Exhausted staff working to meet needs of record COVID cases
While Clay County continues to experience relatively low numbers of COVID-19 cases, area hospitals appear to be struggling to withstand the full brunt of the pandemic's post-holiday spread.
In recent weeks, Union General Hospital in Blairsville, Ga. has seen its highest number of COVID-19 inpatients since the pandemic began, much like the rest of North Carolina and Georgia. North Carolina set a record with 3,992 COVID-19 hospitalizations last Wednesday, Jan. 13, while Georgia set its own new mark the same day with 5,721, the fourth-highest in the nation.
"At Union General, we have well exceeded our capacity for at least two to three weeks," said Julia Barnett, Chief Nursing Officer for Union General Health System. "Our staff is exhausted, they're working extra shifts to make sure we have enough staff to care for the loads that we have. We literally have to find extra space within the hospital where we can make spots for patients to be, where we can care for them. We have made additional units to care for COVID patients while we've been experiencing this surge."
The United States passed a grim milestone Tuesday as the official pandemic death toll reached a staggering 400,000. The nation hit that mark exactly one week after more than 4,300 people died from the virus on Jan. 12 — a single-day record. Georgia has established its own single-day record for COVID-19 deaths five different times during January alone, the most recent mark coming Tuesday as the Department of Public Health reported 170 new deaths.
Clay County Health Department reported only 37 active cases on Tuesday, down significantly from the 63 reported on Jan. 7. The health department also noted 96 cases at Clay Care Center, but specified that those figures are "total numbers only," as several staff and residents have recovered and are no longer active cases.
However, with the absence of a hospital in Clay County, residents who do require hospitalization have become part of the surge that has stretched facilities such as Union General beyond their normal capacity. "Our numbers are pretty evenly distributed as far as COVID patients go from Clay, Cherokee, Towns, Union and Fannin," Barnett said. "It maybe a little bit higher with Union residents, but we see patients from all around the surrounding counties."
Barnett said she watches the statistics at hospitals such as Northeast Georgia Medical Center in Gainesville, Ga., which serves as a kind of bellwether for how Union General's numbers are likely to trend. Judging by those figures, there has been little indication that a break is on the horizon. As of Jan. 14, North Georgia Medical Center's ICU was at 200 percent capacity and staff there have been forced to "treat patients in the hallways and also in the ambulances,” Dr. Deepak Aggarwal told WSB-TV.
With so many hospitals overburdened just like Union General, the facility has thus far managed to avoid diverting patients to other treatment centers. Barnett pointed out that such a decision is akin to a last resort, as it would also take ambulances out of the community for hours at a time in many cases, trying to find a hospital to take patients.
"Even though we've been at and exceeding capacity for weeks now, we have not gone on diversion," Barnett said. "We don't feel like that's the right thing to do as long as we can handle it. We would have to be in an even more desperate situation than we currently are because we want to be able to take care of our community."
The news is slightly better across the state of North Carolina, as the 4,058 new coronavirus infections reported Tuesday are the state's fewest since Dec. 29. Beyond prevention of transmission, healthcare workers' most important asset in the fight against COVID-19 may be the knowledge gained in the year since the pandemic began. A number of key treatments have received emergency use authorization from the federal government in recent months.
The list includes the antiviral drug Remdesivir — one of the therapies received by now former President Donald Trump after he contracted COVID-19 — which has also been a go-to treatment for Union General. Barnett said Union General has access to virtually everything that larger, more urban hospitals have, with the exception of some specialized equipment.
"Our treatments are definitely more effective than they were initially as we've learned and we've tried to rely on our tertiary care centers and their guidance and looking at their protocols, listening to their specialists on what has worked," Barnett said. "We have used lots of Remdesivir and that does seem to be working. Even on the outpatient side, there is a monoclonal antibody called Bamlanivimab that we've tried to take advantage of as much as we can, also on an Emergency Use Authorization, that we've been administering to try to keep people out of the hospital."
Union General has also made use of convalescent plasma — blood plasma collected from donors who have recovered from COVID-19 and now rich in antibodies that can help fight the virus. That treatment is given to infected patients via a blood transfusion, but due to the high demand, the American Red Cross is struggling to keep up with supply needs. The agency has made public pleas for those who have recovered from COVID-19 to now donate their plasma to help others.
As for those on the front line in the battle against COVID-19, Barnett said healthcare workers have been on a constantly-evolving emotional journey since the pandemic began. The early days that were dominated by unpreparedness and a fear of the unknown have since given way to the physical drain of working extra shifts in stifling personal protective equipment.
At the same time, there is an overarching sense of pride about the lives saved within communities in the face of a once unimaginable crisis. "Initially there was a lot of fear, processes that weren't in place, supplies that we didn't have a plentiful amount of, including PPE’s and lack of treatment protocols until we knew what we needed to do for these patients to try to help them," Barnett said. "With this latest surge, it's more of pure exhaustion. I think we have done as good of a job that could have been done to try to take care of our communities and try to push our way through something we never thought we'd be dealing with."