Speaker 1: It's Thursday, December six. I'm oscar Ra Mirrors from the
Speaker 1: Daily Dive podcast in Los Angeles, and this is reopening America.
Speaker 1: Waves of COVID infections continue to cause problems for hospital
Speaker 1: systems facing staff shortages and that are already full treating
Speaker 1: people with other ailments. In most cases, those locking up
Speaker 1: the system are patients who are unvaccinated, and it doesn't
Speaker 1: stop in just one area. The ripple effects of transferring
Speaker 1: patients to different locations with space to treat them also
Speaker 1: puts a strain on hospital workers. Drew Armstrong, Senior editor
Speaker 1: for Healthcare at Bloomberg News, joins us for more. Thanks
Speaker 1: for joining us, Drew, Thank you appreciated. I wanted to
Speaker 1: talk about some interesting reporting you did. You spend some
Speaker 1: time with some Kentucky hospitals, just kind of observing how
Speaker 1: a lot of hospital systems are being pushed to the
Speaker 1: brink with COVID patients, largely driven by people that are unvaccinated.
Speaker 1: You know, there's a lot of data this shows, you know,
Speaker 1: in these highly unvaccinated regions, it rives up the capacity
Speaker 1: of the hospitals. And you know, we've been following the
Speaker 1: story of hospital workers and the hospitals themselves. They're burnt out,
Speaker 1: they're overcrowded. I CU beds can become a space on
Speaker 1: I CU beds can become an issue for a lot
Speaker 1: of people. I think if you don't work in the
Speaker 1: healthcare area, or no somebody or we're at the hospital yourself,
Speaker 1: you don't see a lot of these stories. You don't
Speaker 1: really hear what's going on there. So Drew walk us
Speaker 1: through what what some of your latest reporting ship. Yeah.
Speaker 1: I got really interested in a a couple of months ago
Speaker 1: because I think we've all heard a lot of stories,
Speaker 1: but you know, horrible things are happening to these unvaccinated
Speaker 1: COVID patients. Hospitals are really stressed. But I was interested
Speaker 1: in how healthcare works as a system. We took a
Speaker 1: look at data from every hospital in the country, and
Speaker 1: specific we're looking at how unvaccinated and vaccinated places in
Speaker 1: a broader region kind of play off each other, and
Speaker 1: how that flows through a state's healthcare system or region's hospitals.
Speaker 1: We identified Kentucky as the place to do that parting
Speaker 1: because they've just been through this massive wave of delta
Speaker 1: variant cases and they have some really really low vaccinated
Speaker 1: areas and then they have places that are a lot,
Speaker 1: you know, kind of on the high end, places like Lexington, Kentucky,
Speaker 1: where the University of Kentucky is. And what we found
Speaker 1: was that when this wave of cases hit the state,
Speaker 1: it started in these low vaccinated areas, a lot of
Speaker 1: Mountain Apple, Hi. It's filled up the hospitals there and
Speaker 1: then pushed more and more patients into other hospitals around
Speaker 1: the state. By the time this wave was a couple
Speaker 1: of weeks old, you essentially had locked up the health
Speaker 1: care system where patients in these smaller hospitals that you know,
Speaker 1: they're pretty sophisticated, but they don't take care of the
Speaker 1: really really bad stuff. You know, if you have a
Speaker 1: bad stroke, they can stabilize you, but they're going to
Speaker 1: send you on to University of Kentucky Healthcare for neurosurgery.
Speaker 1: And they couldn't do that because everyone's beds were full.
Speaker 1: There was no way of moving patients around until you
Speaker 1: had a situation where you had COVID patients who needed
Speaker 1: more extreme care who were waiting, but you also have
Speaker 1: patients who had other conditions heart attacks, strokes, who weren't
Speaker 1: able to get what they needed. This system of transfers
Speaker 1: and hospital networks and the way you can kind of
Speaker 1: move patients around and use hospitals that higher and lower acuity.
Speaker 1: It all just fell apart in the middle of this
Speaker 1: wave and and they've put a lot of human consequences
Speaker 1: because of that. Tell me a little bit more about
Speaker 1: this transfer system, because what I said earlier, you know,
Speaker 1: a lot of people don't really realize what's going on
Speaker 1: here unless you're either part of it or had to
Speaker 1: go through some of it. But what happens when these
Speaker 1: smaller hospitals get filled up, the rushes on to call
Speaker 1: other hospitals see where people can get transferred. And as
Speaker 1: you mentioned, there's these regional hospitals. They get pushed there,
Speaker 1: then they get pushed to University of Kentucky for the
Speaker 1: specialized cases. It's really very logistical issue that needs to
Speaker 1: be played out as well. Yeah, you know, if you
Speaker 1: live in a big city. I I work in New
Speaker 1: York City. I live in the suburbs. It's easy to
Speaker 1: take for granted the fact that if something bad happens
Speaker 1: to hear, God forbid, there's a half dozen major academic
Speaker 1: medical centers that all operate. You know, the most sophisticated
Speaker 1: medical care in the world within twenty minutes, I mean,
Speaker 1: and and more likely closer than that. If you're in
Speaker 1: rural Kentucky or a lot of other places in the States,
Speaker 1: the hospital nearest you is probably not going to be
Speaker 1: a big, fancy medical center. It may be a one floor,
Speaker 1: ten bed and they might have an ic U. They
Speaker 1: might have two doctors and critical access hospital. An hour away,
Speaker 1: there may be a two inter bed regional hospital. They
Speaker 1: can handle a lot, like we said, but not really
Speaker 1: really complex stuff. And then the really really nasty stuff
Speaker 1: you're going to be going to a place like University
Speaker 1: of Kentucky. They are the biggest transfer center in the country.
