supporting efforts to shift patients to healthcare facilities that can best support their care," the agency said.

One way Washingtonians can help prevent a crisis is just by seeking out vaccination. The DOH continues to stress that vaccination is the best way to prevent COVID-19 hospitalizations and death: Only one in 200 vaccinated Washingtonians have contracted COVID-19. Of the state's 21,757 vaccine breakthrough cases, just 9 percent of patients required hospitalization and less than 1 percent died of COVID-19 or COVID-related illnesses.

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