Sickest patients overflowing ICU at Tri-Cities largest hospital. Almost all unvaccinated

The Tri-Cities largest hospital is looking closely at how to ration its intensive care unit beds, as ICU patients are overflowing into other departments due to COVID-19.

On some days every staffed bed in the intensive care unit at Kadlec Regional Medical Center is used for a COVID patient, said Dr. Phani Kantamneni, medical director of the Kadlec ICU at a news briefing of the Benton Franklin Health District on Thursday.

Already the state of Idaho has taken the unprecedented step of activating its crisis standards of care for parts of the state, requiring rationing of hospital care because of a lack of beds and staff solely due to the impacts of COVID, said Dr. Amy Person, health officer for Benton and Franklin counties.

Beds and equipment are not available for all patients admitted to hospitals, the Idaho Department of Health and Welfare said earlier this week.

Already at Kadlec surgical cases are being canceled each day and some patients ill enough to need ICU care are instead being treated in the post-operative ward or the emergency department because the ICU is full, Kantamneni said.

Demand for intensive care unit treatment at Kadlec has continued to increase over the last few weeks, with 60% to 100% of staffed ICU beds occupied by COVID-19 patients, he said.

At one time last week the ICU had 21 patients on mechanical ventilators, all of them COVID patients, he said.

And he said the ICU is treating more people ages 20 to 50 for COVID than elderly people, a shift from a year ago in the pandemic.

“Almost everyone that is sick enough to come to the ICU and be on the mechanical ventilator is unvaccinated,” Kantamneni said.

He can only recall four or five patients since COVID-19 vaccine became available to the public who were sick enough to be admitted to the ICU and most had good outcomes, he said.

The ICU has treated no patients for vaccine reactions, he said.

“Please get vaccinated,” he said.

“It not only prevents you from getting sick enough to come to the ICU, it mitigates the spread,” he said. “And if your loved ones need care in the ICU or in the hospital or the OR the chances that they get it are higher if the community vaccination rates go up.”

Tri-Cities slow vaccinations

COVID vaccination rates are increasing at about 1% a week, which is not enough to alleviate the stress on hospitals, Dr. Person said.

In Benton County, 43% of all residents are fully vaccinated and in Franklin County 36% are fully vaccinated. That’s an increase over the last week of less than 1 percent in each county.

Vaccination rates continue to lag the Washington state rate, with 56% of residents statewide fully vaccinated, according to the Washington state Department of Health.

New COVID-19 cases in the Tri-Cities area are primarily in unvaccinated people, Dr. Person said.

About 91% of cases are in people who are not vaccinated, making those who are not vaccinated 10 times more likely to develop COVID, she said.

“If you are not vaccinated, you are much more likely to be hospitalized, to require ICU care and unfortunately potentially to even die from COVID,” she said.

In Benton and Franklin counties, 19 deaths from COVID-19 have been announced already in September, compared to 23 in August and 10 in July, she said.

“While our case rates may be plateauing, we know hospitalizations and deaths tend to lag, so unfortunately we will likely continue to see increasing hospitalization and deaths due to COVID-19,” she said.

Tri-Cities hospitals struggle

The number of hospitalized patients being treated for COVID-19 averaged 38 per day in July and 90 and August, with patient counts exceeding 100 most days in the last three weeks.

Nearly one in three hospitalized patients in Benton and Franklin counties are being treated for COVID, Dr. Person said.

On Thursday, 115 patients were being treated for COVID-19 at hospitals in the two counties, matching the record high number reached Tuesday.

“All of our area hospitals continue to struggle with the demand for beds and with staffing shortages,” she said.

Hundreds of students in Benton and Franklin counties missed the first days of school this fall because they were sick with COVID-19, she said.

The problem is not a spread within classrooms, but the high rate of COVID-19 transmission in the community, she said.

Discussions on whether to wear masks, as required in public indoor places, and to be vaccinated continue to divide households and the community, she said.

The discussions are important, but resources in the community, including hospitals, clinics and first responders, are stressed to the limit, she said.

“When we think about our freedom and our choices, we also need to think about the consequences of those decisions,” she said.

Benton COVID cases down

The Benton Franklin Health District reported 262 new cases of COVID-19 on Thursday, down from the week’s peak of 367 new cases on Wednesday.

New cases so far this week, starting with the weekend, have averaged 241 a day.

Last week new daily confirmed cases averaged 230 per day.

The Benton County the case rate dropped to 909 new cases per 100,000 people over two weeks, as of Thursday.

That is down from a new case rate high of 980 earlier this month, but still above the previous case rate peak in the winter.

The Franklin County new case rate Thursday continued to rise, reaching 1,088 new cases per 100,000 over two weeks.

However, the rate of increase appears to be slowing, Dr. Person said. The new case rate has not yet reached the highs reported for Franklin County in the winter.

New case rates in both counties are highest in ages 29 to 30.

“This age group represents our biggest source of transmission in the community and also our greatest opportunity to make an impact through vaccination,” Dr. Person said.

This story was originally published September 9, 2021 at 1:20 PM.