Speaker 1: They have a office floor where they essentially have their
Speaker 1: transfer center. They get around two thousand calls a month
Speaker 1: from hospitals around the state and around the region where
Speaker 1: they are. You saying, Hey, we have a patient who
Speaker 1: has a really bad stroke and they're gonna need neurosurgery.
Speaker 1: You know, we've got them stabilized here, they've been here
Speaker 1: for an hour. Can you take them in. We have
Speaker 1: a COVID patient who is in dire straits. They're very young,
Speaker 1: they might be to make it. If you put them
Speaker 1: on one of your heart lung bypass machines. Even when
Speaker 1: COVID is not happening, there's a lot of reliance on
Speaker 1: being able to move patients around in these systems. You know,
Speaker 1: not everybody and most people in the country don't have
Speaker 1: the immediate access the first hospital they go to if
Speaker 1: they're having a medical emergency, which is typically hell. How
Speaker 1: do these things happen? Is not going to be some big, fancy,
Speaker 1: highly sophisticated hospital and maybe something that can do a
Speaker 1: little bit, but not everything. As I mentioned, you spent
Speaker 1: some time in Kentucky at Saint Joseph Hospital. Tell me
Speaker 1: about how they handled some of their waves of COVID.
Speaker 1: Because they're pretty big regional area to where you know,
Speaker 1: a lot of smaller hospitals will send people there. They
Speaker 1: had to do something called going in on divert basically
Speaker 1: telling ambulances don't come here, you know, we don't have
Speaker 1: enough space. And that's something that they almost never do.
Speaker 1: I think it only happened twice to them before, and
Speaker 1: in the span of like two weeks they had to
Speaker 1: do it twice there. So these surges, these COVID surges,
Speaker 1: really put the strains on these hospit Yeah, and I'm
Speaker 1: glad you brought this up because it gets to what
Speaker 1: we were just talking about with kind of these systems
Speaker 1: of moving patients around a hospital like you mentioned, if
Speaker 1: they're e er is totally backed up, they will put
Speaker 1: word out to all the ambulances operating there. Yet, hey,
Speaker 1: don't bring patients here. Usually that's not a big deal.
Speaker 1: Let's say they may do it because you know, in
Speaker 1: one case they had a tornado. That was in one
Speaker 1: of the times they went in DIVERT in the last
Speaker 1: twenty years, And that's fine because there might be another
Speaker 1: hospital thirty minutes away or fifteen minutes away and they
Speaker 1: can send ambulotes is there. When COVID hit this hospital,
Speaker 1: they had a situation where they went on DIVERT. It
Speaker 1: was the third or fourth time in August that they
Speaker 1: had gone on DIVERT. They were undervert for two hours.
Speaker 1: They were telling ambulances go away, and then they looked
Speaker 1: around the rest of the region. Every single hospital around
Speaker 1: them was undervert as well. They said, what you saying,
Speaker 1: there's nowhere for these patients to go. We can't be
Speaker 1: on DIVERT. These people are just going to die in
Speaker 1: an ambulance. Okay, take us off, bring them here. We'll
Speaker 1: do what we can. That's what I mean when I
Speaker 1: say the health system locks up. When you know, our
Speaker 1: health system in the U is built for disasters, but
Speaker 1: it's built for short term disasters. It's built for a
Speaker 1: big crash on the inner state and chemical plant explosion,
Speaker 1: things that last a day or a week. It's not
Speaker 1: built for a two year long, constant state of crisis.
Speaker 1: Tell me a little bit more about who's winding up
Speaker 1: in these hospitals, because a lot of time we're hearing
Speaker 1: about very mild cases of COVID uh, you know, the
Speaker 1: amicron variant. Thankfully we're you know, hearing that they're more
Speaker 1: milder cases. We'll see what the data bears out on that.
Speaker 1: But a lot of the last surge that we had
Speaker 1: obviously had to do a lot with the delta variant.
