Saturday, December 9, 2023

GF Hospital busy: Covid surge; more

By Cathy DeDe, Chronicle Managing Editor

Twenty months on, Glens Falls Hospital’s Covid hospitalizations equal or surpass the highest of the pandemic. Tuesday’s count was 44 admissions, seven in the Intensive Care Unit (ICU).

Most chilling, “just between November 10 and 16,” Glens Falls Hospital had four
Covid fatalities, reports Hillary Alycon, the hospital’s Director of Infection Prevention. “That’s consistent, every week.”

Beyond Covid, hospitalizations are up in general, while staffing is down (more about that later in this story).

“The ER [Emergency Room] is busier than a year ago,” said Ray Agnew, Vice President of Community Engagement.

“Behavioral health [and] we’re seeing more people admitted with respiratory illnesses such as pneumonia.” Even: “More babies are being born.”

“Just in raw numbers,” Mr. Agnew said Tuesday, “today we have 198 total in house and last year on this date we had 130.” Assuming 40 Covid patients, that’s still 28 more patients in-house this year, “about a 20 percent increase,” he said.

Based on prior years, the hospital “budgeted” or planned for, say, 130 patients in the surgical unit. Monday they had about 150. In the ER, they budgeted for 112 and saw between 120 and 130 patients. (The Cancer Center number of patients is one area where patient count holds is steady.)

Why the overall surge isn’t clear. Most likely, Mr. Agnew said, “People postponed taking care of themselves, they waited too long and now they have to be admitted.”

Mr. Agnew says, “If you look at the numbers, Warren and Washington Counties are a hot spot in the Capital Region.

“We need to encourage people to not go to work sick. It’s great that sports are happening, but then there’s a lot more travel. All combined: Larger events, letting our guard down. We want to get the message out: Continue to be vigilant. Social distance, masks, get vaccinated.”

“We’re at the highest we’ve ever been, with more inpatients than in the initial days and the second surge December to January 2020-2021,” said Ms. Alycon, who is a clinical epidemiologist.

Glens Falls Hospital has the second highest number of Covid inpatients in the region, behind only St. Peter’s in Albany, Mr. Agnew said.

“Beds are not a concern,” said Mr. Agnew, noting they’re certified for upwards of some 390 beds and they consider 200 a high census.

“We’ve modified a couple of wings” to accommodate additional ICU patients as needed.” They’ve added units to isolate Covid patients from other populations.

“We have capacity,” Mr. Agnew says. “The issue is staffing.” He said that even before vaccination mandates — all staff must be vaxed or lose their positions — “we had shortages of clinical staff and nursing staff. Combine that with high acuity — very sick people, and not all even Covid, though Covid numbers are high now. At one point we had 200 people in the hospital, including 20 Covid cases.” He laments, “It’s the perfect storm.”

Mr. Agnew said Glens Falls Hospital has 38 unvaccinated staff members on unpaid administrative leave. The hospital is “on the bubble” with another 48 who sought religious exemptions. Courts have denied them, “so there’s a good shot we’ll lose some more folks.”

The losses, he said, come ‘“across the board,” from nursing to environmental services to the cafeteria.

With about 2,500 employees, Mr. Agnew says. “Every last one is important. We don’t want to lose a single one. But we do support the vaccination mandate, so — we continue to recruit, and we are using agency nurses where we need to.”

The hospital’s Nov. 1 job fair yielded 25 new hires, Mr. Agnew said — but they have 200 openings, “across disciplines.”

What’s the impact of the staffing shortage? “So far we have not cancelled services like we did last spring,” Mr. Agnew said. “On some occasions, when we have a high census of 200 or more patients, we have had to delay or postpone a procedure that would require an overnight stay.”

Mr. Agnew says: “The uptick in Covid cases, in addition to high volumes of inpatients, high acuity and staffing issues have made it difficult, but Glens Falls Hospital continues to stay open and provide services…We are open for business.

“If you are not feeling well, don’t hesitate to come to the ER or call your physician. We are here for you.”

Mr. Alycon sees Covid fatigue as a factor. “A lot of individuals, they’re just done with it,” she said. “We’re seeing that as some of the spread. They’re waiting five, eight, nine days to get tested. The sheer volume is very real.”

“There are two universes,” she says. “One is the health care people, We’re seeing it’s not done. But in the community, we want our lives back to normal. If you don’t live and breathe it every day…” you’re likely less vigilant.

Ms. Alycon says that from an epidemiological perspective, she expected the pandemic to last two years. “But it’s really about human behavior now. It’s not biology or the pathology of disease.”

Ms. Alycon urges: “If you’re eligible for the booster, get it. If you can be vaccinated, do it. If you’re sick, stay home. In public spaces, mask.”

A new ad campaign jointly created by Warren and Washington Counties’ Public Health departments, Behan Communications, Hudson Headwaters Health Network and Glens Falls Hospital urges Covid precautions and especially getting vaccinated. “It’s absolutely” because of the spiking numbers, Mr. Agnew says.

A few months back, the numbers of Covid patients admitted to Glens Falls Hospital were typically in the teens, with one or two at a time in ICU, Mr. Agnew said.

“Our high point has been about 12 at any point,” he said. “Now we’re over 40, with 7 in the ICU. Considering there are 16 ICU beds, that’s busy.

Changes seen in how Covid presents itself

“With each successive wave, Covid has been presenting differently,” Hillary Alycon, Glens Falls Hospital’s Director of Infection Prevention, tells The Chronicle.

“Initially, it looked like stroke or a heart attack. Then in spring, it presented as a respiratory illness.

“Last summer, people were coming in with altered mental states. Now we see people who are hypoxic, short of breath, lowered oxygen levels.”

That’s the serious cases who are hospitalized, she notes.

In the community, Ms. Alycyon says breakthrough cases might look like a bad cold or allergies.

Get tested, she advises. “Leave no stone unturned when it comes to this thing, because it’s so contagious.”

Ms. Alycon says with Covid, one sick person generally impacts seven others. “You need to isolate sooner than later,” she said. —Cathy DeDe

Who’s hospitalized with Covid?

Who’s in Glens Falls Hospital for Covid during the ongoing surge?

About 60 to 68 percent of the 40+ daily inpatients are unvaccinated, hospital officials told The Chronicle.

The most seriously ill have generally been people who were not vaccinated, and those who are highly at risk with other comorbidities (negative health factors).

Hospitalized Covid patients range from 24 to 97 years old, “a 70-year spread,” said Hillary Alycon, the hospital’s Director of Infection Prevention.

Ray Agnew, the hospital’s Vice President of Community Engagement, says, “We’ve had the stories of a couple of young folks who succumbed. Both were not vaccinated. That should be a warning for folks.”

He added, “As more people are vaccinated, there are more breakthrough cases, but they are less severe and they are survivable.” —Cathy DeDe

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