ELKHART — Even though Elkhart General Hospital has already gone above normal patient capacity following a recent surge in COVID-19 patients, the hospital fears the worst is yet to come.
Since the first wave of the local outbreak had diminished in the second half of summer, the hospital has had roughly 10 COVID-19 patients at a time. But as a second wave that set a record Wednesday for new cases recorded in a day has hit Elkhart County, the hospital now has 29 COVID-19 patients.
“We’ve had a pretty dramatic increase in our hospitalizations,” said Dr. Michelle Bache, vice president of medical affairs at Elkhart General. “That is the effect of the increased amount of community spread that we are seeing in the area.”
The number of confirmed cases per day has more than doubled in Elkhart County over the past month, with a seven-day average of 28 cases per day on Sept. 9 that has been replaced by a daily average now of 71.
From Sept. 9 to Oct. 2 (the latest date with available positive test rate data), the positivity rate for individuals has increased from a seven-day average of 9.1 percent to 16.8 percent; the highest average since July.
More deaths to come
While the first wave of cases in Elkhart County was worst in June, the highest number of people died in July and the first half of August, when an average of one county resident died of COVID-19 each day. From Aug. 15 to Sept. 15, the number of deaths per day fell to 0.44. Since then, the number of COVID-19 deaths has been 0.78 per day. According to Bache, it will likely get worse.
“Deaths and the hospitalizations, those are really lagging indicators,” she said.
The first indicator of a surge is the positive test rate. That is followed by the number of cases, then hospitalizations, and then deaths. The fact the first three have spiked is a “very ominous sign,” according to Bache.
“I don’t think that we are tapped out on our demand for hospital services or, unfortunately, our death rate,” she said.
Most of the patients seeking hospital care are experiencing complications such as shortness of breath, fatigue, fevers and coughs. Elkhart General has had about 500 COVID-19 patients since March: 29 who are still there, 33 who have died, and about 450 who have left. Many of the inpatients are older, Bache said, and a majority of those who have died were at least 60 years old.
Not enough staff
Elkhart General has ventilators and space enough for the current high number of patients but does not have enough people on its staff to handle more. The hospital has increased its number of beds and is currently running above normal capacity.
“We’ve been asking a tremendous amount from our staff, going all the way back to March,” Bache said.
That means the Elkhart General staff members are working longer hours, more shifts, and generally taking on a bigger load than they normally would. The hospital is also using a high number of traveling nurses, but there is a high demand for them in other areas, so they are difficult to get.
“There comes a limit where we can’t push it any further,” Bache said.
So something has to give, and it will likely be elective procedures again, as it was early in the pandemic.
“There are real consequences by delaying those sorts of things too long. That can cause downstream effects to the public and health of our population,” Bache said.
Elkhart General has reached out to the state, asking for help, especially with nurses and respiratory therapists, but given the high demand elsewhere, Bache is not sure what can be provided. There is not much help available from neighboring hospitals either, she said, as Goshen Hospital has also seen an increase in COVID-19 patients and currently has 20, and South Bend Memorial is at 29.
“They are in the same situation we are,” Bache said.
Some things have gotten better, though. As COVID-19 has been around for longer, hospitals are getting better at treating patients. Bache said they are using Remdesivir and Decadron and have gotten better at knowing how to ventilate patients.
People must quarantine
Given the high stakes, Bache strongly encouraged people to take COVID-19 seriously so community spread will decrease.
“People who have exposures really need to be quarantined,” she said. “We can’t have people that get exposed and continue to go out into the community, go to work, do these sorts of things, because that is how we’re spreading it.”
She said researchers believed that about 60 percent of people who get infected with COVID-19 do not show symptoms, so it is not safe to assume that because you feel fine, you are not contagious.
Indiana breaks case record again
Elkhart recorded its highest ever number of new COVID-19 cases on Wednesday, at 131. Another 70 were recorded Thursday and reported Friday, taking the seven-day average to 71 per day, not far below the all-time high average of 78 that was reached on June 18.
Four new COVID-19 deaths were reported Friday. Three of them occurred Thursday, while one occurred Wednesday. A total of 124 Elkhart County residents have died from COVID-19. Twenty-two of them died in the last 30 days.
Indiana on Thursday broke its record, for the second day in a row, for the highest number of new cases recorded in one day, at 1,832. The total number of confirmed cases in Indiana is now 131,493.
The state reported 19 new COVID-19 deaths Friday, taking the total to 3,534. In the last 30 days, 354 Hoosiers have died from COVID-19, according to the Indiana State Department of Health.