POLK COUNTY — As the number of COVID cases continue to rise across the state, local health officials outlined their contingency plans should conditions worsen.
These included opening spaces for COVID treatment within Salem Health facilities, including West Valley Hospital, but at the expense of elective surgeries and infusion services.
Polk County Health Administrator Jaqui Umstead first provided her weekly update of the rising COVID totals to the Polk County Board of Commissioners on Aug. 24. Oregon Health Authority numbers showed for the week of Aug. 15, there were 14,539 positive COVID-19 statewide. Meanwhile, Polk County experienced 326 positive cases and one additional fatality. That brought the county’s test positivity numbers to 389 per 100,000, or 12.2%.
Umstead then addressed the impact on hospitals. She said as of Aug. 23, the state had 937 COVID positive patients in hospitals, with 253 in intensive care units (ICU). Locally, there are 13 Polk County residents hospitalized with COVID.
By age group, Umstead said 25% of Polk County cases were in ages 20 to 29, 18% in ages 40 to 49 and 18% in those under age 20. By city, she said West Salem experienced the most cases at 122, followed by Dallas at 104, Monmouth at 42 and Independence at 34. The unvaccinated continue to be the majority of cases reported.
“Looking at the chart, you see unvaccinated rates are up in the sharp line with more breakthrough cases with delta,” Umstead explained. “That’s what we get because it’s just a more contagious disease.”
She added numbers for Aug. 1 through Aug. 14 show 85.6% were among the unvaccinated statewide and from Aug. 1 through Aug. 21, the number of Polk County COVID positive cases sat 82.1%.
Polk County’s number of vaccinated in the older than 18 age group sat at 45,472 or 70.8% of the population.
“Throughout the spring, we had a sharp increase in vaccinations. That started to decrease toward end of spring beginning of summer but has started to increase again. That’s definitely a positive,” Umstead said.
Commissioner Jeremy Gordon was displeased to hear so many unvaccinated county residents were still proving to be a drain on the health system.
“The least we can do as a community is get our vaccination numbers up,” he said. “Unvaccinated folks are … using their share of medical services that need to be dispersed throughout our communities. We need to get those numbers up. And anything we can do as a local health authority we will continue to do so.”
Michael Gay, Salem Health government relations director, said their COVID positive hospitalizations rose from just six last month to 94 last week, a new high water mark for their system. He added this has also impacted their ICU capacity.
“We have 30 traditional ICU beds, with a capacity to expand outside those beds. Of those, 24 are COVID positive, 16 on ventilators. Five are non-COVID patients in ICU,” Gay said. “We are a 494-bed licensed hospital. Today, there are 458 patients in the hospital. Do the math, about 20% of those on any given day are COVID patients.”
Gay admitted it’s a serious situation with a strong surge occurring. Residents are right to fear the circumstances are threatening Salem Health ability to fulfill a certain level of care with their local health systems across Oregon.
“Salem Health has been planning for this. We’ve built surge plans, worked many scenarios. We’re prepared to create room to care for the community,” Gay assured. “People who need emergency care, are having a medical emergency, we will take care of you. Don’t delay care out of fear for capacity issue.”
Jennifer Broadus, director of operations at West Valley Hospital, said locally they’ve been very busy, hitting as many as 60 patients a day in the emergency department. In addition, West Valley Hospital has been testing eight to 10 patients a day, receiving three or four positive COVID results. Broadus said a large percentage of patients they’re seeing are experiencing respiratory illnesses.
Because West Valley Hospital only has six beds, they have been offloading difficult-to-place patients to Salem.
“We’ve had 20-some in the ED waiting for beds,” Broadus said. “We’ve had two needing hospitalization. We’re in a position for keeping folks several hours, sometimes a day, while they filter in and receive a bed in Salem.”
“The whole region is full,” she added. “West Valley’s challenge really is getting patients a higher level of care into a bed somewhere else.”
Shane Emmert, community director of Polk and Marion counties’ vaccine clinics, explained West Valley Hospital’s surge planning is similar to Salem Health’s which utilizes non-traditional spaces within the hospital.
“We could add four patients to bring (capacity) to 10 beds utilizing surgery staff only,” he said. “If we needed to admit more than that, we could pull on infusion and wounds staff. The result could be us canceling elective surgery and being limited in out-patients services. We could admit up to 14 if we close infusion totally.”
Emmert said West Valley Hospital’s surge plan actually has the ability to go all the way up to 38 patients, but that’s using every single available space, rehab gym, rooms in rehab and infusion wound rooms.
“The real challenge is we don’t have the staff to staff those rooms. It would be very high patient to nurse ratios and would be worst-case scenario for us. We have plans, we just hope and pray we don’t have to implement those plans,” Emmert said.
The lack of staffing is also compounding Polk County Public Health’s ability to contract trace positive cases.
“We had six case investigators, temporary public health workers, and we’re down to one at this point,” Umstead told the commissioners. “It’s a really hard job. We’re overwhelmed at this point with cases, as it is across the state.”
She added they haven’t heard back from the state yet for additional help, but have been told Polk County was not the highest priority county.
“State resources have been redirected to counties in worse shape than we were,” Umstead said.
Chaiman Craig Pope after hearing the testimony concluded, contrary to many media reports, Polk County does not have a “systems collapse” dealing with the pandemic.
“We do have certainly a crisis in hospitals around the state, no question,” Pope said. “I’m always grateful to Salem Health System saying, ‘it’s taxing us, but we’re still taking patients. Still caring for people.’”
He inquired if Salem Health’s surge plans included a field hospital at the county fairgrounds.
Gay confirmed a field hospital is not built into the Polk County surge plan.
“If we were to set up a field hospital at the fairgrounds, that would rely on outside sources of West Valley and Salem Health,” he said.