After a brief lull in new COVID-19 cases following the rollout of the vaccines in late spring and early summer, the surge of the more lethal and contagious delta variant continues to put a strain on Wyoming’s medical facilities hit by record hospitalizations and staff shortages.
As of early October, Wyoming’s two largest hospitals, Cheyenne Regional Medical Center and Wyoming Medical Center in Casper, were still operating at or near maximum capacity, with very few ICU beds open, according to data self-reported to the Wyoming Department of Health.
Smaller hospitals, too, were struggling to keep up with the influx of COVID-19 patients, such as Sheridan Memorial Hospital, an 88-bed facility in northeast Wyoming that has been operating at peak capacity for several weeks.
On average, the hospital is treating anywhere from 12 to 15 new COVID patients per day, CEO Mike McCafferty said. And though this number is down from the nearly 20 patients per day they saw at their peak in mid-August, it’s nonetheless a struggle to care for patients while balancing limited staff resources on top of quarantines and illness.
“Like other health care facilities, we’re dealing with staff shortages, which is exacerbated among increased illness and the depletion of other resources,” he said, noting a national staff shortage that by some estimates exceeds more than 100,000 unfilled registered nursing positions. “It’s been a challenge for shift supervisors to keep all of the positions filled in order to keep up with patients.”
This new surge is affecting the hospital in different ways than it did last year, McCafferty noted, when they did a lot of preparation planning for the spike. This time, it’s not as much an issue of a shortage of supplies than it is with balancing manpower, which has been made worse by the pandemic and the physical toll it’s taken on staff health.
“It’s disheartening,” McCafferty said. “These people are professionals and are doing great work. They keep showing up and dealing with sickness and the heartache of family members. It’s very hard to continuously do that day in and out.”
Another challenge has been finding patients the specialized care needed at other neighboring facilities they’ve traditionally relied on, but that now are also grappling with limited open beds and staffing shortages. For example, McCafferty said, they would typically send a burn patient to Salt Lake City or a pediatric emergency to the children’s hospital in Denver.
“What we’re seeing around the region now is that there’s no availability for those transfers, in a lot of cases,” he said, which has prompted them to do procedures they typically wouldn’t do themselves or forced them to transfer patients to distant facilities like Seattle or Portland.
In other cases, they’ve been able to accept overflow patients from Billings, Montana, and elsewhere when they’ve had open beds, he said. Otherwise, they’ve been deploying and rotating staff to give them breaks and rest, as necessary, and doing the best they can to keep up with services and demand.
In Gillette, Memorial Hospital of Converse County is also working at peak capacity with limited resources. As of Oct. 6, nine of their 10 ICU beds were filled, as were 18 of their 19 beds in their medical/surgical wing. Of that total, 15 were COVID patients. On average, the hospital has treated about 15 COVID patients every day, according to numbers provided for the past week.
The hospital placed all inpatient elective surgeries on hold until Oct. 8, according to Karen Clarke, community relations director for MHCC. They are still performing outpatient elective surgeries and inpatient and all emergent surgeries, as needed, Clarke said, and plan to resume inpatient elective surgeries based on bed availability that they monitor every day.
Like Sheridan, MHCC is grappling with a staff shortage, with several open nurse and certified nursing aid positions to fill as they juggle existing staff amid shortage and staff illness. On Oct. 6, they had 24 staff members out sick with COVID or other illnesses, Clarke said.
“We are asking all staff to work additional shifts to cover, often in areas that they don’t normally work, such as a surgery nurse to work in the ICU,” Clarke said by email.
The hospital also has 13 Wyoming National Guard members helping with housekeeping, laundry and other duties, Clarke noted, after Gov. Mark Gordon on Sept. 21 deployed 95 Guard members to work in 24 hospital locations throughout the state.
Other facilities like Cody Regional Health have suspended nonessential surgeries among a skyrocketing number of COVID hospitalizations. In August, the hospital converted an entire wing for COVID patients, which they hadn’t done since the peak of the pandemic last year.
As of Oct. 5, the COVID wing was at full capacity with 11 patients and no available ICU beds, according to self-reported information from the state's Department of Health.
At present, Cody Regional Health is still operating in a “crisis standard of care,” according to Ashley Trudo, marketing and public relations director for the facility, which means no nonessential surgeries at this time.
With regard to meeting the staffing demand, Cody Regional Health has implemented a Pandemic Premium Pay Policy through the end of October to incentivize extra hands, though Trudo declined to comment on the amount of that pay or whether they’ve had to temporarily hired outside staff or traveling nurses to meet that demand.
Other hospitals around the state are likewise weathering the storm as they balance staff fatigue and shortages with the influx of both COVID and other patients. On Sept. 30, 18 of the 21 available beds at Memorial Hospital of Converse County were full. Half of those were COVID patients.
Like other health care facilities around the state, they’ve been experiencing a steady flow of COVID hospitalizations for the past couple of months, though they have yet to suspend elective surgeries or any other services as a result, said Terry Moss, chief operating officer.