WEBVTT - Hospital Systems Still Under Pressure From Unvaccinated Covid Patients

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<v Speaker 1>It's Thursday, December six. I'm oscar Ra Mirrors from the

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<v Speaker 1>Daily Dive podcast in Los Angeles, and this is reopening America.

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<v Speaker 1>Waves of COVID infections continue to cause problems for hospital

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<v Speaker 1>systems facing staff shortages and that are already full treating

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<v Speaker 1>people with other ailments. In most cases, those locking up

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<v Speaker 1>the system are patients who are unvaccinated, and it doesn't

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<v Speaker 1>stop in just one area. The ripple effects of transferring

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<v Speaker 1>patients to different locations with space to treat them also

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<v Speaker 1>puts a strain on hospital workers. Drew Armstrong, Senior editor

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<v Speaker 1>for Healthcare at Bloomberg News, joins us for more. Thanks

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<v Speaker 1>for joining us, Drew, Thank you appreciated. I wanted to

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<v Speaker 1>talk about some interesting reporting you did. You spend some

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<v Speaker 1>time with some Kentucky hospitals, just kind of observing how

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<v Speaker 1>a lot of hospital systems are being pushed to the

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<v Speaker 1>brink with COVID patients, largely driven by people that are unvaccinated.

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<v Speaker 1>You know, there's a lot of data this shows, you know,

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<v Speaker 1>in these highly unvaccinated regions, it rives up the capacity

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<v Speaker 1>of the hospitals. And you know, we've been following the

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<v Speaker 1>story of hospital workers and the hospitals themselves. They're burnt out,

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<v Speaker 1>they're overcrowded. I CU beds can become a space on

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<v Speaker 1>I CU beds can become an issue for a lot

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<v Speaker 1>of people. I think if you don't work in the

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<v Speaker 1>healthcare area, or no somebody or we're at the hospital yourself,

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<v Speaker 1>you don't see a lot of these stories. You don't

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<v Speaker 1>really hear what's going on there. So Drew walk us

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<v Speaker 1>through what what some of your latest reporting ship. Yeah.

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<v Speaker 1>I got really interested in a a couple of months ago

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<v Speaker 1>because I think we've all heard a lot of stories,

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<v Speaker 1>but you know, horrible things are happening to these unvaccinated

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<v Speaker 1>COVID patients. Hospitals are really stressed. But I was interested

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<v Speaker 1>in how healthcare works as a system. We took a

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<v Speaker 1>look at data from every hospital in the country, and

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<v Speaker 1>specific we're looking at how unvaccinated and vaccinated places in

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<v Speaker 1>a broader region kind of play off each other, and

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<v Speaker 1>how that flows through a state's healthcare system or region's hospitals.

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<v Speaker 1>We identified Kentucky as the place to do that parting

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<v Speaker 1>because they've just been through this massive wave of delta

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<v Speaker 1>variant cases and they have some really really low vaccinated

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<v Speaker 1>areas and then they have places that are a lot,

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<v Speaker 1>you know, kind of on the high end, places like Lexington, Kentucky,

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<v Speaker 1>where the University of Kentucky is. And what we found

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<v Speaker 1>was that when this wave of cases hit the state,

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<v Speaker 1>it started in these low vaccinated areas, a lot of

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<v Speaker 1>Mountain Apple, Hi. It's filled up the hospitals there and

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<v Speaker 1>then pushed more and more patients into other hospitals around

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<v Speaker 1>the state. By the time this wave was a couple

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<v Speaker 1>of weeks old, you essentially had locked up the health

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<v Speaker 1>care system where patients in these smaller hospitals that you know,

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<v Speaker 1>they're pretty sophisticated, but they don't take care of the

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<v Speaker 1>really really bad stuff. You know, if you have a

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<v Speaker 1>bad stroke, they can stabilize you, but they're going to

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<v Speaker 1>send you on to University of Kentucky Healthcare for neurosurgery.

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<v Speaker 1>And they couldn't do that because everyone's beds were full.

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<v Speaker 1>There was no way of moving patients around until you

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<v Speaker 1>had a situation where you had COVID patients who needed

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<v Speaker 1>more extreme care who were waiting, but you also have

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<v Speaker 1>patients who had other conditions heart attacks, strokes, who weren't

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<v Speaker 1>able to get what they needed. This system of transfers

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<v Speaker 1>and hospital networks and the way you can kind of

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<v Speaker 1>move patients around and use hospitals that higher and lower acuity.

