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“The situation has definitely worsened.” Spectrum Health expands ICUs, requires extra shifts

courtesy of Spectrum Health

West Michigan’s largest hospital system says it can handle the current surge of COVID-19 cases.

But compared to last week, “the situation has definitely worsened,” says Spectrum West Michigan’s president, Dr. Darryl Elmouchi.

Then, Spectrum leaders warnedthat their system, spread across 16 counties, was nearing capacity. On a Thursday Zoom call, Dr. Elmouchi told reporters that this week, the hospitals were adapting.

They’ve delayed about 10% of elective surgeries, and converted those freed-up beds into ICU space. Lung doctors who tend to work in the clinic setting are joining hospital staff, and cardiac nurses are redeploying to the ICU.

But, repeating a warning from state leaders and other hospital systems, Dr. Elmouchi says fallout from indoor gatherings could test that performance. Spectrum is currently caring for 345 hospitalized COVID patients, up 71 from last week.

“We are very worried, as everyone is in the country, about Thanksgiving, and how that might drive those numbers further into December,” he says.

Based on Spectrum's modeling, Dr. Elmouchi says the number of hospitalized COVID patients could reach between 600 and 1,200 by early December.

Since the start of November, more than 700 of Spectrum’s 31,000 employees have called in sick with COVID. Spectrum’s own contact tracers have found that many of those workers were exposed to the virus outside the hospital, and that more than 60% know where.

As cases rise statewide, other contact tracers have been less successful, completing 23% of 39,199 case investigations between November 7 and 13, according to the Michigan Department of Health and Human Services.

Of those completed investigations, only 44% of people know where they were exposed to the virus. 

Spectrum employees have also missed work to take care of school-age children whose in-person classes were cancelled.

“Certainly for some of the areas, we’ve required our staff to work extra shifts,” says Shawn Ulreich, chief nurse executive for Spectrum Health West Michigan.

Dr. Elmouchi says that in Spectrum’s hospitals, the COVID patients who need intensive care are sicker than they were in the spring, which he suspects could be due to treatments like remdesivir and the steroid dexamethasone keeping those with less severe cases out of the ICU.

“When you talk to some of our doctors and nurses, they’ve never taken care of this many very sick patients at the same time," he says. 

MDHHS announced on Wednesday that the state was logging an average of more than 500 COVID cases per million residents every day, and that the average rate of tests coming back positive was more than 12%.

Dr. Elmouchi and Ulreich also solicited plasma donations from recovered COVID patients whose blood might harbor virus-fighting antibodies. It’s been unclear since the pandemic’s beginning how long those antibodies last, but as The New York Times reported this week, a new (though not yet peer-reviewed) study suggests it might be a long time.

A durable immune response is crucial to a future vaccine being effective. On Thursday, Dr. Elmouchi noted the promising early results from two separate vaccine trials. 

"We stand ready and able when a vaccine is available for distribution," says Dr. Elmouchi. "Everything from negative 80 freezers to an entire distribution administration network."

The Detroit Free Press, Bridge Michigan and Michigan Radio have teamed up to report on Michigan hospitals during the coronavirus pandemic. If you work in a Michigan hospital, we would love to hear from you. You can contact Kristen Jordan Shamus at kshamus@freepress.com, Robin Erb at rerb@bridgemi.com or Kate Wells at Katwells@umich.edu.

Will Callan, a reporter for Michigan Radio, hails from the Bay Area, where he lived in Oakland and San Francisco and reported for local newspapers and magazines. He enjoys a long swim in chilly water (preferably followed by a sauna) and getting to know new cities. That's one reason he's excited to be in Ann Arbor, which he can already tell has just the right combo of urban grit and natural beauty to make him feel at home.
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