'A dark and long winter': Suburban health leaders say worst is yet to come with COVID-19
Nurse Nicole Kinberg can sense the tension, the exhaustion, the high levels of stress on her COVID-19 floor at Northwest Community Hospital.
A surge in patients has hit the Arlington Heights medical center in recent weeks, she said, adding to the toll on her fellow front-line workers nine months into the pandemic.
Even on her days off, Kinberg is asked to come into work, where she helps care for the influx of patients and communicates frequently with families.
"I'll do that til kingdom come ... but it's very emotionally exhausting," Kinberg said. "I probably cry at work every day."
Northwest Community Hospital reported 85 virus patients as of Friday, up from 70 just three days earlier, climbing closer to its spring peak.
As hospitalizations soar around the state, other local health care systems already are seeing a record-breaking number of COVID-19 patients - and they warn the worst is yet to come. One group of physicians is projecting Illinois will surpass its intensive-care bed capacity around Thanksgiving.
Some hospitals are now evaluating elective procedures on a case-by-case basis, expanding bed capacity and imploring families to cancel holiday gatherings outside their bubble.
But hospital leaders say staffing levels remain a top concern as the pervasive spread of the virus forces employees into quarantine or leaves them vulnerable to exposure in the community.
Nearly 3% of staff members across Rush Copley Medical Center in Aurora were staying home with either COVID-19 or for other reasons at one point last week.
"That's a stressor that did not emerge in the first wave of the pandemic to this degree," Chief Operating Officer Mary Shilkaitis said.
While earlier surges struck different parts of the country at different times, the new wave is straining hospitals in many states, limiting the availability of traveling nurses or other personnel to help with a flood of patients.
"You can put people in beds, but if you don't have the staff to take care of them, it doesn't matter," said Dr. Sanjeeb Khatua, chief physician executive and COVID-19 incident commander for Edward-Elmhurst Health.
Record highs
In mid-April, Edward-Elmhurst Health was treating as many as 124 patients with COVID-19.
The system saw a gradual decline in cases after that, with hospitalizations dipping below the 100-patient threshold a month later and dropping into the teens by late summer.
Admissions rose exponentially in October and topped previous highs this month. As of Friday, the system reported 175 total patients with confirmed COVID-19 cases - 78 at Elmhurst Hospital and 97 at Edward Hospital in Naperville.
Edward-Elmhurst has been preparing for a fall surge, Khatua said, hoping to eliminate the need for another operational shutdown of elective procedures. But as COVID-19 cases continue to rise, he said, hospital leaders are evaluating staffing levels and surgical schedules on a daily basis, ready to redeploy employees from other units if needed.
"We have to prioritize what we (can) care for and what we can't," Khatua said. "I think we're going to start hitting that point fairly soon where we're going to have to start making those difficult decisions."
In Winfield, Northwestern Medicine Central DuPage Hospital has been recruiting additional employees through external agencies, and many workers have been taking on additional shifts, said Sue McCoy, chief nursing executive. Some physicians or nurses who recently transferred outside the hospital environment have offered to return.
"They are resilient, but I'd be lying if I told you it's not taking a toll," McCoy said of front-line staff.
"They see the patients, and they see the struggle, and no matter what, this is what nurses do. This is what we train for."
NorthShore University HealthSystem had about 160 hospitalized COVID-19 patients as of Friday. Glenbrook Hospital, the system's COVID-designated facility, was treating a majority of them. The remaining patients were at Evanston Hospital and Swedish Hospital in Chicago.
The system is evaluating elective surgical cases and interventional procedures on a case-by-case basis. All urgent procedures will continue as planned, according to a spokesman.
Rush Copley in Aurora reached a peak volume of 82 COVID-19-positive patients this past week. The hospital has been assessing what procedures are critical and what can be postponed if needed.
"I think hospitals have learned to manage both COVID and non-COVID patients in a very skilled way at this point," Shilkaitis said.
"So we are taking control of that if you will and regulating the surgical flow so that we can always have the staffing levels to meet the demand."
Northwest Community Hospital hasn't curtailed elective procedures and doesn't anticipate hiring traveling nurses, said Dr. Susan Nelson, vice president of physician operations.
Patient numbers in the spring peak at Advocate Aurora Health reached the mid-800s. Advocate on Friday had 1,041 COVID-19 inpatients throughout the system, including 593 across 10 Illinois hospitals, spokesman Adam Mesirow said.
"We are managing but are facing staffing and capacity challenges, and unfortunately there are no signs of a slowdown," Mesirow said. "That is why we are imploring people in our communities to help stem the spread."
'Huge surge'
In a letter to Gov. J.B. Pritzker, a group of health care workers said Illinois is heading "into a dark and long winter."
Models show the state is on track to run out of ICU beds around Thanksgiving, the Illinois Medical Professionals Action Collaborative Team wrote.
A data analyst for the group, formed in part to amplify physician voices during the pandemic, based the forecast on the current growth rate of cases in Illinois and the tight correlation between cases and hospitalizations, IMPACT co-founder Dr. Shikha Jain said. Admissions tend to lag behind new infections by about two weeks.
The projections don't take into account college students who are heading home or Thanksgiving travel that could push caseloads even higher, Jain said. The projections also do not account for the state's stay-at-home advisory that experts hope will prevent ICU bed shortages if people follow it.
"When we reach Thanksgiving, I'm sure our numbers are going to be significantly higher unless people start taking this seriously and wearing a mask and following the restrictions that have been recommended," Jain said. "After Thanksgiving, I think that we're going to see a huge, huge surge again."
As of Saturday night, Illinois hospitals reported 5,474 people were receiving treatment for COVID-19, 1,045 of them in an intensive-care unit.
Pritzker has said the state has no plans to reconvert McCormick Place to a field hospital.
Construction to turn the former Sherman Hospital campus in Elgin into an overflow site finished in April, but the facility never opened and the property was surrendered to its owner at the end of September, an Illinois Emergency Management Agency spokeswoman said.
Jain and the Illinois Hospital Association cautioned that setting up makeshift facilities this time around would run into the same staffing issues facing health care systems.
"There is a finite amount of us, and we are seeing outbreaks in health care workers across the country," Jain said.
IMPACT is making an urgent plea for people to double down on public health measures to get control of the surge. And the hospital association has launched a "mask up" campaign.
"We're very concerned that hospitals could become overwhelmed in the very near future," spokesman Danny Chun said.