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<v Speaker 1>It all just fell apart in the middle of this

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<v Speaker 1>wave and and they've put a lot of human consequences

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<v Speaker 1>because of that. Tell me a little bit more about

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<v Speaker 1>this transfer system, because what I said earlier, you know,

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<v Speaker 1>a lot of people don't really realize what's going on

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<v Speaker 1>here unless you're either part of it or had to

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<v Speaker 1>go through some of it. But what happens when these

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<v Speaker 1>smaller hospitals get filled up, the rushes on to call

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<v Speaker 1>other hospitals see where people can get transferred. And as

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<v Speaker 1>you mentioned, there's these regional hospitals. They get pushed there,

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<v Speaker 1>then they get pushed to University of Kentucky for the

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<v Speaker 1>specialized cases. It's really very logistical issue that needs to

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<v Speaker 1>be played out as well. Yeah, you know, if you

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<v Speaker 1>live in a big city. I I work in New

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<v Speaker 1>York City. I live in the suburbs. It's easy to

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<v Speaker 1>take for granted the fact that if something bad happens

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<v Speaker 1>to hear, God forbid, there's a half dozen major academic

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<v Speaker 1>medical centers that all operate. You know, the most sophisticated

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<v Speaker 1>medical care in the world within twenty minutes, I mean,

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<v Speaker 1>and and more likely closer than that. If you're in

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<v Speaker 1>rural Kentucky or a lot of other places in the States,

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<v Speaker 1>the hospital nearest you is probably not going to be

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<v Speaker 1>a big, fancy medical center. It may be a one floor,

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<v Speaker 1>ten bed and they might have an ic U. They

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<v Speaker 1>might have two doctors and critical access hospital. An hour away,

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<v Speaker 1>there may be a two inter bed regional hospital. They

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<v Speaker 1>can handle a lot, like we said, but not really

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<v Speaker 1>really complex stuff. And then the really really nasty stuff

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<v Speaker 1>you're going to be going to a place like University

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<v Speaker 1>of Kentucky. They are the biggest transfer center in the country.

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<v Speaker 1>They have a office floor where they essentially have their

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<v Speaker 1>transfer center. They get around two thousand calls a month

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<v Speaker 1>from hospitals around the state and around the region where

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<v Speaker 1>they are. You saying, Hey, we have a patient who

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<v Speaker 1>has a really bad stroke and they're gonna need neurosurgery.

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<v Speaker 1>You know, we've got them stabilized here, they've been here

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<v Speaker 1>for an hour. Can you take them in. We have

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<v Speaker 1>a COVID patient who is in dire straits. They're very young,

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<v Speaker 1>they might be to make it. If you put them

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<v Speaker 1>on one of your heart lung bypass machines. Even when

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<v Speaker 1>COVID is not happening, there's a lot of reliance on

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<v Speaker 1>being able to move patients around in these systems. You know,

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<v Speaker 1>not everybody and most people in the country don't have

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<v Speaker 1>the immediate access the first hospital they go to if

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<v Speaker 1>they're having a medical emergency, which is typically hell. How

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<v Speaker 1>do these things happen? Is not going to be some big, fancy,

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<v Speaker 1>highly sophisticated hospital and maybe something that can do a

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<v Speaker 1>little bit, but not everything. As I mentioned, you spent

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<v Speaker 1>some time in Kentucky at Saint Joseph Hospital. Tell me

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<v Speaker 1>about how they handled some of their waves of COVID.

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<v Speaker 1>Because they're pretty big regional area to where you know,

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<v Speaker 1>a lot of smaller hospitals will send people there. They

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<v Speaker 1>had to do something called going in on divert basically

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<v Speaker 1>telling ambulances don't come here, you know, we don't have

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<v Speaker 1>enough space. And that's something that they almost never do.

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<v Speaker 1>I think it only happened twice to them before, and

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<v Speaker 1>in the span of like two weeks they had to

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<v Speaker 1>do it twice there. So these surges, these COVID surges,

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<v Speaker 1>really put the strains on these hospit Yeah, and I'm

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<v Speaker 1>glad you brought this up because it gets to what

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<v Speaker 1>we were just talking about with kind of these systems

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<v Speaker 1>of moving patients around a hospital like you mentioned, if

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<v Speaker 1>they're e er is totally backed up, they will put

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<v Speaker 1>word out to all the ambulances operating there. Yet, hey,

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<v Speaker 1>don't bring patients here. Usually that's not a big deal.

