The temporary personnel will enable hospitals to discharge hundreds of patients who been stuck in a bed they didn’t need because a long-term care or other facility didn’t have enough stuff to accept them
BY LYNNE TERRY AND ALEX BAUMHARDT, Oregon Capital Chronicle
Oregon officials are working to discharge hundreds of hospital patients who have been languishing and taking up critically-needed beds because the care they need in the community isn’t available.
The move is expected to free up hospital beds for the still-growing influx of Oregonians so ill with coronavirus they need hospitalization.
State officials said Thursday they are contracting with staffing agencies to add hundreds of employees to personnel in long-term care facilities and skilled nursing homes, creating the capacity to care for those still stuck in hospitals.
They also intend to hire hundreds of additional health care professionals to help hospitals cope with a massive influx of patients expected by the end of the month.
All together, the state will add 1,800 nurses and other staff to ease the burden of the state’s exhausted health care workers, who’ve often worked longer hours, watched patients die and dealt with supply shortages.
Patrick Allen, director of the Oregon Health Authority, announced the additional staffing contracts at a news conference on Thursday. He said the state has expanded its existing contract with Jogan Health in Colorado and signed a new one with Maxim Healthcare Group in Maryland to supply the new workers. These new professionals will join just over 600 contract staff that are already on the job, Allen said.
The new temporary workers will include a “rapid relief pool of 200 health care professionals who will stand ready to be deployed to facilities that are on the brink of being overwhelmed,” Allen said.
Gov. Kate Brown also bumped up the mobilization of National Guard members: 1,200 will be in hospitals by the end of the month, performing transport, cleaning, logistical and other duties to allow clinicians treat patients.
The measures come as the number of Oregonians infected with coronavirus soar to unprecedented levels, and state and local health officials try to manage a wave of seriously ill people in already-strained hospitals and clinics.
The announcement of a major increase in contracted health care workers comes two weeks before an expected peak in the number of COVID-19 patients needing hospitalization. As of Thursday, nearly 780 people infected with COVID are in Oregon hospitals.
“Our statewide ICU capacity is now at 5%,” Allen said. “Hospitalizations are more than 45% above the past week.”
COVID forecast largely unchanged
Peter Graven, an assistant professor at Oregon Health & Science University, forecast again on Thursday that the peak in hospitalizations is expected by the end of the month, with more than 1,600 people with COVID-19 needing hospitalizations. Graven said he expected that the latest surge of omicron cases to start in urban areas and fan out to rural parts of the state.
“That’s already happened,” Graven told lawmakers on Thursday during a meeting of the House Interim Special Committee on COVID-19 Response. He said the variant, which appears to be the most infectious one yet, has affected “all our regions.”
“They’re all increasing,” Graven said.
That level of hospitalizations would dwarf the peak of last September, when about 1,200 people were hospitalized. According to the Oregon Health Authority’s data, most areas of the state were running out of hospital beds on Thursday.
Gilliam, Hood River, Sherman and Wasco counties have no adult intensive care beds available, while hospitals in Benton, Lincoln, Linn, Marion, Polk and Yamhill counties only have one of 85 that is free. The Portland-area west to Tillamook County has 6% of its intensive care beds for adults available but only 1% of its regular adult beds.
“The system is really teetering on the edge,” Becky Hultberg, president and CEO of the Oregon Association of Hospitals and Health Care Systems told the House COVID-19 committee on Thursday.
She said about 600 patients currently in hospital beds are waiting to be admitted to a long-term care or other facility. Another 200 patients are “boarding” in emergency rooms, waiting to be moved to a more appropriate setting, like a residential care facility for behavioral health patients.
To address that issue, which has plagued the health care system throughout the pandemic, the state is hiring 600 licensed practical nurses and registered nurses to work in long-term care facilities throughout the state.
Allen said the state is doing all it can to avoid a situation in which hospitals have to turn patients away.
Last week the health authority released guidelines in case a hospital runs out of beds, which happened on a few days last summer at the peak of the delta surge. But he said he can’t be completely confident that the new contracted staff will be enough.
“We’re doing absolutely everything we think we can to get as much staff as we possibly can,” Allen said. “It really matters a lot if there are relatively fewer people in ICUs.”
Omicron appears to cause less severe symptoms than the delta variant but it spreads much faster. The unvaccinated are at the highest risk but even those with booster shots only have a 50% chance of not becoming infected if exposed to the virus, experts said. Nevertheless, vaccination helps stem severe disease.
Last month, the state set a goal of getting an additional 1 million people boosted by the end of January. Allen said at the news conference that Oregon will miss that goal.
“It’s no secret we’re behind the pace we need to reach the booster goal,” Allen said. “Right now we’re likely to hit about 650,000 new boosters by the end of the month.”
State reaching testing capacity
Allen said there are plenty of vaccines in Oregon for people needing first, second or third doses. What the state needs more of, however, are COVID tests.
Finding a rapid COVID-19 test in a store is practically impossible. When shipments do arrive, they often sell out in minutes, pharmacists say. It often takes a few days to make an appointment at testing sites, Allen acknowledged, with long lines at walk-up sites.
“These frustrations are real and they may be with us for weeks,” Allen said, adding that “Oregon’s testing volume has never been higher than it has today.”
He said the state currently ranks 16th in the number of tests given each week. Last week, labs processed more than 300,000 tests, Allen said, and is nearing its “maximum capacity” to test. It wasn’t clear whether that was due to a lack of staff or tests.
Allen said the state is asking the federal government to add three new testing sites in the Willamette Valley, Allen. Tribal leaders at the Spirit Mountain Casino at Grande Ronde will open a high-volume vaccination site on Saturday with testing provided next week. Kathleen George, council member for the Confederated Tribes of the Grande Ronde, said at the news conference the tests would be open to everyone.
The state also has purchased 6 million rapid antigen tests, which each contain two tests, but they have not arrived as quickly as expected.
Last week, Oregon received nearly 590,000 test kits from iHealth, the manufacturer, and on Wednesday, nearly 400,000 test kits arrived, bringing the total to nearly 1 million. Nearly 1 million more are expected within the next week, Allen said.
“We expect to have all 6 million test kits in the state by the end of January,” Allen said.
They won’t be available to the public. Allen said the priority is to get the tests to hospitals and schools, along with local public health authorities, tribal governments, community based organizations serving communities disproportionately affected by the pandemic, Head Start programs and organizations who serve farmworkers and the homeless.
“Our test distribution strategy is grounded in fairness and equity,” Allen said.
In recent days, some schools have closed or switched some classes to online because of infections among staff. Each district is making its own decision on how to react to staffing shortages and quarantines of students and staff. The state Education Department said it would continue to leave that choice to local school officials.
There are more than 1,300 schools in Oregon and few have had to switch to online learning during the current surge of infections, Colt Gill, Education Department director, said during the news conference. “Only a few dozen schools have had to make a temporary move away from in person learning,” Gill said. “Holding school in person remains the highest priority for our state and for everyone in each of our schools.”
The Salem-Keizer School District, the state’s second largest, decided to close Friday because of inadequate staffing. Other districts in the Portland area and rural Willamette Valley school systems such as in Dayton have announced some or all of their schools will temporarily close.
Education Department officials said they have no plans to recruit more substitute teachers to fill empty jobs as the state has done with hospitals and long-term care centers.
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