COVID, Flu, and Winter Weather Create Perfect Storm for Local ER, Providence St. Joseph Hospital Creates New Incident Command Center

Heavy rain and high winds inundated Humboldt County at the start of the new year, bringing with it an increase in hospital visits as another rise in seasonal flu and other respiratory ailments joined the party, creating a problematic set of circumstances for healthcare providers. The past two weeks have been particularly difficult for caregivers who are fielding all manner of medical emergencies, as well as a new COVID-19 Omicron variant nick-named “The Kraken,” which has contributed to an uptick in hospitalizations and emergency room visits. In response, administrators at Providence St. Joseph Hospital in Eureka established an Incident Command Center to deal with the crisis.

Locals began asking what was going on at Providence St. Joseph in Eureka after being told that their procedures needed to be rescheduled due to a strain on the hospital’s capacity. Speaking to a staff member who preferred to remain unnamed, they indicated that functions inside the hospital – particularly in high-acuity departments – are quite strained. The staff member told us, “They are halting all surgeries that lead to patients having to be admitted unless it’s an emergency situation. Outpatient procedures are still happening.” 

The Incident Command Center explained in an email to staff that the hospital faced a number of challenges, including: “Increase in patients into our emergency department that require critical care; Weather challenges that have affected transfers of higher acuity patients to regional care centers; Inability to transfer to local skilled nursing facilities due to their own constraints; Staffing challenges at St. Joseph Hospital.”

According to Providence St. Joseph’s Communications Director, Christian Hill, the Incident Command Center will remain operational until “current patient influx and staffing challenges lessen” and until such time when there is “improvement to obstacles.”

According to sources inside the hospital, staffing levels are insufficient to meet demands, and with the influx of flu-related and COVID-19 cases into the ER as well as other medical emergencies that regularly occur, staff is under even more pressure than before thanks to a perfect storm of ailments coupled with a limited ability to transfer patients to other area hospitals. Urgently needed medical interventions are, of course, still being handled by way of the Emergency Department (ER) while many other elective procedures are being rescheduled, including any “procedures that require an admission to the hospital and that are non-emergent.” 

An email circulated January 10th by Providence St. Joseph Hospital Incident Command to “all caregivers and Medical Staff in Humboldt County” outlines the changes made regarding hospital intake and prioritization of care.

As one nurse explained, “There are so many virus patients (COVID, flu, and RSV) that St Joes is canceling all non-emergent surgeries.”  Detailing the scene playing out on the inside of the hospital, this veteran nurse described what the current nurse to patient ratio is in various hospital departments, explaining, “There are not enough nurses for rooms the hospital has, for instance [medical-surgery level 2] can take 35 patients but has nurses for 30; [medical-surgery level 3] is the same but only has nurses for 20.” 

Summing it up, she added, “So the ER has patients waiting for days for beds to become available,” and added, “Because there are no beds available in the hospital, they wait in the ER” (depending on the level of urgent care needed) sometimes for over 36 hours, “usually 2 days” this nurse told us, before either being offered a hospital bed, or deciding to leave “Against Medical Advice”.

A graphic showing recommended “safe staffing ratios” which are routinely minimized within the Providence Hospital network, according to California Nurses Association members, and National United Healthcare Workers union members alike.

As an example of how thin resources are being spread in an effort to meet the needs of St. Joseph’s high acuity patients like those having had emergency procedures, the experienced nurse added, “One year nurses are training new grads because there are not enough [experienced] nurses to train… .” 

Outside the main entrance at Providence St. Joseph Hospital, a Rouge Valley Medical Transport van is stationed, patiently waiting to depart last week.  Communications Director Christian Hill said that transfers are limited right now.  [Photo by Ryan Hutson]

In the current staffing crisis, which comes on top of the pre-existing under-staffing problem locally, another program is being offered to select departments and staff, according to a hospital team member who told us, “Providence recently rolled out an incentive program for EPES (Extra Pay Extra Shifts) with Nurses getting up to an extra $500 per shift on top of the overtime pay.”  They also explained that this bonus is not being offered widely. “The more we work extra, the less incentive for admin to not hire more staff,” added a nurse who says they themselves rarely work overtime–they consider the likelihood of the ‘burnout factor’ not worth the extra pay.

According to local union representatives and their members alike, chronic understaffing continues to be an issue raising daily alarms in local hospitals where there still are not enough hands to go around, even with the limited ESEP bonuses for taking on an extra shift. For many nurses and technicians who are already working extra shifts, and handling more patients than is recommended by standard RN-to-Patient ratios, a maximum $500 bonus does not make the extra time and effort  worthwhile at the expense of much-needed rest and recuperation, family time, etc. 

One Providence employee told us that, “especially with such a heavy patient load after years of being understaffed,” the bonus just wasn’t appealing considering the high acuity patient load combined with the already strained circumstances of staff running on fumes, being spread too thin during regular shifts – which is typically a 12 hour stint – requiring much more stamina than your average 9-5 gig.  This sentiment was echoed by a second interviewee, who felt that the ESEP bonus was not worth the strain.

Another staff member speculated that some staff may not choose to take the extra shifts because the payroll system change implemented in August of 2022 is still seeing problems, and, that “even if it was worth the time and money for the bonus, you don’t know if you can rely on the payment because of their system – it’s still not fixed fully.” 

The Kraken, a COVID-19 Omicron Mutant

In addition to the influx of emergency room visits due to weather or accident-related events, perhaps a car accident or a cardiac arrest, an increase in COVID-19 cases also factored into the lack of beds and staff for non-emergent needs, which are now being rescheduled to give the hospital staff some breathing room between crises.   As one staff member told us, “It seems to be a mix of low staffing and an influx of “sick” patients. We seem to be having an uptick in flu and COVID.” 

The COVID strain, XBB.1.5, dubbed “the Kraken” – a foreboding moniker for the COVID-19 mutant – is a combination between two previous Omicron strains, BA.2.75 and BA.210.1, and has quickly spread across the globe. The Kraken is currently tracked as the fastest spreading variant in California according to the California Communicable Diseases Assessment Tool. 

Grace Roberts, Research Fellow in Virology at the University of Leeds, in the city of Leeds, across the pond in the United Kingdom explains that so far, “laboratory studies, yet to be peer-reviewed, have shown that “the Kraken”  “is less sensitive to antibodies acquired from vaccination than previous variants XBB and BQ1.1. So it’s very good at evading our immune response.”

According to data collected by the state, Humboldt County is treating a total of 10 patients listed as positive for the virus, with zero ICU beds listed as available.

Staff at St. Joseph Hospital, and those who are tasked with caring for these COVID-19 positive patients say that although these folks may not be admitted for COVID, they are in the hospital with it, and therefore require additional resources, space, time and energy from staff because of the required precautions that come with the territory when treating a patient with (or for) an aerosol transmissible virus – per CalOSHA standards and California’s Assembly Bill AB-394 regarding health facilities and nursing staff. 

With calmer weather and St. Joseph’s Incident Command Center, hopefully, the ER waits will drop and residents will have better access to care. However, staffing – or lack thereof – is widely considered the underlying problem, and nurses say that hiring more full-time ancillary staff, as well as additional nurses, could be the solution. 

This article is written by Ryan Hutson, a local freelance journalist. Follow Ryan at Humboldt Freelance Reporting on Facebook, Insta and YouTube. To support Ryan’s award winning reporting, please consider donating here.