The COVID Effect: Longer Waits, Delayed Surgeries

Sep 14, 2021

Sentara RMH in Harrisonburg reports longer waiting times for care and beds.
Credit Sentara RMH

As COVID-19 cases spike again, some local hospitals report longer wait times for admittance, and they’re delaying elective surgeries. WMRA's Randi B. Hagi reports.

The ER at Sentara RMH in Harrisonburg has been hit by two separate, but related, surges -- new COVID-19 cases, and also a backlog of people needing treatment for other illnesses and injuries.

Dr. Ian Steines is the medical director of the emergency department at RMH.
Credit Sentara RMH

DR. IAN STEINES: There was a phenomenon [during the] first surge of people really avoiding medical care for some things that needed medical care: heart attacks, strokes.

Dr. Ian Steines is the medical director of the emergency department at RMH.

STEINES: Some people stayed home through their illnesses or showed up later in their illnesses. Those people have been coming back in. So our volumes of patients coming into the emergency department right now are very high, because we're seeing sick COVID patients, we're seeing some relatively well COVID patients, and we're no longer seeing people delay care.

A representative from Sentara told WMRA that they are not currently disclosing the number of COVID patients there.  It's enough to have an effect on operations, though. Steines said that at RMH's emergency department, like elsewhere in the country right now -

STEINES: … you're much more likely to have a waiting room time. You're more likely to have longer times in beds. If you need hospitalization, you spend a longer time waiting for a bed in the hospital. And if you need to be transferred, it can really take a long time to get that done. If you have a complex illness and need a tertiary care center, it can be a lot of work looking for a bed before we can actually institute transfer.

Typically, Sentara would transfer patients who need specialty treatment - like neurosurgery, for example - to Charlottesville, Richmond, or Winchester, depending on the type of care needed. Now though, they're reaching out to hospitals in Maryland, North Carolina, West Virginia, and beyond, for some of their patient transfers.

Dr. Laura Kornegay is director of the Central Shenandoah Health District.
Credit Central Shenandoah Health District

Dr. Laura Kornegay, director of the Central Shenandoah Health District, said that all four hospitals in the district are seeing an increase of COVID patients alongside staffing shortages, particularly in nursing.

DR. LAURA KORNEGAY: The Virginia Hospital and Healthcare Association just put out a call basically imploring people to get vaccinated because of the increase in hospitalizations in Virginia. …  Really since mid-July, we've seen increasing hospital utilization for COVID cases. We've seen increased use of ICU beds for COVID cases, and a lot of our hospitals are seeing COVID positive levels higher than really even in the surge in the winter time.

Augusta Health in Fishersville had 63 COVID patients as of Monday morning. Lisa Schwenk, director of public relations, said in an email that the hospital is "planning for a surge that will go much higher than 63 by the end of the month."

The Virginia Department of Health and Augusta Health are financial supporters of WMRA.  That support does not affect our coverage.

She also said that, between 9 a.m. on Saturday and 9 a.m. Sunday, there were 120 new COVID cases diagnosed at Augusta Health testing sites - the highest daily total they've experienced during the pandemic. In a press release issued last week, Schwenk said the skilled nursing floor and other units at the hospital have been temporarily converted to COVID care wards, and surgeries have been reduced to less than half their usual volume so the hospital can divert staff and resources.

UVA Health in Charlottesville is faring a bit better.

Dr. William Petri is an infectious diseases doctor at UVA Health.
Credit UVA Health

DR. WILLIAM PETRI: We've instituted a surge plan where we've added additional teams of doctors and healthcare providers to manage the surge. And it is substantially busier at UVA, especially on the Five South and Four South wards, which we have specifically designed for COVID-19, but we're not over capacity. We're able to care for the patients in the community that are contracting COVID.

Dr. William Petri is an infectious diseases doctor at UVA Health.

PETRI: We were very fortunate - a new tower of the hospital, the south tower, was scheduled to open like right at the time of the pandemic … The engineering team at UVA was able to reverse engineer the rooms before the tower opened so that they're all negative airflow, and so that means if someone, you know, is speaking and exhaling COVID virus into the air, that is sucked out of the room into a filtration system.

All three physicians who spoke with WMRA urged listeners to get vaccinated. Steines said he and his colleagues are feeling worn down.  (Side note, he uses the shorthand 'E-D' for emergency department.)

STEINES: The affected individuals are still very sick. They're younger … And getting the right care for people just takes some extra steps, so we're trying to expand what we do to meet all those demands and be flexible, but it's - it's definitely been a long haul. So I guess the plug is please vaccinate. Please social distance. Testing, routine testing - there's so many good options now with things like telemedicine, home tests, drive-through testing. When people come to the ED for minimally symptomatic testing, it's a possibility that they could expose other vulnerable people.