Akron’s hospitals are starting to near capacity during the current surge in coronavirus cases and hospitalizations, and their leaders are pleading with people to stay home to try to curb the spread and prevent more hospital workers from getting sick.
The leaders of Cleveland Clinic Akron General, Summa Health and Akron Children’s Hospital discussed the situations at their respective hospitals this week during an Akron City Council meeting, where members adopted a 30-day rule limiting the number of guests at private gatherings to six people from outside the home.
Summit County has recorded 20% of all cases during the eight-month-long pandemic in the last week alone. A deeper look coming this Sunday from the Beacon Journal will explore infection rates and the exponential spread by ZIP code in Summit County.
“Our world’s on fire, and we are near the edge,” said Cleveland Clinic Akron General President Brian Harte.
The Akron Regional Hospital Association has reactivated its plans for a mass casualty event, which includes mobile morgues, with the expectation that more people will be dying from COVID-19, said Summit County Public Health Commissioner Donna Skoda.
“This is going to overwhelm our hospital systems, and we never want our hospital systems to get to a point where they have to choose who gets care for what and who doesn’t,” Skoda said. “And I think it would shock a lot of people if they knew that those plans are in place, that if you can’t care for everybody, who really does get to get care, and who doesn’t? And so I think it’s not just the impact on your choice. It will cause a lot of other death and disability for the whole county if we don’t do things differently.”
Summa President and CEO Dr. Cliff Deveny said Monday that the hospital system had 88 people hospitalized with COVID. Three weeks ago, Summa averaged 20 total coronavirus patients in the system’s Akron and Barberton campuses.
“We are averaging about 15 to 20 new admissions on a daily basis,” Deveny said. “We had four people this weekend on heart and lung machines — these are people who were transferred from other hospitals to Summa because their breathing had gotten so bad and their lungs were so damaged that we needed to give them a rest.”
Summa’s intensive care units are 90% full. Three extra COVID units were opened at the Akron campus, and one at the Barberton campus, with Summa on the verge of opening another unit in Barberton “if we can find enough people to work,” Deveny said.
No sign of slowdown
Deveny said at Summa’s urgent care centers, more than 50% of those being tested are positive.
Deveny said the hospitals are prepared with supplies, unlike at past points in the pandemic. The issue now is having enough staff to treat sick patients. Summa has not canceled any surgeries yet, but he said the system is “on the verge of that.”
“The predictions now with the current number of positive cases is that we will see a doubling of the number of patients in the hospital over the next two weeks, and potentially this could go into January if we don’t start to see some really tough interventions around exposing each other,” Deveny said.
Cleveland Clinic Akron General jumped from 17 to 61 COVID-19 patients in the past month.
“Sixteen of those patients are in the ICU,” Harte said Monday. “That’s the second most in the entire Cleveland Clinic health system, behind just the main campus itself [in Cleveland].”
Harte said Akron General is routinely over 95% capacity for adult care. Cleveland Clinic postponed some elective surgeries this week throughout the system, including at Akron General, to maintain bed capacity for COVID patients.
The hospital admits 10 new patients each day, Harte said. He said Akron General opened a second COVID unit last week that is full and expects to open a third unit “imminently.” The hospital is also opening another critical care unit just for COVID patients.
“I am happy to say that many of those patients ultimately get better and go home, but they’re coming in faster than we’re able to discharge them, and about one a day are dying,” he said.
About 25% of the 350 people tested daily at Cleveland Clinic’s two testing locations in Summit County — one in Green, the other in downtown Akron, and only available for caregivers, pre-operative patients or symptomatic patients with a doctor’s order — are positive.
“That number has gone up,” he said.
Bracing for the worst
Harte said the hospital is also prepared with supplies but struggling with staffing, with more than 50 caregivers out sick with positive COVID tests.
“We don’t have the nurses, therapists and doctors to staff enough beds for the worst-case scenarios,” he said. “We can do all we can, but we cannot do everything.”
