On the second-floor intensive care unit at Mercy Health’s Saint Mary’s Hospital in Grand Rapids, Eric Prichard, a nurse anesthetist, pulled on a pair of blue rubber gloves and headed into the room of a COVID patient who had just been put on a ventilator.
A month ago, or even a few weeks ago, Prichard may not have been here.
As a nurse anesthetist, he’s normally part of a team that helps patients prepare for surgeries. Back surgeries. Knee surgeries. The kind of surgeries that Saint Mary’s has had to postpone as the number of COVID patients has spiked.
“We’ve redeployed a lot of our surgical service staff in order to support other operations in the hospital,” said Dr. Matt Biersack, the hospital’s president.
One floor above, a neurological unit has been converted to mostly care for COVID patients. In recent weeks, staff have had to double up patients in rooms, leaving only a small fabric curtain between them.
Rachel Catinella, a nurse in the neuro unit, said figuring out how to treat two patients in a room designed for only one has created challenges for staff. But that’s not the only challenge.
Catinella said nurses who treat neurological issues have seen death before in their units. Seeing patients die from COVID though — it’s different.
“They deteriorate really quickly,” she said. “They’re younger a lot of times, they get really sick really fast. Sometimes [the hospital is] full, it’s hard to get them transferred to the ICU fast enough. And [it’s] a lot more death than we’re used to seeing.”
For hospital workers across the state, the scenes are becoming more familiar. After weeks of surging COVID numbers, many hospitals have reconfigured rooms, reassigned staff and done everything possible to cope with a fourth surge of COVID-19 in Michigan.
On Wednesday, the state of Michigan reported this surge has now hit hospitals harder than any of the previous surges. The number of confirmed COVID cases in Michigan hospitals now stands at 4,419, according to data published by the state on Wednesday. That’s a new record high.
“And if this trend continues unabated, it truly is going to create an untenable situation for our hospitals,” said Brian Peters, president of the Michigan Health and Hospital Association.
“It is absolutely fair to describe the situation we’re in now as a crisis,” Peters said.
And it’s a crisis that most hospital leaders say was completely avoidable.
“Not a generic plea.”
It was almost exactly one year ago when the first doses of a COVID-19 vaccine were administered in Michigan. Health care workers at Spectrum Health in Grand Rapids, and at Michigan Medicine in Ann Arbor, were the first to get their shots. Not long after, millions more Michiganders joined them, sometimes lining up at massive vaccination sites staffed by National Guard troops. But many people in the state held back, worrying that the vaccines had been rushed, that the federal government’s approval of them was for “emergency use” only. Still others fell victim to online misinformation campaigns, believing in increasingly bizarre conspiracy theories about the vaccine.
Today, nearly 200 million people in the United States have been fully vaccinated against COVID-19; more than five million of them live in Michigan. Despite early fears, the CDC reports serious side effects from the vaccines have been rare.
Meanwhile, the risks of not being vaccinated have become much worse.
Medical experts warn that the 44% of people in Michigan who remain unvaccinated are putting not only themselves at risk, but increasingly, their entire community.
In recent weeks, as the number of coronavirus patients spiked, hospitals began publishing updates on how many of those patients had been vaccinated. At Spectrum Health in West Michigan earlier this week, 86% of people hospitalized with COVID were unvaccinated, according to the hospital system. At Henry Ford Health System, in Southeast Michigan, 78% of COVID inpatients were unvaccinated. At Bronson Healthcare, in Southwest Michigan, the number is at 59% as of Wednesday.
Doctors have pleaded with increasing urgency for anyone who hesitated before to get the shot now, if not for themselves, then to help lessen the onslaught of patients crowding hospitals.
“I want to stress that this is a health care capacity crisis, not just a COVID crisis,” said Dr. Scott Gibson, an emergency department physician at Bronson’s Kalamazoo hospital during a briefing yesterday that was streamed online by WWMT-TV.