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<v Speaker 1>Let's say they may do it because you know, in

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<v Speaker 1>one case they had a tornado. That was in one

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<v Speaker 1>of the times they went in DIVERT in the last

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<v Speaker 1>twenty years, And that's fine because there might be another

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<v Speaker 1>hospital thirty minutes away or fifteen minutes away and they

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<v Speaker 1>can send ambulotes is there. When COVID hit this hospital,

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<v Speaker 1>they had a situation where they went on DIVERT. It

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<v Speaker 1>was the third or fourth time in August that they

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<v Speaker 1>had gone on DIVERT. They were undervert for two hours.

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<v Speaker 1>They were telling ambulances go away, and then they looked

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<v Speaker 1>around the rest of the region. Every single hospital around

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<v Speaker 1>them was undervert as well. They said, what you saying,

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<v Speaker 1>there's nowhere for these patients to go. We can't be

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<v Speaker 1>on DIVERT. These people are just going to die in

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<v Speaker 1>an ambulance. Okay, take us off, bring them here. We'll

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<v Speaker 1>do what we can. That's what I mean when I

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<v Speaker 1>say the health system locks up. When you know, our

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<v Speaker 1>health system in the U is built for disasters, but

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<v Speaker 1>it's built for short term disasters. It's built for a

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<v Speaker 1>big crash on the inner state and chemical plant explosion,

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<v Speaker 1>things that last a day or a week. It's not

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<v Speaker 1>built for a two year long, constant state of crisis.

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<v Speaker 1>Tell me a little bit more about who's winding up

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<v Speaker 1>in these hospitals, because a lot of time we're hearing

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<v Speaker 1>about very mild cases of COVID uh, you know, the

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<v Speaker 1>amicron variant. Thankfully we're you know, hearing that they're more

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<v Speaker 1>milder cases. We'll see what the data bears out on that.

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<v Speaker 1>But a lot of the last surge that we had

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<v Speaker 1>obviously had to do a lot with the delta variant.

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<v Speaker 1>And you know, we're talking about places that have low

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<v Speaker 1>vaccination rates too. So what else do we see in

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<v Speaker 1>some of these places, you know, higher rates of diabetes,

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<v Speaker 1>heart disease, So we know that these are the people

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<v Speaker 1>that are more vulnerable to getting severe illness. But so

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<v Speaker 1>who is showing up at the hospitals when when the

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<v Speaker 1>surges are happening. If you look at the demographics of

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<v Speaker 1>vaccination in Kentucky, but this is also true of a

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<v Speaker 1>lot of less vaccinated places in the country, and you

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<v Speaker 1>kind of drilled down own on the groups within those places.

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<v Speaker 1>Older people are tend to be pretty vaccinated, you know.

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<v Speaker 1>So if you're looking at a county, let's say, with

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<v Speaker 1>a fifty percent vaccination rate, that doesn't sound that bad.

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<v Speaker 1>I mean, let me be clear, it's not great. But

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<v Speaker 1>when you look at it more closely, you realize that

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<v Speaker 1>a lot of that is the older population, which means

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<v Speaker 1>your younger population is very, very, very unvaccinated. This most

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<v Speaker 1>recent variant, the delta variant, and I think we're you know,

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<v Speaker 1>remained to be seen what's going to be happening with

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<v Speaker 1>a macron, but it's very good at finding unvaccinated people

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<v Speaker 1>and finding them all at once. At St. Joseph in London, Kentucky,

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<v Speaker 1>it's about an hour and a half south of Lexington,

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<v Speaker 1>you heard a lot of stories about whole families that

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<v Speaker 1>would be sick at the same time and with multiple

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<v Speaker 1>family members in the hospital. They told me a story

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<v Speaker 1>about a grandmother, a mother, and a son who were

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<v Speaker 1>all hospitalized at the same time, and not all of

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<v Speaker 1>those people live. I mean, that is not an uncommon

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<v Speaker 1>thing to have happened down there, because this is a

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<v Speaker 1>virus that spreads within households most effectively, and you know,

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<v Speaker 1>it's a lot of people who are all going to

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<v Speaker 1>get sick at the same time. The patients that they

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<v Speaker 1>have seen most recently in this wave. Earlier on a

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<v Speaker 1>year ago, they were old and frail people. Now they

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<v Speaker 1>are younger and relatively healthy people. You know what everyone said,

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<v Speaker 1>these are the folks you're going to see walking around

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<v Speaker 1>the Walmart or in the Kroger or something like that.

