Omicron presents bad ‘math equation’ for Atlanta hospitals, leaders say

Thursday was the third day in a row Georgia set a record for new coronavirus infections, and hospitals called on the public for help
People wait outside of the emergency room at Grady Memorial Hospital. Officials with the Georgia Department of Public Health stressed to the public that hospital emergency rooms should not be used to seek COVID-19 testing unless people are experiencing severe COVID-19 symptoms. 
Thursday, December 30, 2021. Miguel Martinez for The Atlanta Journal-Constitution

Credit: Miguel Martinez for The Atlanta Journal-Constitution

Credit: Miguel Martinez for The Atlanta Journal-Constitution

People wait outside of the emergency room at Grady Memorial Hospital. Officials with the Georgia Department of Public Health stressed to the public that hospital emergency rooms should not be used to seek COVID-19 testing unless people are experiencing severe COVID-19 symptoms. Thursday, December 30, 2021. Miguel Martinez for The Atlanta Journal-Constitution

Hospitals simply can’t keep up with omicron.

Across metro Atlanta, the epicenter of Georgia’s fifth coronavirus wave, hospitals are seeing record-breaking COVID-19 cases amid unprecedented staff shortages. The rapid speed of the omicron variant’s spread isn’t helping.

”With delta, we could get a warning shot from what was happening with surrounding states and knew it was coming,” Dr. Doug Olson, medical director of the emergency department at Northside Hospital Forsyth said of the variant responsible for Georgia’s fourth wave in the summer. “But we didn’t expect it (omicron) to be so rapid and so soon and such an increase in patient volumes. Essentially we have broken all records with volume at our all of hospitals.”

Georgia’s hospitals were pushed to their breaking points in last winter’s surge and this summer’s delta wave, when daily COVID-19 patient counts approached 6,000. At 3 p.m. Thursday, 2,831 people were hospitalized in Georgia for COVID-19, more than triple the number hospitalized on Thanksgiving. But the trendline is ominous.

The state’s hospitals reported a net addition of more than 400 COVID-19 patients from noon Wednesday to Thursday afternoon, an increase of nearly 20% in just 27 hours.

211229-Atlanta-Gov. Brian Kemp holds a press conference to talk about Covid in Georgia on Wednesday, Dec. 29, 2021. Ben Gray for the Atlanta Journal-Constitution

Credit: Ben Gray

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Credit: Ben Gray

The wave of coronavirus has caught off-guard state government and its public health and health care infrastructure. A few days before Christmas, Gov. Brian Kemp told reporters he would not institute any new measures to curb the spread of COVID-19.

”I think from looking where we are, we’re still holding our own,” he said. On Wednesday, Kemp again declined to put in place new restrictions to mitigate the virus, but he announced the state would spend $100 million in federal relief funds to buttress hospital staffing and mobilize 200 National Guard troops to testing sites and hospitals.

On Thursday, Georgia set yet another daily record for new confirmed and probable coronavirus infections with more than 25,000, nearly double the worst day Georgia reported before omicron. It was the third day in a row of record-breaking daily infections, following reports of 13,670 cases Tuesday and 19,894 on Wednesday.

More infections lead to more hospitalizations and to more deaths. A Georgia Department of Public Health spokeswoman, citing data on omicron from South Africa and estimates by federal officials, said the state may not see the peak of the current wave for several weeks.

Hospitals in Ohio, Maryland and Washington, D.C., are also reporting record COVID-19 patient loads.

”We don’t have to look very far to see where things are in other parts of the country that are a few weeks ahead of us,” said Dr. Harry J. Heiman, a clinical associate professor at the Georgia State University School of Public Health.

Before noon Thursday, Grady Memorial Hospital was caring for 175 patients with COVID-19. The hospital’s previous daily pandemic high was in January when it cared for 162 on its main campus and more than 30 others at a field hospital. At midday, Grady, the state’s largest safety net facility, was diverting ambulances to other hospitals. So was Emory Hillandale Hospital in DeKalb County and University Hospital in Augusta.

About 87% of all hospital beds in Georgia were occupied at 3 p.m. Thursday, including 82% of intensive care beds.

Hospital leaders said they were anxious for planned assistance from the state, though none expected it to be enough. Kemp said he will spend $100 million in American Rescue Plan Act funding to hire contract hospital staffing, enough for about 1,000 medical workers for 13 weeks.

File photo of Grady Hospital healthcare workers arrive for work. (John Spink / John.Spink@ajc.com)

Credit: JOHN SPINK / AJC

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Credit: JOHN SPINK / AJC

“I think at this point any help is welcome,” said Dr. Phillip Coule, chief medical officer for Augusta University Health System. Coule said the system had 470 or more vacancies and is getting hit hard. “We’re seeing record Emergency Department volumes. We’re seeing record positivity rates in our testing. We have staff having breakthrough COVID infections (which is) worsening what was an already existing staffing problem.”

