The lack of ICU bed availability in Grand Junction hospitals is not currently presenting a significant challenge at Montrose Memorial Hospital, which is part of a statewide network prepared to take on overflow as COVID-19 cases ramp up.
“We’re on heightened alert, but we’re still on Tier 1 (COVID-19 response level), ready to go to the next level if we need to, but we’re not there right now,” said Dr. Drew Bolton, who practices at Montrose Memorial.
Thursday, the public health department in neighboring Mesa County announced all ICU beds in Grand Junction were full. Not all ICU beds there are occupied by COVID-19 patients, but hitting capacity means alternatives must be employed to fully care for patients.
Mesa County Health said in a news release that hospitals there will begin activating surge capacity to ensure rooms and beds are ready, implementing a plan that was put in place at the start of the pandemic.
“St. Mary’s, like other healthcare facilities across the nation, has been and continues to be impacted by COVID-19 as cases continue to rise in Mesa County,” said Bryan Johnson, president of St. Mary’s Medical Center, in the news release.
“We have hospital beds available, and we have surge plans in place that will allow us to grow capacity and ensure safe, quality care to as many patients as need us.”
Mesa County hospitals are part of the Western Health Alliance, along with Montrose Memorial Hospital; they communicate in a nearly real-time basis, Mesa County Public Health spokeswoman Amanda Mayle said.
“They are working in tandem to ensure all residents in western Colorado get the care they need,” she said.
Other options for care are in place, but regular availability has been tapped out, she added.
“When we reach that point, then we move in this direction. We have been working together from the beginning and have been fortunate to this point that we haven’t reached this level,” Mayle said.
Mesa County hospitals currently have an urgent need for staffing; its news release quotes Veterans Affairs Western Colorado Health Care System Executive Director Richard Salgueiro as saying it is “a call to arms.” He encouraged retired or displace clinical personnel to help if possible.
Hospital patient numbers fluctuate frequently, as patients are released and new patients admitted. At Montrose Memorial, the daily census of COVID patients is between two and six, Bolton said. There were three COVID patients there Thursday, marketing director Leann Tobin reported.
“It’s a steady kind of influx, but nothing overwhelming,” Bolton said.
If the hospital here has a patient who needs a higher level of care than MMH can provide, it communicates with other hospitals to see which one is best able to provide the level of needed care.
Recently, MMH transferred a patient who needed a neurosurgeon to St. Mary’s, which had an opening in its neurosurgery department.
“We may have had the patient here longer than usual, but we were able to move them,” Tobin said. “We also had to transfer another patient to Porter Hospital in Denver, because St. Mary’s was not able to accept them. It’s a juggling act, for sure.”
Bolton said the state is rolling out an inner-hospital transfer system with the idea it will function as a “release valve” for hospitals at capacity, primarily with non-COVID patients.
Montrose Memorial would normally transfer certain trauma cases and other issues to St. Mary’s, but because of the capacity situation, MMH would turn to the state’s collaborative placement network to help determine where to send patients needing more care, Bolton further said.
All hospitals in the state are on at least a Tier 1 response level, like MMH.
This is the lowest level of tier planning and means the hospital does not have to find a way to open up more beds or call in extra staff. For MMH, it means five or fewer COVID patients, with some overflow into ICU or surgical beds allowed.
Tier 2 would nearly triple the available COVID response (13 COVID patients for MMH), while Tier 3 would mean MMH has 20 or more COVID patients and again opens its COVID unit.
On Thursday, Montrose County Public Health asked people to develop a COVID-19 response plan for their households. The county recommended a checklist to encourage families to think about what they would do if someone in the home has COVID — for example, considering where could the ill person isolate; whether a separate bathroom is available; if there are sufficient cleaning supplies and what steps would be taken to keep caregivers safe.
A key component of making a plan entails finding a doctor before COVID strikes, rather than scrambling to find someone taking patients after a household member is diagnosed with the viral ailment. The county also recommends assembling family medical information into a central location so it is readily accessible.
Info on how to make a plan can be found at montrosecountyjic.com, as can a link to the Make a Plan video.
“We’re seeing an increase in family transmissions,” Montrose County Media Relations Manager Katie Yergensen said. “There are a lot of family units in Montrose and multiple generations that live together. We want to make sure we’re doing the best we can to reduce the spread of COVID and keep those family units as safe as we can.”
Montrose County has recorded 689 COVID cases and 15 deaths. Between Wednesday and Thursday, cases had gone up by 21.
Community spread remains a significant driving force. Because of its two-week positivity rate — which as of Thursday was 14.2% — Montrose County has been placed on the state’s “yellow” risk level, or “caution.” Mesa County is two notches up on the risk dial, at red.
“Transmission among families is high — we know it is important to help care for loved ones when sick, but we are encouraging the public to have a plan in place to help keep the rest of the household residents safe,” Montrose County Assistant Public Health Director Allison Howe said, in a news release promoting COVID plans.
“Also, because many households have multiple generations, and it is extremely important to keep our vulnerable populations safe from COVID-19.”
Having a plan will help the community in the long run because following a solid one should cut the spread of the virus, Montrose County Commissioner Sue Hansen said, also in the news release.
“It will help keep schools and businesses open and ultimately, help protect our community,” she said.
Montrose Memorial’s Tobin echoed reminders to guard against COVID, reiterating the need for good hand hygiene, face coverings in public and maintaining social distance. She said there is a trickle down effect when COVID spreads through the community.
“The bottom line in all this is that the hospital system across the state is currently substantially affected,” Tobin said.
“In addition to COVID patients, with the wide spread through our community, our staff is also being affected. When schools close due to COVID, our staff have children in the schools and now they have to find child care. When the virus is spread through the community, our staff members run the risk of being exposed and becoming ill, too.”
Montrose Memorial Hospital has restricted visitors to a single visitor, per patient, per day. All hospitals in Grand Junction have implemented a no-visitor policy.
To obtain a COVID test, people need to reach out to their health care providers for an assessment. If they are given a test order, they can go to the Montrose County Event Center, 1036 N. Seventh St. (just off the San Juan Bypass).
Those who do not have a provider’s order can call Delta County Public Health at 970-874-2165 to discuss options.