WA Hospitalization Rates Steady, But 'Things Are Still Very Bad'

SEATTLE — After weeks of COVID-19 hospitalizations surging to new highs in Washington, including another all-time record set over Labor Day, admission rates may finally be starting to plateau — but health care leaders are a long way from celebrating. The Washington State Hospital Association hosted its weekly news briefing Monday, warning that the state's health care system remains stretched near its limit.

"Things are still very bad," said Taya Briley, a registered nurse and executive vice president of the WSHA. "This week, we have 1,673 COVID hospitalizations, compared to last week's number of 1,674. While these numbers are steady, they are still very sobering."

Briley said plenty of uncertainty lies ahead heading into the fall, especially as more activities resume.

"We are in the midst of the worst peak of COVID cases that we have experienced since the beginning of the pandemic," she said. "We could be at the beginning of a plateau but we also don't know the impact of large events that are occurring across our state, including fairs and other social events. Labor Day was not that long ago, and school events are also resuming, so we're unsure of the impact of those events."

While hospital admissions leveled off, Briley said the number of patients on ventilators increased, from 251 last week, to 260 by Monday morning.

"This is unfortunately consistent with what we know about the course of COVID," she said. "There is a lag time between when people get sick, when they're hospitalized ... and after some time they may need to be placed on a ventilator if they've nor improving. Unfortunately, we expect that this number will probably continue to trend up some."

The overwhelming majority of COVID-19 hospitalizations continue to be among unvaccinated patients, while the vaccinated people who require care tend to have compromised immunity.

"More than 95 percent of those that are hospitalized are unvaccinated," Briley said. "That is a staggering number, which means that almost all of these cases could have been ones that did not occur. Those that are vaccinated and are in the hospital usually have an underlying condition. They might be immunocompromised from having an organ transplant, or they might be immunocompromised from receiving cancer treatment."

With Washington's hospitals are stretched thin, the added strain from a prolonged surge in COVID-19 admissions has ramifications well beyond patients with infections.

"We are actively canceling surgeries that people need to be able to function at a very basic level of life," Briley said. "We're also really worried about those who need emergency treatment and whose treatment is being delayed. For example, for those who are experiencing a heart attack or a stroke ... there is a narrow window of time which people can receive treatment and have minimized loss of heart tissue or brain tissue."

So far, Washington hospitals have avoided activating "crisis standards of care," but a growing surge in Idaho is adding another layer to the challenge in Eastern Washington. As the New York Times reported Monday, Washington hospitals are fielding a growing number of requests for aid from hospitals in Idaho, where vaccination rates are among the lowest in the United States and officials have declined to enact mask orders or other precautionary measures.

"Our colleagues in north Idaho are struggling with an incredibly difficult situation," Briley said. "Parts of it have declared crisis standards, which means that they will be needing to make decisions about what patients receive life-saving care and which patients do not. This is obviously having some ripple effects into our Spokane hospitals and therefore across the state."

In Washington, officials said staffing levels continue to be the primary challenge — a long-term problem that predates the pandemic.

"To the extent that resources are constrained in our state, it is almost entirely driven by not having enough staff," Briley said. "We have room in our hospitals to care for patients. What we don't have is the ability to staff those beds."

Three unions representing more than 71,000 nurses and health care workers released a joint statement Monday, calling Washington's hospitals "on the brink of unprecedented crisis" and demanding immediate action to address inadequate staffing.

"COVID has been a stress test on our health care system, and we are seeing the system fail that test due to management's choice to understaff," said Jane Hopkins, executive vice president for SEIU Healthcare 1199NW. "Retention bonuses for frontline workers who have stayed on the job, adequate pay for extra hours worked, and aggressive hiring to staff at full capacity would go a long way right now."

With October deadlines fast approaching for state employees and health care workers to become fully vaccinated or face termination, hospitals are also bracing for the potential staffing impacts brought by workers who refuse to comply.

"We have been really concerned about the impact of the requirement on our staffing levels," Briley said. "Just last week we learned that there will be a similar national requirement that will be put into place by the Biden administration. We are hopeful that because this will be a nationwide approach ... that we will have less attrition of staff perhaps to other states is they had a different type of requirement in place."

WSHA officials said they did not have data detailing vaccination rates among the state's health care workers, but percentages could vary widely by facility and geography.

"There are still a number of unvaccinated staff across our state, including in rural areas in particular," Briley said. "Hospitals are working with those staff to encourage them to be vaccinated, and there is still time to have those folks vaccinated."