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Prepare For Limited Treatment Options As COVID Patients Fill Montana Hospitals

 St. Peter's Health in Helena, MT
Shaylee Ragar
Montana Public Radio
St. Peter's Health in Helena, MT

The surge of COVID-19 cases is leading to rationed health care at a Helena-area hospital. Hospitals around the region say they are hitting capacity.

Dr. Shelly Harkins, the president and chief medical officer of Helena’s Saint Peter’s Health made this sobering announcement Thursday morning.

“For the first time in my career we are at the point where not every patient in need will get the care we might wish we could give," she says.

Harkins says this means the hospital is putting in place what are known as “crisis standards of care” to guide how scarce resources are allocated between patients. Billings Clinic announced earlier this week it may also soon need to adopt those standards.

Saint Peter’s has treated or hospitalized anywhere from 15 to 22 COVID-19 patients at any one time.

“Our ICU is 100% full," Harkins says. “Our advanced medical unit is 100% full, meaning our critical-care resources are at max capacity.”

Harkins received this particularly grim news last Sunday.

“Our morgue is full. For the first time in this pandemic, we face the reality that we’re going to need to bring in additional morgue support. What that actually means is a freezer truck in the parking lot.”

She says the COVID-19 Delta variant is making people far more sick than the original strain last winter.

“These patients are on extremely high levels of oxygen support. Many patients are on levels of oxygen that are like a fire hose,” she says.

The oxygen delivery system is stressed. Specialty drugs to treat COVID-19 are also in short supply.

“Earlier this week we ran out entirely and we had to wait for our allocated shipment to come in — not knowing exactly when that might be. Therefore, through that time no patients got the medication. This is what crisis standards of care looks like,” she says.

Harkins says Saint Peter’s is so overwhelmed that staff are now providing some critical patient care outside of units specifically designed for that purpose. Some patients are getting discharged sooner than normal because there are more sick patients right behind them.

Hospitals across the Mountain West are strapped for valuable bed space. Idaho public health officials are rationing care statewide under crisis standards of care.

Bozeman Health Deaconess Hospital announced this week its critical care unit and surgical unit are at or over capacity.

COVID-19 Incident Commander Kallie Kujawa says hospital officials are actively planning emergency surge plans.

“It can include hiring emergency crisis staffing, which we have done. These types of plans can include scaling back on non-essential services to use those staff in the hospital and acute care setting. Although we have not done that yet, we are prepared to do so,” she says.

The Missoula City-County Health Department announced a new record this week for local COVID-19 hospitalizations. Officials say Missoula hospitals are now overwhelmed with unvaccinated patients. This week, Providence St. Patrick Hospital announced the average age of its patients is now 45 to 50 and that they often require weeks of care. Providence officials say before the Delta variant, the average age of hospitalizations was 80.

Back at Saint Peter’s in Helena, Chief Medical Officer Shelly Harkins says the hospital is facing the same workforce challenges affecting so many other industries. The remaining staff, she says, are tired, stressed and facing an increasingly aggressive public.

“Choose kindness. Every day that staff that I just told you were stepping up and doing the unthinkable — the true heroes — they are verbally assaulted every day. They are yelled at, cussed at, spat at. They have things thrown at them. All because they don't want to wear masks or they don't agree with our visitor limitations,” she says.

She says limitations imposed by hospitals are there to protect patients, staff and caregivers alike.

Saint Peter’s has requested National Guard support to help with non-clinical hospital work.

Gov. Greg Gianforte’s Administration says it’s now reviewing several similar requests from other Montana hospitals.

Copyright 2021 Montana Public Radio. To see more, visit Montana Public Radio.

Edward O'Brien is Montana Public Radio's Associate News Director.