Local hospitals try to keep up with COVID-19 while prepping for vaccines

The bad news is that more people than ever are in Boulder County hospitals with COVID-19; the good news is that patients have a better chance of avoiding the most serious or deadly outcomes compared to when the pandemic began.

“We have been thrilled with the progress we’ve made since March as health care providers, learning how we take care of these patients,” said Boulder Community Hospital Vice President of Operations and Chief Nursing Officer Jackie Attlesey-Pries. “We are able to support them in a different way than we first did in March, so that we are seeing patients coming in and leaving the hospital sooner and in better condition.”

Attlesey-Pries said that in March, 50% - 60% of patients ended up in the ICU where they got the most critical care, including ventilators. That’s down to 20% - 30%, “which means we’re preventing them from getting sick to the point where they need a ventilator, which is really good news,” she said. “We’re supporting their respiratory system with oxygen. Patients do better if they can get through that critical period without a ventilator.”

Steroids have also proven to be an important factor in better outcomes, Attlesey-Pries said. BCH is also using drugs that have been given emergency use authorization by the FDA, like Remdesivir, when specific situations call for it. “There aren’t a lot of drugs to give these patients. There isn’t that magic drug to give them,” she said.

Outcomes may be improving, but some people still can’t be saved. There is typically a rise in the number of COVID-19 deaths two to three weeks after hospitalization numbers rise. Boulder had 115 deaths as of Monday. That’s why Attlesey-Pries and others are pleading with the public to follow proven public health strategies that help prevent infections - physical distancing of six feet or more, wearing masks and washing hands.

The number of COVID-19 cases has gone up after every holiday, so things may only get worse in the next couple of weeks. Attlesey-Pries is echoing what the Colorado Department of Public Health and Environment is saying about keeping Thanksgiving celebrations contained to people that live in the same household. It’s a tough ask, but there is no telling who might be infected with a highly contagious virus that can be spread by people who don’t show symptoms.

The number of people hospitalized at BCH went from 10 - 12 patients in early November, to 17 last week. This number is expected to climb higher since a rise in hospitalizations comes about two weeks after a surge in positive cases. That is likely to put pressure on staffing.

Attlesey-Pries said BCH is getting by for now. “We certainly don’t have extra staff hanging around. Everybody is working really hard. They are stretching and picking up extra shifts and working really hard to continue to care for all of the patients who need our care at this point.”

BCH recently set up an incident command system to deal with potential staff shortages. It allows the hospital to quickly adjust as numbers fluctuate. Attlesey-Pries said there are volunteers on standby. Some are physicians and nurses, including those who may have retired recently, while others are in various medical positions and may shift over to patient care, primarily as helpers for front line staff. Attlesey-Pries is an administrator now, but she said it’s likely that she will be using her nursing experience to assist the medical staff in the future.

Some BCH staff have become sick with COVID-19 over the course of the pandemic, though Attlesey-Pries said only one contracted it at work. The hospital is offering wellness and resiliency support services for a workforce that faces pandemic stress on several levels. “They are stressed at work and in their personal life, like the rest of everybody else. Everybody is isolated. They have kids home from school. All the things that everybody is going through,” she said.

The hard work has not gone unnoticed. The hospital has received emails and letters from patients, families and the community.

One person thanked the hospital staff for supporting patients who are cut off from outside visitors, helping them stay connected through Facetime and other virtual technology. “Not only is your medical expertise key to help patients deal with the trauma of COVID, your compassion to reduce the fear that family members and patients experience is incredible,” the person wrote. “Thank you for being the family to those who are isolated and dealing with their worst fears - being alone.”

Marie Groh from Gunbarrel sent an email to BCH after seeing a post on Nextdoor that said hospital staff were getting stressed, depressed and exhausted and would be uplifted by some positive words. “That was the best idea I heard in a long time so I just ran with it,” she said.

Groh’s words were welcomed, laid out on a beautiful blue background and emailed to the staff. Attlesey-Pries raved about it and said that kind of appreciation helps keep everyone going. It read in part, “We know you’re all exhausted. We know the anguish you feel for every lost soul in your care. We want YOU to know that there are millions of us in this country who really, really, REALLY appreciate you and think of you often with so much gratitude and reverence. Please give yourselves a hug because we cannot hug you.”

There may be plenty more reasons to write letters of encouragement in coming months. Experts warn that winter is likely to bring more hardship for the community, patients, families and the essential workers who take care of the sick day in and day out.

But there is hope on the horizon. BCH expects to receive sub zero freezers any day now in preparation for storing the new Pfizer vaccine. The hospital ordered the freezers months ago and has additional refrigerators and storage for vaccines that don’t need sub zero temperatures.

Front line hospital workers and first responders are expected to be prioritized once the vaccine is distributed. Attlesey-Pries said the hospital will then help vaccinate different segments of the community as manufacturing ramps up and additional vaccines get FDA approval.