Fort hospital faces COVID inpatient boost, staffing woes

By Chris Spangler

Fort HealthCare is not immune to the inpatient surge and staffing woes facing hospitals nationwide as the COVID-19 pandemic enters its third year.

As of Jan. 13, the COVID-19 patient occupancy in the intensive care unit (ICU) at Fort Memorial Hospital in Fort Atkinson was 95%, according to U.S. Department of Health and Human Services data reported by the New York Times. That compares to 83% across Wisconsin and 80% nationwide.

The Times noted that the daily national average number of persons hospitalized with COVID-19, as of Jan. 13, was 148,782, up 79% in the past 14 days. In Wisconsin, 2,400 people were hospitalized, up 35% during that period.

In Jefferson County, an average 33 people were hospitalized with the coronavirus per day, up 25% in the past two weeks. Countywide on Jan. 13, there were 109 new cases of COVID-19 and a seven-day average of 145. 

In light of these statistics, Fort Atkinson Online emailed questions about Fort Memorial Hospital’s patient and staffing situations to Fort HealthCare President/CEO Mike Wallace, who in turn shared them with pertinent staff. Specific respondents were not identified.

“The hospital’s ER/Urgent Care visits averaged 72 visits per day in December, about a 20% increase from the normal volume of 59 visits per day,” hospital officials said.

“About 25% of the visits are individuals presenting with COVID-like symptoms,” they reported. “We have also detected the flu in Jefferson County, which complicates the whole situation.”

The inpatient census has fluctuated between 18 and 29 since the first of December.

“The current surge began in October,” the health officials said. “A normal census for us — prior to COVID — was about 15. We are licensed for 49 beds and are typically staffed for 12 to 18 inpatients.”

The number of COVID-positive inpatients varies day to day.

“We’ve been as high as 11 and averaging around seven to eight per day,” officials said. “The majority of our COVID inpatients are not vaccinated.”

A recent census study indicated that about 80% of patients admitted to the Fort Atkinson hospital due to COVID-19 were not vaccinated.

Although experts say that the Omicron variant of the virus seems to be milder than the Delta variant —- especially in people who have been vaccinated and received a booster shot — its high transmissibility has shot infection rates up nationwide, followed by hospitalizations.

“Since we don’t sequence the specific variant in our testing, it is hard to say whether the Omicron variant is causing a spike in ER visits,” officials said. 

They noted that as of the last week of December 2021, the Wisconsin State Laboratory of Hygiene (WSLH) stated that the proportion of Omicron variant is the predominant variant in Wisconsin (83%), and nationally was the predominant detected (95%).

“It is difficult to say how much Omicron vs. Delta we have here in Jefferson County, as WSLH only takes a sampling,” officials said. “We have seen an increase in ER visits since the beginning of (the) current surge.”

Jefferson County logged 717 positive COVID tests in July and August, 1,731 in September and October, and 3,605 in November and December, per state reported data.

“Just in the first five days of January, Jefferson County had 434 positive COVID tests, putting Jefferson County at a trajectory of 2,700 positives for January alone,” hospital officials said.

In addition to the ER, Fort Memorial Hospital continues to operate its COVID drive-through testing.

“We have seen a surge in individuals seeking testing in the last few weeks,” officials said, citing an average of 45 to 50 patients per day. “That number has gone over 70 a few times in the past weeks.”
They said that 13% of the tests were positive in early November. That rose to 20% in December and 30% of all tests being positive for the first week of January.

Since the beginning of the pandemic, Jefferson County has experienced 195 deaths, according to state-reported data. Twenty-nine of those deaths occurred in November and December 2021.

Staffing ‘severely affected’

Meanwhile, hospital officials said that, like facilities nationwide, the pandemic has severely affected staffing.

“We currently have 80 positions open; we typically have 25 openings at any given time,” they said. “The openings aren’t just clinical positions. There is an undersupply of people available to work across the board.”

Topping the highly-sought-after list are registered nurses.

“Our shortage in nursing is due to many reasons,” officials said. 

They include:

• An increase in the number of patients needing care. 

• The fact that the intensity of the care that a typical COVID patient requires is much higher than an average patient. 

“By the time a COVID patient needs to be admitted to the hospital, they are pretty sick,” officials noted.

• COVID patients stay in the hospital much longer than our average patient.

• Four to five staff have left to work as “traveling” nurses.

• A few nurses have retired since the last big surge.

• “We do have some of our staff that are getting COVID as well,” officials said. “Fortunately, they are vaccinated and are able to return to work quickly.”

The problems are compounded due to the staffing problems being the same story at every other hospital and healthcare provider in Wisconsin and the Midwest.

To help combat the personnel shortages, officials said, Fort Memorial Hospital has:

• Hired contract staff.

• Redeployed staff with the appropriate credentials to help work on the inpatient units and the ER.

For example, these include staff coming from Fort HealthCare’s clinics, surgery and administrative roles.

• Critically evaluated elective procedures to see which can be pushed out to free staff for more urgent areas.

Fort Memorial Hospital staff also are working with area hospitals to provide the best care possible during this unprecedented time, officials noted.

“All hospitals in the area work well with each other,” they said. “We are in constant contact with each other, checking to see where we can transfer patients when their acuity dictates or when we don’t have adequate resources to keep the patient here.

“They all have the same story that we have in the surge of COVID patients and the challenges of staffing,” they added.

Not surprisingly, as the pandemic and seven-week surge in COVID-19 cases continue, healthcare workers are reporting exhaustion, stress, anxiety and frustration that never has been experienced before.

“Not only are we caring for COVID patients, but (we also are caring for) patients experiencing serious acute illness, stroke, heart attacks, car accidents that require immediate care and hospitalization,” officials said. “Due to the high acuity of patient needs and at times the inability to transfer to a tertiary-care facility, we care for patients for an extended stay in the emergency department.” 

Little, if anything, will change without the public’s assistance, they emphasized.

A need for ‘community to help’

“We really need our community to help,” officials said. “We are asking that the public get vaccinated, not only for COVID 19, but for seasonal Influenza. Also important is getting a booster dose that is now available for ages 12 and up.

The Jefferson County Health Department, in alignment with guidance from the U.S Centers for Disease Control and Prevention (CDC) and Wisconsin Department of Health Services (DHS), recommends that all individuals age 12 and older should receive a booster dose of COVID-19 vaccine 5 months after having received their second dose of the Pfizer-BioNTech (Pfizer) or Moderna vaccine. 

All individuals aged 12 or older are eligible for booster doses, which most strongly are recommended for everyone aged 50 and older due to the high risk for severe disease. 

Individuals who received the Johnson & Johnson COVID-19 vaccine two or more months ago also are eligible for a booster dose of any of the available COVID-19 vaccines. 

The Jefferson County Health Department is administering COVID-19 vaccine at the health department Monday through Friday by appointment only. Appointments may be made by calling the department at (920) 674-7275. 

To find other COVID-19 vaccination sites, visit www.vaccines.gov, text your zip code to 438829, or call 211. Persons also may also call (844) 684-1064 or (800) 232-0233. 

Members of the public also is advised to visit their primary care providers rather than seek care in the Emergency Department when appropriate (not emergent).

“Get tested when symptomatic at any location that is available,” hospital officials said. “We are urging everyone to please take care of themselves.”

And they encourage area residents to continue to practice safe hygiene and gathering practices.

“Stay socially distanced, wear an appropriate mask and please be kind to the healthcare workers, as they are being stretched thin,” officials concluded.

Fort Memorial Hospital, File photo/Chris Spangler.

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