Covid testing

A nurse with Christiana Care gives a free test for the coronavirus to a driver at the Riverfront complex on Friday, March 13, 2020, in downtown Wilmington, Delaware. Photograph by Butch Comegys / For WHYY

The unprecedented and escalating spike in COVID-19 cases and hospitalizations led Delaware hospitals to implement a “crisis” level of care Monday because “it is no longer possible to deliver care according to normal standards,’’ said ChristianaCare, the state’s largest health care system.

About 4 in 10 patients at its two Delaware hospitals and one in bordering Elkton, Md., are positive for the coronavirus, ChristianaCare said in a news release about noon Monday. The patients were admitted because they are experiencing adverse symptoms of COVID-19 that require hospital care, or because the virus exacerbated underlying conditions.

The system’s facilities, including emergency rooms, urgent care centers, and medical practices, have been beyond 100% of capacity “for weeks,” hospital officials said.

As of Sunday, the state’s weekly average for new daily cases was 2,579 — three times last January’s previous high mark. The current inpatient count is 784 — more than 300 higher than last January’s high.

“The health care system is under unprecedented strain,’’ said Dr. Janice Nevin, ChristianaCare’s CEO. “Never have there been this many people in our community who need hospitalization, emergency care, and other health care services.”

“We have taken this step to implement Crisis Standards of Care so that our caregivers have the flexibility and decision-making tools they need in order to deliver care to patients with the highest need at this time when the demand exceeds all available resources.”

Joining ChristianaCare in implementing crisis care are Bayhealth, TidalHealth Nanticoke, and Trinity Health Mid-Atlantic-Saint Francis Hospital.

The crisis was declared because of “challenges” it faces in providing patients with “staffing, space, and supplies,” ChristianaCare said.

The new, lower standard gives caregivers flexibility in areas such as:

  • Advancing different care models.
  • Simplifying documentation requirements.
  • Changing workflows.
  • Changing admission or discharge criteria.
  • Modifying surgical and other procedural and diagnostic schedules.
  • Adjusting how supplies are allocated.
  • Changing how treatment resources are distributed.
  • Redeploying clinical and non-clinical staff.
  • Adjusting staffing standards including, among other things, staffing ratios, return to work, annual educational requirements, or credentialing requirements.
  • Limiting the availability of non-urgent services.
  • Adapting documentation, reporting, and approach to regulatory requirements.

ChristianaCare said “decisions regarding the use of limited resources will be made in a just, equitable, and transparent way, and our caregivers will engage with patients and their family members about expectations and options of care.“

Dr. Ken Silverstein, chief physician executive, said that even though fully vaccinated people comprise nearly 30% of COVID-19 patients statewide, most people requiring inpatient care are unvaccinated or partially vaccinated.

“We need everyone to understand that while an individual can get COVID and feel bad for a few days or suffer mild-to-moderate symptoms and be OK, there are still many, many people who are becoming seriously ill and dying from this disease,” Silverstein said.

National data shows that an unvaccinated American is 14 times more likely to die from COVID-related complications than a fully vaccinated person, ChristianaCare said. The death rate is 20 times as high as someone who has received a booster shot.

“This is not sustainable,” Silverstein said. “We urgently need the community to help us. We need everyone to get vaccinated, get their booster dose when eligible, and continue to practice the safety steps that we know are effective in reducing the spread of COVID—masking, social distancing, and hand-washing—even in places where guidelines aren’t posted or masking isn’t required.”

Silverstein urged people not to go to the emergency room for the time being unless they are experiencing a medical emergency. He also said not to go to the ER for a COVID-19 test.

Gov. John Carney reinstated a state of emergency for Delaware one week ago due to the soaring case numbers and hospitalizations. Unlike the emergency order he issued at the start of the pandemic, the latest declaration doesn’t require residents to wear masks or limit capacity at businesses.

Carney is scheduled to deliver another update on the state’s fight against the virus Tuesday afternoon.

This article first appeared on WHYY.org.

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