Speaker 1: And you know, we're talking about places that have low
Speaker 1: vaccination rates too. So what else do we see in
Speaker 1: some of these places, you know, higher rates of diabetes,
Speaker 1: heart disease, So we know that these are the people
Speaker 1: that are more vulnerable to getting severe illness. But so
Speaker 1: who is showing up at the hospitals when when the
Speaker 1: surges are happening. If you look at the demographics of
Speaker 1: vaccination in Kentucky, but this is also true of a
Speaker 1: lot of less vaccinated places in the country, and you
Speaker 1: kind of drilled down own on the groups within those places.
Speaker 1: Older people are tend to be pretty vaccinated, you know.
Speaker 1: So if you're looking at a county, let's say, with
Speaker 1: a fifty percent vaccination rate, that doesn't sound that bad.
Speaker 1: I mean, let me be clear, it's not great. But
Speaker 1: when you look at it more closely, you realize that
Speaker 1: a lot of that is the older population, which means
Speaker 1: your younger population is very, very, very unvaccinated. This most
Speaker 1: recent variant, the delta variant, and I think we're you know,
Speaker 1: remained to be seen what's going to be happening with
Speaker 1: a macron, but it's very good at finding unvaccinated people
Speaker 1: and finding them all at once. At St. Joseph in London, Kentucky,
Speaker 1: it's about an hour and a half south of Lexington,
Speaker 1: you heard a lot of stories about whole families that
Speaker 1: would be sick at the same time and with multiple
Speaker 1: family members in the hospital. They told me a story
Speaker 1: about a grandmother, a mother, and a son who were
Speaker 1: all hospitalized at the same time, and not all of
Speaker 1: those people live. I mean, that is not an uncommon
Speaker 1: thing to have happened down there, because this is a
Speaker 1: virus that spreads within households most effectively, and you know,
Speaker 1: it's a lot of people who are all going to
Speaker 1: get sick at the same time. The patients that they
Speaker 1: have seen most recently in this wave. Earlier on a
Speaker 1: year ago, they were old and frail people. Now they
Speaker 1: are younger and relatively healthy people. You know what everyone said,
Speaker 1: these are the folks you're going to see walking around
Speaker 1: the Walmart or in the Kroger or something like that.
Speaker 1: They are not sick. You know, old people who were
Speaker 1: vulnerable to any kind of illness who would strike them.
Speaker 1: And your time they're observing these hospitals as well, tell
Speaker 1: me about the human element, because this is an important part.
Speaker 1: Doctors and nurses are burnt out, experiencing burnout. And one
Speaker 1: of the interesting things one of the physicians you spoke
Speaker 1: to said that that she feels like a failure sometimes
Speaker 1: because they think vaccines are the answers, but people don't
Speaker 1: want to listen to them. And there was a recent
Speaker 1: Gallop survey that said, you know, people are losing trust
Speaker 1: in their doctors. Small percentage, but that that was the trend.
Speaker 1: And you know here they are fighting every day. You know,
Speaker 1: it's tough to get those messages across. How do they
Speaker 1: feel about it all? I think that burnout doesn't even
Speaker 1: get close to describe it. I met with people at
Speaker 1: a hospital called Saint Clair Regional Medical Center. They were
Speaker 1: in a truly horrific situation, and almost everybody I talked
Speaker 1: to seems to have some level of significant PTSD. Had
Speaker 1: conversations with people who said that they put somebody in
Speaker 1: a body bag every single day for two months, that
Speaker 1: they worked, people who would come home from work and
Speaker 1: working in nursing shift in the hospital and be unable
Speaker 1: to hug their daughter because they felt so emotionally disconnected
Speaker 1: from the world. A lot of people cried to me
Speaker 1: when we had this conversation, these conversations, I cried, which
Speaker 1: is not something I do. I've seen a lot as
Speaker 1: a reporter, and they have been through things and seeing
Speaker 1: an amount of death that I think is going to
Speaker 1: be profoundly important for whether or not these people stay
Speaker 1: in the healthcare workforce in the coming years. They are
Speaker 1: traumatized and frustrated, and they have poured their hearts and
Speaker 1: their bodies in to trying to save these people, and
Speaker 1: they have just watched too many of them die. And
Speaker 1: they also feel like nobody outside the hospital walls has
Speaker 1: a good sense of what has been happening inside the hospital,
Speaker 1: you know, And that's exactly why I like to highlight
Speaker 1: these stories. It's tough to see what's going on in
Speaker 1: these areas in a point where everybody has COVID fatigue
Speaker 1: right now, right there's a lot of regulations, were just
Speaker 1: on lockdown all this other stuff. People are ready to
Speaker 1: move on, and these are the true things that are
Speaker 1: still happening behind the walls. As I mentioned, if you're
Speaker 1: not going through it or part of it, or know somebody,
Speaker 1: and you're not hearing a lot of these stories. So
Speaker 1: there's a lot of really great details in Drew's piece,
Speaker 1: I suggest everybody go out and read it. Drew Armstrong,
Speaker 1: Senior editor for Healthcare at Bloomberg News, thank you very
Speaker 1: much for joining us. Thank you. I'm Oscar Rome Mirrors
Speaker 1: and this has been reopening America. Don't forget that. For
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