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As the omicron surge overwhelms emergency rooms, hospitals can't keep up

STEVE INSKEEP, HOST:

The United States has hit a new pandemic record. There are now more people hospitalized with COVID-19 than at any other point in the pandemic. If you doubt this, visit an emergency room. NPR's Will Stone reports.

WILL STONE, BYLINE: America's astronomical number of infections can feel abstract. But in emergency rooms, they are concrete - excruciating wait times, patients filling the waiting rooms, unable to get a bed.

GABE KELEN: This is about as bad as I can recall in my lifetime.

STONE: That's Dr. Gabe Kelen, chair of emergency medicine at Johns Hopkins in Baltimore.

KELEN: The emergency departments are, like, the one open venue for everybody, and we are being absolutely crushed.

STONE: They're putting patients outside in tents or keeping them in the hallways, wherever they can find space. Maryland is in especially bad shape, but it's a similar picture all over the country, including in Tucson, Ariz., where ER doctor Bradley Dreifuss works.

BRADLEY DREIFUSS: Literally, there are patients in our emergency department who have been there for over 200 hours waiting for a placement.

STONE: That is, they're on a gurney in the hallway, waiting for an actual hospital bed. Problem is there are none.

DREIFUSS: Our hospitals are totally full. We're not able to admit patients. We don't even have admitting teams currently. We are not able to get patients where they need to be because our system is literally collapsing.

STONE: Dreifuss is seeing the fallout firsthand - patients leaving the ER only to come back later even more sick.

In St. Louis, Dr. Alok Sengupta oversees the emergency rooms at Mercy Hospitals. He says one day last week, their busiest ER saw about a 50% jump in patients.

ALOK SENGUPTA: All of our emergency departments in our hospitals are really getting hit much harder this time around.

STONE: This is true for many ERs right now, and Sengupta says there are two primary reasons.

SENGUPTA: We have large volumes, but then we also have staff that are out. And they have to quarantine before they can come back to work.

STONE: Omicron is so infectious and moves so fast that the sheer volume of patients pouring into ERs is staggering. But Seattle ER doctor Gregg Miller says he's seeing some differences.

GREGG MILLER: ERs are as busy or busier than ever, but the overall group of patients that's coming in isn't quite as sick now as it used to be.

STONE: Miller is chief medical officer for Vituity, a company that has thousands of ER doctors around the country. In general, he says doctors are finding that the proportion of COVID patients who show up at the ER and need to be admitted is smaller than earlier in the pandemic. That's largely because people have immunity from vaccination and prior infection and because of omicron itself. Studies in the U.S. and from overseas do show people have less severe illness compared to delta.

MILLER: And so you've got these two competing forces - increased infectiousness, decreased lethality. Which one of those forces is going to win out? And unfortunately, what we're seeing right now is it's the increased infectiousness that's really winning out and driving hospital admissions.

STONE: In other words, the numbers are just too big, especially in places where vaccination rates are low. Dr Casey Clements is with the Mayo Clinic in Minnesota.

CASEY CLEMENTS: The majority of the patients who have been in our ICU in the last several weeks are still unvaccinated.

STONE: And with their hospital as full as it ever has been, that keeps people stuck in the ER and backs up the entire hospital, disrupting care for all kinds of patients.

CLEMENTS: This omicron wave is really turning out to be much worse than previous waves, including delta.

STONE: And he worries this surge could be the most dangerous yet.

INSKEEP: NPR's Will Stone has been reporting there. And, Will, I want to follow up on that. This is less dangerous for any given individual, but some people get sick. So what kinds of people are ending up in the hospital?

STONE: Yeah, most of the vaccinated people who are sick enough to be admitted to the hospital, they often have several underlying risk factors, and COVID kind of tips them over the edge. Then there are still unvaccinated people coming in - some of them young, otherwise healthy, who are very sick. And then some people are coming into the ER for a different medical emergency. They just turn out to be positive. Actually, there are quite a few people who are showing up simply to get tested because they can't find a test anywhere else. And, of course, that's not how things are supposed to work.

INSKEEP: How does that affect hospital patients who do not have COVID?

STONE: Yeah. When hospitals are under duress, everyone suffers. Surgeries are canceled. Patients who have emergencies can't find a bed. I spoke to Dr. Ruth Franks Snedecor, and this is what she's seeing in her big hospital in Phoenix. And we should warn it's pretty graphic.

RUTH FRANKS SNEDECOR: I couldn't believe that in a single week on service in a hospital, I had three patients that needed amputations. Their infections in their limbs had gone too long that they needed - one needed an above-the-knee amputation, and two of them needed below-the-knee amputations.

STONE: Snedecor said none of these patients had COVID, but they had either waited too long at home or they couldn't get the care they needed. And she says this would not be happening if the health care system wasn't so overwhelmed.

INSKEEP: Just a reminder that whatever choices we make and whatever chances we run into can affect other people. Will, thanks so much.

STONE: Thank you.

INSKEEP: NPR's Will Stone. Transcript provided by NPR, Copyright NPR.