Leaders at six major metro Atlanta hospital systems, in a group statement late Wednesday, urged the public to help by getting vaccinated or taking a booster shot. The overwhelming majority of those with serious symptoms haven’t been vaccinated. The hospital officials also told residents who can’t find a COVID-19 test — which is a lot of people — to not come to an emergency room for a test if they don’t need hospital care.

Dr. Robert Jansen, chief medical officer of Grady Health System, said the omicron variant presents a perplexing challenge for health care workers. It spreads faster than previous variants, though at least early indications are that many patients generally have less severe symptoms. That doesn’t necessarily decrease the number of people who need to be in the hospital, as evidenced by Grady’s record-setting stats Thursday.

“This is the math equation,” Jansen said. “The more people you have infected, the more likely you will have people require hospitalization, and a certain percentage of those will get really sick and require intensive care.

It was a busy morning at Grady Memorial Hospital’s emergency department. Officials with the Georgia Department of Public Health stressed to the public that people should not seek COVID-19 tests at hospital emergency rooms unless they are experiencing severe COVID-19 symptoms.
Thursday, December 30, 2021. Miguel Martinez for The Atlanta Journal-Constitution

Credit: Miguel Martinez for The Atlanta Journal-Constitution

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Credit: Miguel Martinez for The Atlanta Journal-Constitution

“ICU use for COVID patients is beginning to increase,” he said.

The situation presented by the variant illustrates why everyone should be concerned with rising case numbers, health experts say. If coronavirus patients flood emergency rooms and hospital beds, it strains hospitals already full of patients with other conditions.

That can diminish the level of care for trauma patients or people who suffer heart attacks or strokes, putting lives at risk.

On a recent day, Grady saw a near-record of about 500 patients with various conditions turn up at its emergency room. That led to long waits for all patients.

Olson, the Northside Forsyth emergency medical director, said the facility is not currently experiencing a significant increase in the number of COVID-19 patients needing to be admitted to the ICU. But, he said, “We are getting a lot of admissions where patients require oxygen.”

Another problem is staff members out sick with symptoms and positive tests.

At Savannah’s Memorial Health hospital, staff callouts have been picking up since Monday. Dr. Stephen Thacker, associate chief medical officer, attributed that and the hospitals’ rising but still manageable COVID-19 caseload to the holiday season.

If the number of staff members working drops low enough, hospitals are forced to treat fewer patients.

“That’s not a sustainable solution either,” Thacker said. “So we’re pulling on every lever we can to get folks to work additional shifts, as well as bringing in part-time and traveling nurses.”

The toll on health care workers has been immense.

“I have never seen such emotional stress on physicians, advanced practitioners, nurses, technicians, everyone,” said Olson. “I know every American has been feeling stress, and for health workers, it has been an extremely daunting couple years, and we just dig in and try to do the best we can.”

In this file photo from September, Dr. Jason Laney looks through charts at Jeff Davis Hospital in Hazlehurst. Dr. Jason Laney, a family medicine doctor who is the closest thing this tiny rural Georgia hospital has to a doctor who's trained in critical care, and has been leading the charge against COVID-19. (Hyosub Shin / Hyosub.Shin@ajc.com)

Credit: HYOSUB SHIN / AJC

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Credit: HYOSUB SHIN / AJC

Atlanta hospitals plead with public to do their part as COVID surges

Six metro Atlanta hospital systems released a joint statement Wednesday night pleading with the public to do their part to curb the spread of the coronavirus.

The six hospital systems — Children’s Healthcare of Atlanta, Emory Healthcare, Grady Health System, Northeast Georgia Health System, Piedmont Healthcare and Wellstar Health System —asked the public to:

— Go to the most appropriate medical facility for your condition when you require care – and do not delay care if you are in need of immediate medical attention.

— Please remember that emergency rooms are for those seeking examination and treatment for medical emergencies, not for routine COVID-19 testing or mild symptoms.

— Anticipate increased wait times for medical services. Due to the influx of patients and increased demands placed on our health care workforce, we ask everyone who enters our facilities to practice patience and kindness with each other and with our care team members who are providing expert, compassionate care.

— Use at-home testing kits, public health testing locations or independent testing facilities if you need to be tested for COVID-19 unless you are ill and need medical care. For routine COVID-19 tests, you can find a location near you on the Georgia Department of Public Health (DPH) website at: dph.georgia.gov/covidtesting.