As hospitals across Alaska become overrun with COVID-19 cases, Fairbanks Memorial Hospital has been taking in seriously-ill patients from other regions this week.
The hospital has converted waiting areas and conference rooms to make space for more patients, said Dr. Angelique Ramirez, chief medical officer of Foundation Health Partners, which operates the Fairbanks hospital.
As of Tuesday, the Fairbanks hospital reported 72 inpatients, and 18 of them had COVID-19. That’s 25%, a huge indicator of a statewide spike of coronavirus infections, Ramirez said during a presentation Tuesday at a Greater Fairbanks Chamber of Commerce meeting.
“We had a spike in November-December. We had a spike and we were unusual in April-May, we were the only ones that did. And we kind of learned how to manage surge capacity. It was challenging,” she said. “But now we are in a spike far bigger than anything that we have seen to date. And unfortunately we’re in it at the same time as many places across the country and Alaska.”
That means resources are spread thin.
Alaska hospitals work together to share the load, and when one is full, patients are diverted to the others, especially those needing intensive care.
During her presentation, Ramirez showed the data she watches to track statewide hospital capacity. On Tuesday, Fairbanks Memorial Hospital was the only place with any room.
“Across Alaska, all of our ICUs have been full,” she said. “Fairbanks, we are the only ones today and yesterday that has ICU capacity.”
In Anchorage hospitals, she said, patients are waiting in emergency rooms for an ICU bed to open up.
In the prior 48 hours, she said, four patients from outside the region had come to Fairbanks for treatment.
Also, Ramirez said, an important indicator of the pandemic is how many people are testing positive for COVID-19.
“So out of all the measures, this is the one that I look at the most closely,” she said. “This is the earliest sign because the testing positivity rate goes up first, then your case counts, then the hospitalizations, and then the deaths. You want to be responding when the testing positivity rate goes up, so you can get prepared.”
Ramirez said the local positivity rate is 15%.
“Our highest prior to this spike was 9%,” she said. “This tells us that we have a lot more people out there in the community who have COVID, who are not aware that they have COVID.”
In the mix of all the other challenges, is a staff shortage. The hospital has 200 open positions – that’s twice the normal vacancies.
As of Monday, the hospital had stopped doing some specialized procedures like endoscopies because the staff was needed elsewhere.
“We are working with staff that are extremely exhausted,” she said. “We have been short for a long time now, and people are leaving health care by choice.”
Ramirez said a big factor in the burnout is caring for patients who could have protected themselves and not ended up in the hospital.
During the previous Interior Alaska spike of COVID-19 last spring, Dr. Barbara Creighton said in a presentation “this place is on fire with COVID.” She was quoted widely. And that quote still feels relevant today, said Ramirez.
“This place is on fire with COVID does now become a little bit of a mantra for clinicians to feel like being in a burning building and that everyone else outside is walking by and not doing anything,” she said.
There are bright spots, she said: The hospital has strategically rearranged areas to handle more patients and to keep non-COVID patients protected from the disease. And they have converted a waiting room into a treatment room for COVID-19 patients who want to avoid a hospital stay by getting an infusion of monoclonal antibodies.
“If you know of anybody who tests positive who’s at any type of increased risk, this is a phenomenal treatment and only takes 20 minutes,” she said. “We were only doing like three or four a day, and now we’re doing 18, 20, 22 every day.”
The treatment room didn’t exist two weeks ago, but now is open for monoclonal antibody infusions from 7:30 a.m. to 6 p.m. seven days a week.