Harte said in Ohio, there’s been a doubling of cases roughly every two weeks.
“This is the nature of exponential rises that a pandemic is characterized by, which is by the time you realize it’s time to act, you’re already on the vertical part of the curve, and you’re running out of time very quickly,” he said. “In health care and our hospitals, we’re on a very thin margin at this point. We are about out of time, and people are sick and they are dying. What we do today will have an impact starting five to 10 days from now…whatever happens tomorrow has already been decided because of the nature of this particular virus.”
Akron Children’s Hospital President and CEO Grace Wakulchik said Children’s plans to take in patients who are 35 or younger to take as much pressure as possible off of the adult hospitals. With lower rates of hospitalization in youths, the children’s hospital is averaging two COVID-19 patients.
“We’ve got a unit that we can open,” she said. “We’ve got ICU beds, and we have staff.”
Children’s has about 100 employees out either because they’re sick or under quarantine, which Wakulchik said is “community-acquired disease from these small social gatherings of people that they don’t think are gonna bring them the infection, their friends or their family.”
Skoda said in the county, weekly hospitalization rates and emergency room visits are increasing rapidly while hospital bed capacity is diminishing rapidly, with COVID-19 deaths increasing statewide.
“We have increasing hospitalizations. We have increasing death from this disease,” she said. “But more than that, we have families that are left destroyed, and we have families that are left with debilitating conditions for the rest of their lives.”
‘A chronic burden’
Deveny said people need to understand the seriousness of the virus.
“I think people still think this is like the flu oftentimes, that they’re sick for a couple days or they’re in the hospital, then they get home. A third of people who contract this will continue to have problems for the rest of their life,” including cardiac, liver and kidney problems, he said. “People who are admitted to the hospital once with COVID will be back in the hospital again; 10% of those people would be back in the hospital within 30 days. So this is gonna be a chronic burden on this community for years to come.”
Deveny, Harte, Wakulchik and Skoda all said small private gatherings are driving the current surge. Skoda specifically said it’s not tied to businesses or the classroom, but to people’s activities outside of those locations.
Wakulchik said medical professionals are “very concerned” about Thanksgiving and encouraged people to stay home and only have meals or gatherings with family members who live in their homes.
Skoda described the current situation in Summit County as “extensive and uncontrolled community spread.” She said the current surge is partly related to Halloween gatherings, noting there’s been an increase in cases after holidays in the past.
“What has happened with this virus is we have slowly tried to get back to what we perceive as more of what we would call a normal life,” she said. “When that happened, we started to increase our risk levels.”
Bubbles are bursting
With school back in session, Skoda is getting first-hand accounts of parents allowing children to have friends sleep over or play games after what would be a normal school day.
“You may know them well, and you may be related to them, but they are not in your bubble,” she said. “Unless they sleep in your house every night, they’re not in your bubble. But we started to let our guard down. And then so as a result of that, what we have started to see is exponential case climb.”
Skoda noted the surge is being mirrored in congregate living settings, like long-term care facilities, as the people who work in those facilities live in the community and bring it back in to the facilities.
People need to realize that what they think is a cold might not be just a cold, Skoda said. She also noted it’s flu season, although she hopes it will be a mild one, given people should be wearing masks and staying away from each other.
“I think I talked to 20 people this week doing initial investigations who told me oh, I just thought it was a cold, so I went to my family’s quote-unquote birthday party, sat out at an igloo at a restaurant, any number of things,” she said. “And now everybody’s positive because they thought they had a cold.”
Skoda said “the last thing I think any of us want is a shutdown of small businesses again,” but she said that could be a reality if the pandemic doesn’t get under control, despite the devastating effects it would have on employees, small businesses and the economy.
“We want to blame the classrooms. We want to blame noncompliant businesses. But really it’s just people being people,” she said. “They get together. They think all is fine. They haven’t seen their relatives in five, six months. They’re excited. They think because they’re related, that they’re family, and that it’s all gonna be OK. But it’s not.”