Home Health News As Rural COVID Patients Are Moved To Nearby Cities, Hospitals Struggle To Cope : Shots

As Rural COVID Patients Are Moved To Nearby Cities, Hospitals Struggle To Cope : Shots

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Saint Luke’s Hospital of Kansas City is among the 18 hospitals within the Saint Luke’s Health System. Two-thirds of the COVID-19 sufferers transferred to Saint Luke’s from rural areas want intensive care. “We get the sickest of the sick,” says Dr. Marc Larsen.

Carlos Moreno/KCUR


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Carlos Moreno/KCUR

Saint Luke’s Hospital of Kansas City is among the 18 hospitals within the Saint Luke’s Health System. Two-thirds of the COVID-19 sufferers transferred to Saint Luke’s from rural areas want intensive care. “We get the sickest of the sick,” says Dr. Marc Larsen.

Carlos Moreno/KCUR

Registered nurse Pascaline Muhindura has spent the final eight months treating COVID-19 sufferers at Research Medical Center in Kansas City, Missouri.

But when she returns residence to her small city of Spring Hill, Kansas, she’s usually surprised by what she sees, like on a current cease for carryout.

“No one in the entire restaurant was wearing a mask,” Muhindura says. “And there’s no social distancing. I had to get out, ’cause I almost had a panic attack. I was like ‘What is going on with people? Why are we still doing this?'”

Many rural communities throughout the U.S. have resisted masks and requires social distancing throughout the coronavirus pandemic, however now rural counties are experiencing record-high an infection and demise charges

Critically ailing rural sufferers are sometimes despatched to metropolis hospitals for high-level remedy, and as their numbers develop, some city hospitals are buckling below the added pressure.

Kansas City has a masks mandate, however in lots of smaller communities close by, masks aren’t required — or masking orders are routinely ignored. In the previous couple of months, rural counties in each Kansas and Missouri have seen a few of the highest charges of COVID-19 within the nation.

At the identical time, about three out of four counties in Kansas and Missouri do not have a single intensive care unit mattress, so when individuals from these locations get critically ailing, they’re despatched to metropolis hospitals.

A current affected person depend at St. Luke’s Health System in Kansas City confirmed 1 / 4 of COVID-19 sufferers had come from outdoors of the metro.

Two-thirds of the sufferers coming from rural areas want intensive care and keep within the hospital for a median of two weeks, says Dr. Marc Larsen, who leads COVID-19 remedy at St. Luke’s.

“Not only are we seeing an uptick in those patients in our hospital from the rural community, they are sicker when we get them because [doctors in smaller communities] are able to handle the less sick patients, and we get the sickest of the sick,” says Larsen.

Dr. Rex Archer, head of Kansas City’s health division, warns that capability on the metropolis’s 33 hospitals is being put in danger by the inflow of rural sufferers.

“We’ve had this huge swing that’s occurred because they’re not wearing masks, and yes, that’s putting pressure on our hospitals, which is unfair to our residents — to our residents that might be denied an ICU bed,” Archer says.

A study newly launched by the Centers For Disease Control and Prevention confirmed that Kansas counties that had mandated masks in early July had decreases in new COVID-19 circumstances, whereas counties with out masks mandates had will increase.

Hospital leaders have continued to plead with Missouri’s Republican Governor Mike Parson, and with Kansas’s conservative legislature, to implement stringent, statewide masks necessities however with out success.

Parson received the Missouri gubernatorial election on Nov. 3 by practically 17 factors. Two days later at a COVID-19 briefing, he accused critics of “making the mask a political issue.” He says county leaders ought to resolve whether or not to shut companies or mandate masks.

“We’re going to encourage them to take some sort of action,” he said Thursday. “The holidays are coming and I as governor of the state of Missouri am not going to mandate who goes in your front door.”

In an e-mail, Dave Dillon with the Missouri Hospital Association agreed that rural sufferers could be contributing to hospital crowding in cities, however argued the pressure on hospitals is a statewide downside.

The causes for the rural COVID-19 crisis contain way over the refusal to mandate or put on masks, in line with health care specialists.

Both Kansas and Missouri have seen rural hospitals shut for yr after yr, and public health spending in each states, as in lots of largely rural states, is much beneath nationwide averages.

Rural populations additionally are typically older and to undergo from larger charges of persistent health circumstances, together with coronary heart illness, weight problems and diabetes. Those circumstances could make them extra vulnerable to extreme sickness after they contract COVID-19.

Rural areas have been grappling with health issues for a very long time, however the coronavirus has been a form of tipping level, and people rural health points at the moment are spilling over into cities, explains Shannon Monnat, a rural health researcher at Syracuse University.

“It’s not just the rural health care infrastructure that becomes overwhelmed when there aren’t enough hospital beds, it’s also the surrounding neighborhoods, the suburbs, the urban hospital infrastructure starts to become overwhelmed as well,” Monnat says.

Unlike many elements of the U.S., the place COVID trendlines have risen and fallen over the course of the yr, Kansas, Missouri and several other different Midwestern states by no means considerably bent their statewide curve.

Individual cities, reminiscent of Kansas City and St. Louis, have managed to sluggish circumstances, however the continuous emergence of rural hotspots throughout Missouri has pushed a sluggish and regular improve in general new case numbers — and put unrelenting pressure on the states’ hospital methods.

The months of sluggish however steady development in circumstances created a excessive baseline of circumstances as autumn started, which then set the stage for the sudden escalation of numbers within the current surge.

“It’s sort of the nature of epidemics that things often look like they’re relatively under control, and then very quickly ramp up to seem that they are out of hand,” says Justin Lessler, an epidemiologist at Johns Hopkins Bloomberg School of Public Health.

Now, a current native case spike within the Kansas City metro space is including to the statewide surge in Missouri, with a median of 190 COVID sufferers per day being admitted to the metro area’s hospitals. The variety of individuals hospitalized all through Missouri elevated by greater than 50% within the final two weeks.

Some Kansas City hospitals have needed to divert sufferers for durations of time, and a few at the moment are delaying elective procedures, in line with University of Kansas Hospital chief medical officer Dr. Steven Stites.

But mattress house is not the one hospital useful resource that is operating out. Half of the hospitals within the Kansas City space at the moment are reporting “critical” staffing shortages. Pascaline Muhindura, the nurse who works in Kansas City, says that hospital employees are fighting nervousness and depression.

“The hospitals are not fine, because people taking care of patients are on the brink,” Muhindura says. “We are tired.”

This story comes from NPR’s health reporting collaboration with KCUR and Kaiser Health News.



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