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<v Speaker 1>They are not sick. You know, old people who were

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<v Speaker 1>vulnerable to any kind of illness who would strike them.

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<v Speaker 1>And your time they're observing these hospitals as well, tell

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<v Speaker 1>me about the human element, because this is an important part.

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<v Speaker 1>Doctors and nurses are burnt out, experiencing burnout. And one

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<v Speaker 1>of the interesting things one of the physicians you spoke

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<v Speaker 1>to said that that she feels like a failure sometimes

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<v Speaker 1>because they think vaccines are the answers, but people don't

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<v Speaker 1>want to listen to them. And there was a recent

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<v Speaker 1>Gallop survey that said, you know, people are losing trust

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<v Speaker 1>in their doctors. Small percentage, but that that was the trend.

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<v Speaker 1>And you know here they are fighting every day. You know,

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<v Speaker 1>it's tough to get those messages across. How do they

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<v Speaker 1>feel about it all? I think that burnout doesn't even

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<v Speaker 1>get close to describe it. I met with people at

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<v Speaker 1>a hospital called Saint Clair Regional Medical Center. They were

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<v Speaker 1>in a truly horrific situation, and almost everybody I talked

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<v Speaker 1>to seems to have some level of significant PTSD. Had

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<v Speaker 1>conversations with people who said that they put somebody in

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<v Speaker 1>a body bag every single day for two months, that

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<v Speaker 1>they worked, people who would come home from work and

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<v Speaker 1>working in nursing shift in the hospital and be unable

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<v Speaker 1>to hug their daughter because they felt so emotionally disconnected

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<v Speaker 1>from the world. A lot of people cried to me

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<v Speaker 1>when we had this conversation, these conversations, I cried, which

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<v Speaker 1>is not something I do. I've seen a lot as

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<v Speaker 1>a reporter, and they have been through things and seeing

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<v Speaker 1>an amount of death that I think is going to

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<v Speaker 1>be profoundly important for whether or not these people stay

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<v Speaker 1>in the healthcare workforce in the coming years. They are

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<v Speaker 1>traumatized and frustrated, and they have poured their hearts and

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<v Speaker 1>their bodies in to trying to save these people, and

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<v Speaker 1>they have just watched too many of them die. And

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<v Speaker 1>they also feel like nobody outside the hospital walls has

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<v Speaker 1>a good sense of what has been happening inside the hospital,

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<v Speaker 1>you know, And that's exactly why I like to highlight

0:11:15.200 --> 0:11:17.720
<v Speaker 1>these stories. It's tough to see what's going on in

0:11:17.760 --> 0:11:21.600
<v Speaker 1>these areas in a point where everybody has COVID fatigue

0:11:21.720 --> 0:11:23.880
<v Speaker 1>right now, right there's a lot of regulations, were just

0:11:24.000 --> 0:11:26.760
<v Speaker 1>on lockdown all this other stuff. People are ready to

0:11:26.800 --> 0:11:29.240
<v Speaker 1>move on, and these are the true things that are

0:11:29.240 --> 0:11:32.240
<v Speaker 1>still happening behind the walls. As I mentioned, if you're

0:11:32.240 --> 0:11:34.480
<v Speaker 1>not going through it or part of it, or know somebody,

0:11:34.480 --> 0:11:36.480
<v Speaker 1>and you're not hearing a lot of these stories. So

0:11:36.640 --> 0:11:39.720
<v Speaker 1>there's a lot of really great details in Drew's piece,

0:11:39.760 --> 0:11:42.920
<v Speaker 1>I suggest everybody go out and read it. Drew Armstrong,

0:11:43.240 --> 0:11:46.040
<v Speaker 1>Senior editor for Healthcare at Bloomberg News, thank you very

0:11:46.120 --> 0:11:51.520
<v Speaker 1>much for joining us. Thank you. I'm Oscar Rome Mirrors

0:11:51.520 --> 0:11:54.319
<v Speaker 1>and this has been reopening America. Don't forget that. For

0:11:54.400 --> 0:11:56.120
<v Speaker 1>today's big news stories, you can check me out on

0:11:56.160 --> 0:11:59.280
<v Speaker 1>the Daily Dive podcast Every Money through Friday, so follow

0:11:59.360 --> 0:12:01.520
<v Speaker 1>us and I heart rate or wherever you get your

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<v Speaker 1>podcast