Hospital leaders say they were already dealing with high numbers of patients in their hospitals, in part because of an increase in illness from delayed procedures last year, and in part because hospitals almost always see an increase in patients this time of year.
But the skyrocketing numbers of mostly unvaccinated COVID patients has sent nearly every hospital in the state into crisis mode.
That’s having an effect on all patients, not just those diagnosed with COVID.
At Oaklawn Hospital, a small community hospital in Marshall, chief medical officer Dr. J. Summer Liston-Crandall said several patients have arrived after heart attacks, only to have to wait days, or even weeks to be transferred to another hospital that can perform a cardiac catheterization. Patients with brain bleeds have been sent home from the emergency department to recuperate, rather than being transferred to a larger hospital with neurosurgeons on staff who can evaluate the patients. And other patients have arrived at the hospital’s emergency department only to be given counseling on end-of-life care and a referral to hospice, without the patients ever being admitted to the hospital.
These types of events were rare before, Dr. Liston-Crandall said at Tuesday’s briefing. Now it’s happening often. And the only way to begin to reduce the burden, she said, was for more people in the community to get vaccinated against COVID-19.
"[A]s much as I want to allow my patients and the community to come willingly to the decision to get your COVID vaccine, we are now at the point where we all must.”Dr. J Summer Liston-Crandall, Chief Medical Officer at Oaklawn Hospital in Marshall.
On Tuesday, Dr. Liston-Crandall said Oaklawn nearly ran out of ventilators, before more arrived Wednesday morning. The hospital’s entire critical care unit was full of COVID patients, and two-thirds of all the beds in the hospital were occupied by COVID patients, most of them unvaccinated.
“We are in crisis,” Dr. Liston-Crandall said at Tuesday’s briefing. “And as much as I want to allow my patients and the community to come willingly to the decision to get your COVID vaccine, we are now at the point where we all must.”
“Our health care system in our town cannot support the care of the largely unvaccinated patients in the hospital,” she said. “This is not a generic plea. This is a plea for our town, and our region of Michigan, to step up and get vaccinated, wear your mask indoors and quarantine as required.”
What’s next
Even as hospitals and staff buckle under the strain of an increasing number of COVID patients, hospital leaders say you won’t see outside field hospitals popping up anytime soon.
Dr. Darryl Elmouchi, president of Spectrum Health West Michigan, said health officials learned in the early days of the pandemic that these remote sites were a challenge to set up, and often went unused. And, anyway, these types of sites are usually reserved for sudden, short, catastrophic events.
“COVID is obviously anything but a short event,” Elmouchi said.
Instead, the plan for now at most hospitals is to continue to add capacity where they can inside existing hospital buildings. This means doubling up patients in existing rooms, converting surgery recovery areas to inpatient treatment, placing beds in hospital conference rooms or offices and looking for any other space within the hospital that can be converted to care for patients.
At many hospitals, these expansions have already taken place. Elmouchi says Spectrum Health’s ICUs currently operate at 140% of its previous capacity.
At Saint Mary’s hospital in Grand Rapids, staff have been reassigned, rooms reconfigured. In one corner on the third floor, a row of chairs and tables is lined up against the wall, after being removed from patient rooms.
“We don’t have room for furniture anymore because we need to fill that space with hospital beds,” said Dr. Matt Biersack, the hospital president.
Over the past week, there has been one hopeful sign at this hospital: The number of COVID patients has stopped increasing. Biersack said it’s too soon to know if his hospital has seen the peak. But he knows it hasn’t seen the end.
And what he hopes for, he said, is for more people outside the hospital’s walls to realize just how bad things have gotten, just how dangerous COVID still is, especially for those who remain unvaccinated.
“Because it is real,” he said. “It is taking the lives of younger and younger people. It is unrelenting and it is very apolitical.”
Virginia Gordan contributed to this report.
This story has been corrected. A previous version incorrectly abbreviated the name for Mercy Health Saint Mary's, and had incorrect spelling for Rachel Catinella.
