Hospital staff at Northeast Georgia Health System and first responders are struggling to find bed space for patients as today the number of COVID-positive patients hit a new record.
“We’re used to having one of three busiest Emergency Departments in the state here in Gainesville, but our current situation is unlike anything we’ve ever seen,” said Dr. Mohak Dave', Chief of Emergency Medicine for NGHS. “We’re treating patients in hallways and waiting rooms every day. Sometimes patients have to spend the night there, because there’s no bed available.”
The latest report this morning from the NGHS website shows 340 COVID-positive patients, a new record, are being treated across all Northeast Georgia Medical Center hospitals and long-term care facilities. The next-closest number to that record was 322 COVID-positive patients on December 22, 2020.
Today, there are 22 hospital beds available between the four Northeast Georgia Health System campuses. There are fifteen available beds at the Gainesville location and seven at the Braselton campus.
The number of administered COVID-19 tests from NGHS coming back positive is at 34 percent, according to Dr. Deepak Aggarwal, Chief of Medical Staff for NGHS. Aggarwal said that this number is also a record high for the healthcare system and approaching double the state average.
In addition to the rise in hospitalized patients and positive tests, Aggarwal said that the death toll has also increased in the last 30 days.
"We’ve seen more than 150 COVID-related deaths in the past 30 days, which accounts for roughly 25% of all the COVID-related deaths we’ve seen during the entire pandemic," said Aggarwal.
Despite the influx of patients, spokesman for NGHS Sean Couch said in an email statement that the hospitals are “generally accepting ambulances”. However, according to Davé, with nowhere to take the patients, hospital staff at NGMC Gainesville have no choice but to treat them inside the ambulance.
“In the past two weeks, we’ve had moments when we can’t bring a patient in from an ambulance because there’s literally no place to put them in the Emergency Department – so our nurses and doctors treat the patient in the ambulance until we find space inside,” said Dave'. “That also holds up the EMS services, because their ambulances have to stay parked and are not able to respond to the next call.”
In the meantime, hospital staff are encouraging the public to only call for an ambulance if they have a true medical emergency.
"If you need health care, try seeing your primary care doctor or an urgent care center – unless it’s a true emergency," said Aggarwal. "If you need to come to the emergency room, know you may wait longer than normal. If you need to be admitted to the hospital, it may take several hours and perhaps spending the night in an area you’re not used to like a waiting area or hallway."
Aggarwal encouraged the public to continue following the 3 Ws- wear a mask, wash your hands, watch your distance.
Davé said that staff at the NGMC Braselton campus have also struggled to find a place for patients. But despite this strain on hospital staff and first responders at both hospitals, he said that they will continue to treat every patient that they can.
“While some hospitals might simply stop accepting patients via ambulance and redirect them to other places, we see it as our responsibility to care for as many patients as possible. We’re this community’s hospital, and a safety net for the entire region,” he said.
In Banks and Habersham counties, first responders are experiencing the struggles described by Dave'.
“When you have the capacity issues that hospitals have and the staffing issues that hospitals have, everything starts backing up,” said Habersham County Emergency Services Director Chad Black. “That of course transfers into the pre-hospital sector that we handle. When we’re picking up patients and transporting and you’ve got 10 to 15 ambulances waiting to unload a patient, there’s only so much the hospitals can do.”
Black said he has been told every hospital south of Gainesville is on diversion.
“Northeast Georgia, thank goodness, has not diverted us,” Black said. “They are taking patients. I know of an ambulance from Northwest Georgia that came to Northeast Georgia [Medical Center]...10 hospitals declined them is my understanding.”
Black said that COVID-19 has only exacerbated the staffing issues faced by most EMS providers in the region and state. Like officials at NGHS, Black and other EMS providers encourage those who are not experiencing a true emergency to utilize local doctors or urgent care clinics rather than tie up ambulances and hospital emergency beds.
However, he said that true emergency patients are not being left in the parking lot without care.
“Cardiac arrests, strokes, major trauma, heart attacks, they see those,” Black said. “They’re not sitting out waiting, but the other minor stuff that can be triaged they’re trying to get them in as quick as they can.”
Black said delays at hospital are creating issues for outlying counties whose travel time already places ambulances out of service for an hour or more.
“All that does is delay us that we can’t come back and run calls in this county – or White County,” Black said. “Yesterday we sent two ambulances to White County to help them out. The day before, Hall County was here helping us, so it’s a domino effect.”
EMS providers do not blame the hospitals for the issue but urge the public to think seriously about whether they have a true emergency that cannot be handled through a doctor, urgent care center, or by going to the hospital in a personal vehicle.
The words serious and critical should be considerations in whether to call 9-1-1 for an ambulance response.
“If you need help, by all means call for help,” Habersham County Emergency Services shared in a social media post Wednesday. “But this is not the time to use the system when it’s not needed. Services are at a breaking point, so please use the system as it’s designed to be used – for emergencies.”
Otherwise, the result can be delayed response and care for those in true need of immediate medical intervention, such as car wreck or accident victims or those experiencing a life-threatening illness in which seconds count.
“It leaves us without any ambulances in the county,” Black said. “The minor ailments or ‘my head is congested’ is not a reason to call an ambulance, for example. Go to the local doctor or find an urgent care, but when you tie up an ambulance even in normal times is not good.”
Black said mutual aid agreements with surrounding counties are crucial, but not always viable under current circumstances.
“Trying to rely on mutual aid may not be a possibility,” Black said. “The next two to three weeks are going to be critical following New Year’s.”
In fact, medical providers predict things will get worse before improving.
“We anticipate it may be some of the worse times we’ve seen,” Black said. “We’re not going to have an ambulance to send to somebody if they’re tied up on calls that are not justified and if they’re waiting to offload those patients, whether it be at Habersham or Gainesville.”
As a rule, White County operates three or four ambulances, Banks County runs three and Habersham runs an average of five.
“We’re supposed to be running six – five 24-hours and a 10-hour,” Black said. “This past Monday we only had three trucks due to all of us have people with COVID. Our staffing was already limited, and it’s even more limited with the COVID and our calls are up. Just like hospitals, they’re limited staffing and their patient counts are up. That does not add up to be a good thing.”
The increased call volume and hospital delays are especially hard on counties that have no hospital emergency rooms within their borders, such as Banks and White counties. Ambulances already have extended travel times to reach a hospital, then have to factor in unloading delays before they can return to service.
“We’re actually seeing some delays of two hours and up because of the hospital overflows,’ said Banks County Fire/EMS Chief Steve Nichols. “We call it wall time because we get stuck on a wall with our patient – we can’t unload into an ER room or anything else until they can get one available.”
Nichols said often there is line of ambulances waiting to get to the hospital because the normal unloading area is overflowing.
“One trip to Northeast Georgia last week, we were eighth in line trying to get to the emergency bay, to even get the truck in,” Nichols said. “We had doctors and nurses coming out actually treating patients in the back of our trucks.”
Banks County has a smaller population than some of the surrounding counties, but also has only three ambulances staffed to respond to calls currently. COVID-19 and hospital delays for ambulances that transport to a medical center are changing that.
“It hurts when you lose a truck for three hours, so actually as of the end of this week we’re putting up a fourth med unit,” Nichols said. “We’re going to staff it and keep it in service, so we’ve got something available if we get caught in those situations again.”
Nichols said Banks County EMS call volume has decreased a little bit this week, but he anticipates another spike soon as a result of recent holiday gatherings.