Open Mics With Dr. Stites: Caring For Rural COVID Patients Without an ICU

The number of COVID patients being treated at The University of Kansas Health System is back down today. 31 with the active virus are being treated, down from 33 yesterday. Just seven of those 33 are vaccinated. Nine patients are in the ICU, down from 12 yesterday, with only one vaccinated. Seven are on ventilators, the same as yesterday. 33 other patients are still hospitalized because of COVID but are out of the acute infection phase, down from 38 yesterday. That’s a total of 64 patients, down from 71 yesterday. Those vaccinated patients continue to have other serious medical problems besides COVID, and would have been much sicker without the vaccine.
Today it was Open Mics With Dr. Stites. Joining Steve Stites, MD, chief medical officer at The University of Kansas Health System, were Dr. Heath Latham, specializing in pulmonary and critical care medicine at the health system and Dr. Jonathan Pike with Great Bend Family Medicine. As the Great Bend campus has seen more COVID patients in recent weeks, finding a hospital to transfer more serious cases has been a challenge. We also heard more on how our doctors here in KC are helping doctors and patients in smaller communities.
Dr. Pike kicked off the discussion by explaining the challenge of treating very ill patients in a hospital like Great Bend which does not have an ICU. He says it’s been very hard telling some sick people they can’t stay there, as the hospital has only 29 beds and 30 to 50 percent are full of COVID patients. That’s why he says the collaboration between Great Bend and the health system’s main campus has been “an absolutely phenomenal benefit.” Being able to share medical records and have variety of specialists to consult has made caring for many seriously ill people in Great Bend much easier, especially since there are often no beds available in bigger cities. He says often staff spend half their shift on the phone looking for beds, and sometimes they get lucky if they call the right hospital at the right time that just had an opening. He says it’s like “being the 7th caller to a radio show and actually getting in for the prize.” He reminds everyone they still have regular non-COVID patients to treat, who often need extra care, and mentioned two other huge benefits of the collaboration. One is infectious disease consults and the other is lung cancer screenings. He says COVID in his community is not isolated to meat plants like a year ago but more in the general population, and he says infections there usually lag about two weeks behind bigger cities. He says it would be huge to reduce the number of COVID patients in his hospital by 80 percent and the only way to do it is get everyone vaccinated. To those who ask, “Why should the vaccinated be afraid of the unvaccinated if the vaccines are so effective?” he says there’s a fine line between fear and caution and vaccinated people are trying to be cautious for all of the people around them.
Dr. Latham has been giving many consultations to Great Bend doctors and patients, especially when no beds are available here, which is more and more common. He told the story of a small hospital that tried 20 places to find a bed for a critically ill patient, who ultimately made it to the health system after a 70 mile drive to an airport for a flight to get here. He says that’s become common as big city hospitals are full of COVID patients. Sometimes through consultation, the patient is able to be stabilized and stay in their community hospital, which he calls a big win. He described some of the physical changes the health system made, such as regulating airflow, to accommodate COVID patients and described some of the advanced masks and protective equipment worn by the staff caring for them. He believes that for the foreseeable future, masks will be required in healthcare settings. He urges everyone to get vaccinated so he and his colleagues in the ICU can open up for all the critically ill patients across the region.
Dana Hawkinson, MD, medical director of Infection Prevention and Control at The University of Kansas Health System, compared COVID vaccines to a seat belt. Wearing one won’t prevent you from getting into a car wreck but will protect you from those severe injuries. Just like the vaccines won’t prevent you from getting COVID but will make any symptoms much less severe and keep you out of the hospital. He discussed vaccine boosters and said we may all be getting one. He adds the current vaccine still offers great protection, and the boosters will help decrease transmission even more. As for masks, whether it’s cloth or surgical, he says the best one is one that offers the tightest fit around your face. He also says we need to be prepared for a flu season with more cases this year since mask requirements have eased since last year, when the flu was nearly nonexistent.

[katemayer]

Your channel is heartwarming and professional. I'm so glad I found you and I hope others do too. Great way to end on stewardship, Dr. Stites. Keep up the great work! -Kate in Chicago