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It was bad enough when Stephanie Deer learned her younger sister was found blue-faced and unresponsive in her Herriman home after a sudden heart attack.
But then the doctor delivered the news: Laurie Pratt Terry could die any minute, she urgently needed to be transferred to a larger hospital — and there was no room for her.
“The look on the doctor’s face when he’s telling us they can’t find a place for my sister — I will never forget,” Deer said. “He was beside himself. He said, ‘We can’t find a bed because of COVID.’ ”
For 2½ hours, Terry’s family watched as pulses of electricity kept her heart beating and medical staff pleaded on the phone with other hospitals for the advanced care she needed.
With 1,498 new coronavirus cases reported Thursday, Utah’s weeklong rate of diagnoses was at a record high, averaging 1,204 diagnoses per day — and hospitals are fast running out of wiggle room to take patients needing critical care.
Although the Utah Department of Health has been reporting that intensive care units are typically 65% to 75% occupied, that’s a statewide figure. It doesn’t account for different locations or the type of care a patient actually needs.
In the early hours of Oct. 7, Terry needed advanced imaging and life-support tools — in particular a heart-lung device called an ECMO machine. That’s something only three hospitals in Utah have, said Dr. Mark Ott, medical director of Intermountain Medical Center. And only two Utah hospitals — IMC and University of Utah Hospital — have the level-one trauma centers that Terry’s doctors said she needed.
“ECMO, high-end, complicated surgical procedures — those are the things that are resource intensive and may not be available for everybody all the time,” Ott said. “There are [ICU] beds out there, but if you need a special bed, that capacity might be one or two beds for what you need in the whole state.”
For Terry, that need was critical. The seemingly healthy 47-year-old began to struggle shortly after she went to bed. Terry’s husband, who permitted Deer to disclose details of Terry’s condition to The Salt Lake Tribune, turned on a light and saw Terry’s skin was blue. She wasn’t breathing.
Terry’s husband, Jeremy, performed CPR. Medics used a defibrillator four times in the short ride to the hospital. At the hospital, she was placed on a ventilator. The physician overseeing Terry’s care, Deer said, was “desperate.”
“Here was an emergency room physician, managing all the people trying to save her life," Deer said, “and the whole time they were doing that, they were calling hospitals.”
When space opened at IMC, Terry’s condition was so dire after the 2½-hour wait that they made the short trip from Riverton by helicopter, Deer said. At IMC, doctors told Terry’s family to return the next morning, but then chased after them moments later to bring them back, Deer said.
“They were telling us, ‘Laurie’s life is being measured in minutes.' ”
Eventually Terry was stabilized and doctors since have discovered she likely has a heart condition. They also found she’d had a stroke — but they don’t know when, or whether the delays may have worsened her condition. Deer said it’s still too early to tell how well her sister will recover; she was still on a ventilator as of Wednesday, and communicating with blinks.
Deer says she hopes Utahns will realize that a crisis of hospital crowding is already here, and to stop assuming they’ll get the treatment they need — especially if specialized care is required.
“I don’t think people understand that. They see 69%, 70% of ICUs are occupied, and they think, ‘Oh, of course there’s a bed,’ ” Deer said. “People need to understand that if they have a serious health event, then they are in peril of not being able to access higher-level medical care — right now. If you have a car accident, if you have a heart attack, anything. The medical staff and the hospital system in Salt Lake County is so stressed that you may not be able to get health care in enough time to save your life.
“It was 3 o’clock in the morning on a Wednesday," Deer said, “and they could not find space for my sister.”
Ott said that, generally speaking, “we still have capacity in the Intermountain Healthcare system and in other systems.”
But, with case numbers in older age groups continuing to rise, with non-COVID-19 hospitalizations unusually high and flu season beginning — Utah’s hospitals are just a small surge from the breaking point.
“If we had a couple of bad days with lots of people coming in," Ott said, “that could push us to a brink, where we’re having a problem.”
There were 258 Utah coronavirus patients admitted as of Thursday. For the past week, the average is 249 — a record high. Looking at the past two weeks, there have been 629 hospitalizations — the most reported in any 14-day period since the pandemic began.
And even the state’s ICU occupancy figure — 73.6% on Thursday — is in the highest transmission-risk category under new state guidelines, whose restrictions took effect statewide Thursday and require Utahns in most counties to wear masks and limit gatherings to 10 people.
While Intermountain has declined to provide recent occupancy rates for its ICUs or regular hospital beds, infectious disease specialist Dr. Eddie Stenehjem said in a news media briefing Thursday that IMC was treating 46 admitted patients for COVID-19, with another 30 at Utah Valley Hospital and 31 at Dixie Regional Medical Center in St. George. Officials at the University of Utah have said its ICU beds have repeatedly reached 95% occupancy in the past two weeks.
“We’ve never seen this many patients. ... [It’s] about 40% higher than we were back in July. We’re load-leveling like we never have done before," Stenehjem said, referring to how health care systems distribute patients to avoid a shortage of hospital beds. “This is getting to a point where we’re going to be opening up overflow ICUs. We may have beds ... but our staff is getting incredibly tired.”
Pressure on ICUs ebbs and flows even during a normal year, Ott said; occasionally, a patient who needs ECMO, for example, will not get it.
The problem, Ott said, is that the coronavirus has now eaten through the margins built into hospital resources — and people apparently have not internalized the reality that if they catch the flu or the coronavirus and are hospitalized, or infect someone who goes on to fill a bed, they may end up costing a stranger precious minutes and resources.
For now, Ott said, “we will find beds, we will find staff, we will work extra shifts, we will do whatever it takes. But that’s not a sustainable situation.”
Deer said health care workers shouldn’t have to be put through that; instead, she said, Utah should be more protective of the hospital resources it still has.
“I don’t understand," she said, "We don’t leave our house without masks, ever. Why won’t people wear masks? Why are there high school sports when there aren’t hospital beds?”
Utah’s death toll from the coronavirus rose to 529, with two fatalities reported since Wednesday — both Salt Lake County men, older than 85.
During the past week, the largest case increases per capita occurred in Utah County, with the worst outbreaks in Provo and the northern neighborhoods of Orem. But case numbers throughout the county are rising a little less sharply than they were a week ago, according to the state’s “small area” data.
Salt Lake County again reported near-peak levels of new infections, with Herriman now reporting the county’s worst infection rates, followed closely by Draper, Riverton and Bluffdale.
New weekly cases reached record-high levels Thursday in the Central Utah, Southeast Utah and Southwest Utah health districts, as well as Tooele County. Southwest Utah also posted its largest one-day increase in cases since the pandemic began, with infection rates higher now than they were in late June, when Dixie Regional Medical Center in St. George reported being close to maxing out its capacity.
Meanwhile, 97% of Utahns live in communities and neighborhoods with more than 101 new infection per 100,000 residents in the past week — a rate federal health officials have called the “red zone.” As of Sept. 1, only about 25% of Utahns lived in communities with rates that high. Of the 98 “small areas" health officials use to study community-level health trends, only three were below the “red zone” threshold: Daggett and Uintah counties, Duchesne County, and Cedar City.
For the past week, 13.9% of all tests have come back positive — a rate state officials say indicates a large number of infected people are not being tested.