COVID hospitalizations have spiked in the Fox Valley. Health officials warn if behavior doesn’t change, we could be in for a tough fall.
Wisconsin health officials have warned of it since the beginning of the coronavirus pandemic: When case numbers rise, hospitalizations will follow.
For weeks, cases have been burgeoning in the Fox Valley.
Oshkosh, Neenah, Appleton and Green Bay all appear on the New York Times’ list of metro areas in the United States where new cases are rising the fastest. Outagamie County on Wednesday had the second-highest case rate in the state, with 545.2 cases per 100,000 declared in the last two weeks. And the city of Appleton, along with Winnebago County, have each broken records for new cases in a single day or week.
Now hospitalizations have begun to follow at a rate that has some local leaders alarmed — a trend that breaks with what Wisconsin is seeing statewide.
The number of patients hospitalized for COVID-19 has increased four-fold in recent weeks throughout the Fox Valley Healthcare Emergency Readiness Coalition, which includes Outagamie, Winnebago, Calumet, Menominee, Shawano, Waupaca, Waushara and Green Lake counties.
On Aug. 29, 13 patients were hospitalized in the eight-county region. On Wednesday, just over two weeks later, that number had grown to 60.
The area covered by the Fox Valley HERC also makes up a disproportionate amount of the state’s 370 hospitalizations — accounting for 16% of the total patients hospitalized on Wednesday, despite having a combined population of about 550,000, roughly 9% of Wisconsin’s 5.8 million people.
Sixty patients spread throughout eight counties is not an unmanageable number. Fox Valley HERC coordinator Tracey Froiland said in an email Monday that there is “plenty of hospital capacity” throughout the region.
But the speed with which the number of patients spiked has prompted local hospitals to activate their surge plans, which detail how to expand capacity for COVID patients, and triggered concern that area hospitals could be overtaxed later this fall.
Models show that new cases could begin to overwhelm hospital resources by mid-October if the region’s trend isn’t reversed, said Winnebago County Health Officer Doug Gieryn.
“It’s going to really take off from there, if we can’t get a lid on this somehow,” Gieryn said.
Appleton-area hospitals prepare for a sustained increase of COVID patients in coming weeks
Sixty percent of the patients who are currently hospitalized in the region are at ThedaCare Regional Medical Center in Appleton, which has been the health system’s primary location for COVID patients since the pandemic began, said Dr. Imran Andrabi, ThedaCare president and CEO.
The region was lucky to have low hospitalization numbers throughout most of the summer, Andrabi said.
In an email to ThedaCare employees obtained by The Post-Crescent, leaders detailed their plans to begin housing COVID patients at their Neenah hospital as well as at critical access hospitals in Berlin, Shawano and Waupaca.
The hospitals will likely see a continued increase for at least the next several weeks “pending dramatic changes in social distancing and masking practices by the community,” Michael Hooker, vice president and chief medical officer of acute care, wrote in the email.
In a plea to the community to keep practicing social distancing and mask-wearing, Appleton Mayor Jake Woodford also expressed concern that local health systems could become inundated with new patients, as hospitalizations tend to lag a few weeks behind a large surge in confirmed cases.
“If we don’t change something … we are back to square one, where we were back in February and March, and actually probably even somewhat worse off than at that moment in time,” Andrabi told The Post-Crescent Wednesday.
Staff at Ascension Wisconsin’s St. Elizabeth campus in Appleton have noted that an increase in large social gatherings — weddings, funerals, Green Bay Packers watch parties — is driving rapid rates of infection and then hospitalization, said Dr. Tom Nichols, vice president of medical affairs at the hospital.
At the moment, the hospital hasn’t had to use any of its emergency overflow units to house COVID patients, Nichols said, but those units are at the ready.
To blunt the impact on hospital staffing and resources come fall, people must make personal sacrifices to keep themselves and others safe, Nichols said. He said it’s discouraging when doctors and nurses are on their way to the hospital and see multiple cars at someone’s house for some sort of get-together.
“I can’t stress enough how much the behavior of the community has on what the next month or two will look like in the Fox Valley,” Nichols said.
Even as some residents experience “COVID fatigue,” the term linked to the rise in social gatherings and poor adherence to Gov. Tony Evers’ mask mandate, now is the time to step up safe behaviors, Andrabi said, as cases rise and the additional threat of seasonal influenza looms.
Rampant infection could pose risk of illness, mental exhaustion for hospital staff
Even as the state health department has logged multiple record-breaking days of new COVID-19 cases, with a seven-day average of 1,339 cases per day, overall hospitalizations are not jumping up across the state.
Hospitalizations rose statewide from 268 patients on Aug. 29 to 370 on Sept. 16, a far cry from the rate at which the Fox Valley numbers are rising.
State and local officials are unsure what’s driving the sharper increase in this region compared to the rest of Wisconsin, but Andrabi said many new hospitalizations are of people ages 50-59, not the elderly or other populations that have been more typically vulnerable to serious illness from the virus.
So the message hospital leaders will continue to push in the coming weeks is that the community once again has to play a part in flattening the curve, as was the case in spring.
Wearing masks, physical distancing, hand-washing and avoiding larger gatherings are all still the best tools to slow the spread of the virus. Community buy-in on those practices is suffering, Gieryn said.
“It’s a lot easier to keep the levels low than it is to recover from when things get out of control,” Gieryn said. Once hospitals are strained, “it may be too late to come back.”
Beyond bed space and personal protective equipment, there’s another problem should hospitals become inundated with COVID-19 patients: Staff burnout, both mental and physical.
Having 60 COVID patients in the hospital systems already requires a significant amount of resources, Andrabi said.
And ThedaCare employees have already navigated the pandemic with limited PPE and shortages of critical ingredients needed to run coronavirus tests, he said. If infection rates rise to the level where doctors and nurses are getting sick, that further depletes resources.
The Fox Valley has a smaller pool of additional health care providers to pull from should large swaths of hospital staff get sick than large metro areas, Nichols said.
“We don’t want to push our staff to the point of exhaustion,” he said, “and we don’t have to, if the community can really band together.”
Contact Madeline Heim at 920-996-7266 or firstname.lastname@example.org. Follow her on Twitter at @madeline_heim.
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