In mid-June, Tidelands Health of South Carolina, which covers the Myrtle Beach area, had only 3 patients with COVID-19 in its system.
That number exploded for 50 patients in just over 2 weeks.
“It was very fast,” said chief operations officer Gayle Resetar MedPage today.
The system’s ICU capacity is now 90%, and could add an additional 10 to 12 ICU beds, but there is no team to oversee them, said Resetar. A total of 58 employees, including health professionals, contracted the disease.
Personnel recruitment has also been a challenge at the Medical University of South Carolina (MUSC) in Charleston, which served only 6 patients with COVID-19 in mid-June. Last week, he was treating 110 COVID-19 patients.
“He just grew up, grew up, grew up,” said CEO Patrick Cawley MedPage today.
As of now, Cawley said he has “the physical beds, but can I get the team to cover those beds? That will be a problem in the next four to six weeks. We are early, but close.”
South Carolina hospital executives are warning that a growing wave of COVID-19 cases threatens to overwhelm their systems.
Although South Carolina was barely touched by COVID-19 in early spring, it averaged nearly 2,000 cases a day in mid-July, with a total of more than 63,880 cases and 1,053 deaths at the end of last week.
Melanie Matney, head of operations for the South Carolina Hospital Association, said the increase is putting a lot of pressure on hospitals, especially those in the Charleston area, in Horry and Georgetown counties (which include Myrtle and Atlantic beaches) and the metropolitan area of Columbia.
“It’s difficult. I’m not going to sweeten it,” said Matney MedPage Today. “The biggest problem we are working on now is the team. Our health team is not immune to the spread of the community. This harms the health workforce ”.
Tidelands Health
In May, Tidelands Health – which has two acute care hospitals, two inpatient rehabilitation facilities and 50 outpatient centers in Horry and Georgetown counties – was 25% below typical census numbers. It is now 25% ahead of a typical July census. Resetar attributes all this increase to COVID-19.
She said the system had expanded the ICU staff, reserved the emergency department for “the most sick” and organized drive-through test events for asymptomatic people.
Cars line up for COVID-19 tests outside a Tidelands health facility in mid-June. (Photo courtesy of Tidelands Health)
Elective surgeries with hospitalization were also suspended again. The clinical team was relocated to the ICU and offered financial incentives for the team to work extra shifts. Resetar has also hired temporary staff, but few clinical nurses are available, she said.
In addition, as the system cut elective surgeries at the start of the pandemic, it began to fall short of normal staffing levels and has yet to reach the full level. “It is a big challenge for the team,” said Resetar.
Another problem: 58 Tidelands employees, including healthcare professionals, hired COVID, forcing them to be quarantined for two weeks. Most appear to have contracted the infection outside the hospital, said Resetar.
The clinical staff at work is feeling overwhelmed, she said. During the first three weeks of the increase, they accepted the challenge. “But it wears out over time,” she noted.
Last week, about 30 to 40 National Guard doctors assisted in the next round of Tidelands tests, in the parking lot of the city’s secondary league baseball stadium, a Tidelands Health spokesman said. Doctors can also help with Tidelands DEs soon.
“It doesn’t give me nurses in the ICU, but any extra pair of hands would be welcome,” said Resetar. “Every avenue we can explore, we are exploring.”
The good side: the system has enough PPE at the moment.
Some people in the area still believe that COVID is a scam, said Resetar, although she has noticed more use of masks recently.
“We have tourists all over the beach,” she said. “There have been a lot of PSAs trying to get the message across, so I hope they have been heard.”
In the meantime, COVID is costing Tidelands more than just operational sanity. The reimbursement for COVID care does not fully cover costs, said Resetar. More than half of the patients in the system are older than 65 and are generally covered by Medicare, which typically pays less than private insurers. COVID’s patients also stay longer in the hospital and suspending surgery is depriving the system of profitable procedures.
Health MUSC
Although MUSC Health has been able to open new units whenever it can find enough staff to serve them and is currently able to “take care of everyone”, Cawley is not optimistic that his system can continue on this path.
Tourists flooded Charleston over the weekend of July 4, and he expects to see a sudden increase in the coming weeks.
Cawley is concerned with ensuring enough staff to care for the patients from this increase; he said that hospitals across the state are in similar ties and compete for the same diminishing number of available talent.
Meanwhile, many of MUSC Health’s current employees have been affected by COVID, and Cawley said they are generally catching the disease in the community. Of a total of 12,400 employees, 325 tested positive during the pandemic – 166 in the past two weeks, according to a spokesman for MUSC Health.
The outbreak forced Cawley to delay equipment and IT upgrades, and to permanently fire some non-clinical employees. “Financially, we are going to deal with this for a long time,” he said.
The surgeries continued, but Cawley fears that a second wave will force them to be suspended again, further damaging the hospital’s finances.
Can the tide be changed?
South Carolina hospitals are accustomed to deploying emergency plans, Matney said, especially coastal centers that face hurricanes almost annually. But in this case, they need the help of the whole community, Matney said.
“We have to stop the spread,” she said. “It is essential … If we can delay what is happening, we are optimistic.”
Governor Henry McMaster (R) is wearing a mask and encouraging people to follow that leadership, but refuses to institute the mask requirement. He was one of the first governors to reopen his state in early May, while the number of COVIDs was still low – and before the state’s coastal cities started to fill up with tourists.
McMaster said he will not close the state again. He is working with the South Carolina Hospital Association to spread messages about combating the spread of the virus, Matney said.
Other obstacles include the federal government’s order to move from the CDC to the Department of Health and Human Services (HHS) platform, which has only complicated efforts, Matney said. The new HHS surveys are more specific, which helps, but in general the change means “we don’t have big eyes for what’s going on right now”.
Still, Matney said she and other state officials have joined health executives in their determination to survive the increase.
“We will make sure,” she said, “that we are going to face this problem together.”