Kansas hospitals are taking steps to prepare for rise in COVID-19 cases as Delta variant threat looms

Andrew Bahl
Topeka Capital-Journal
Hospitals like Stormont Vail Hospital, pictured here, seek to avoid a repeat of the fall surge of COVID-19 cases in the state. Concern has risen that spikes fueled by the Delta variant in Missouri, and elsewhere, will seep into Kansas.

At Mercy Hospital in Columbus, things are starting to veer dangerously towards a state of deja vu.

Mercy, the last hospital in the state before you exit southeast Kansas and enter Missouri, has been called into action in recent weeks, as a flood of COVID-19 patients again inundates its sister facility across the border in Joplin.

Because Mercy is a critical-access facility, the smallest type of hospital, primarily found in rural and frontier areas, it doesn't typically house COVID-19 patients long term. Usually, that type of patient would be sent to Joplin — something that currently isn't an option.

Instead, the Columbus hospital is caring for non-COVID-19 patients from the region who are rehabbing less severe injuries in a bid to reduce the burden on their Missouri counterparts.

The problem for Angie Saporito, the hospital administrator, is what to do with COVID-19 patients from the community, with those numbers slowely ticking up in recent days. While family and loved ones would prefer they stay in the Joplin metro area, the hospital has sometimes had to move patients to Kansas City, Missouri — roughly two-and-a-half hours away.

Having those conversations, she acknowledged, "is a challenge."

"(We are) helping them understand this is just kind of unforeseen times,"  Saporito said. "And unfortunately, there's not a local bed available, and we're going to give them good care, and we're finding them a bed elsewhere and helping them be OK with the fact that we're going to find them a bed, but it may be a little farther out than where they would like them to be given the circumstances."

While many other hospitals in the state are seeing their own COVID-19 numbers rise, officials note they are better prepared to cope with a potential surge of cases — powered by the Delta variant — than they had been earlier in the pandemic.

The state has been able to keep at bay the worst-case scenario, which is being felt in Missouri, Colorado and Arkansas. But there appears to be an understanding that things will be able to hold on only so long, with Delta cases doubling in the past 12 days to over 600 cases in the state.

"We don't want to give the signal that everything is fine and won't get bad again, but we're not at that point yet," said Cindy Samuelson, spokesperson for the Kansas Hospital Association.

As Delta cases increase, hospitals revisit COVID-19 plans

The Centers for Disease Control and Prevention have cautioned that more than half of the new cases being uncovered in Kansas and the surrounding region are linked to the Delta variant.

First identified in India, the Delta variant is just one of a number of variations on COVID-19 that have gained footholds in recent months. 

Also known as the B.1.617.2 strain, it is believed to be faster spreading than other strains of COVID-19, although it still isn't clear whether it makes those infected sicker than other versions of the virus.

While there is strong evidence that Pfizer and Moderna vaccines provide protection against the Delta, the variant has wreaked havoc on parts of the Midwest where vaccination rates continue to lag.

Dana Hawkinson, infectious disease specialist at the University of Kansas Health System, noted that upwards of 80% of the cases in their hospital's intensive care unit were unvaccinated, including one patient in their 20s.

"The theme is vaccination will significantly reduce the overall spectrum of disease and especially prevent you from having to go to the ICU," Hawkinson said.

Hospital utilization isn't yet at the breaking point many Missouri facilities are encountering, with a hospital in Springfield, for instance, opening a sixth COVID-19-specific ward. The bulk of the ICU beds in southeast Kansas remain available and statewide over 40% of intensive care beds are free.

Gov. Laura Kelly told reporters last week that Kansas hasn't had to reach out for federal support, like their neighbors in Colorado and Missouri.

"We know we’ve had little spikes here and there," she said. "If we need help, we won’t hesitate to ask."

Still, some facilities are already beginning to brace for impact.

In Arkansas City, for instance, SCK Health Medical Center has re-imposed many of the same social distancing and mitigation procedures put in place at the beginning of the pandemic in spring 2020.

"There is an increasing concern about the transmissibility of this new Delta strain of the coronavirus, and as a health care institution it is our responsibility to prevent the spread of this and any illness, and protect our patient population to the best of our abilities." Trevor Langer, the hospital's director of marketing, said in an email.

Facilities in Kansas have been supporting Mercy Hospital Joplin, pictured here, as parts of Missouri seek to cope with a rise of COVID-19 cases fueled by the Delta variant.

Facilities worry about ‘nightmare months’ for staffing

Many Missouri hospitals have been grappling with staffing challenges, with the surge staffing used at the height of the pandemic long gone in many cases. In rural areas, longstanding shortages in many health professions are having an impact as well. 

Statewide, there is less concern about the potential for staff shortages in Kansas, said Samuelson, of the Kansas Hospital Association. While facilities would previously report data to KHA on the number of employees out at a given time, that stopped as the pandemic eased and the organization hasn't felt the need to restart that process.

Still, in Columbus, Saporito noted things could get tricky for her small hospital. 

For instance, the facility has one housekeeper, who is sent home in the afternoon.

If a COVID-19 patient comes to the emergency room overnight, they either have to call that staffer back to the hospital or someone else has to spring into action in order to do the deeper clean the virus requires. In some instances, that person has been Saporito.

 And many staff members are on vacation or taking time off over the summer — a reality that makes staffing the emergency room tricky, even in a normal year.

"June, July are always kind of my nightmare months, even without COVID," Saporito said.

A person holds a sign outside Houston Methodist Hospital to protest a policy that says hospital employees must get vaccinated against COVID-19 or lose their jobs.

Will vaccines be required at Kansas hospitals?

The staffing shortage in Missouri has gotten to the point where some health systems have begun requiring their workers be vaccinated against COVID-19, arguing it is also vital for keeping patients safe from the virus.

In Kansas, there is no state law preventing facilities from taking similar actions, despite legislators considering such a ban in the 2021 session. Federal court cases thus far have also upheld the rights of hospitals to require their staff get the vaccine.

But Samuelson said facilities would likely remain hesitant until the emergency use authorization is lifted and the vaccines are approved on a permanent basis. Such a decision is handled by the Food and Drug Administration and there is no timetable yet for when it might take place.

Still, she acknowledged the uncertainty posed by the variant.

"If something changed drastically with the variant and they felt it was important to protect their staff ... I could see hospitals revisiting that," Samuelson said.

Mercy's parent system required staff at all of their hospitals be vaccinated by September — a move that includes Columbus. Saporito said most of their workers had gotten the shot anyway and that conversations were underway with the holdouts to answer their questions.

Despite the political fracas such a requirement has caused at other hospitals, including protests outside facilities in Texas and Missouri, she said everyone had taken it in stride.

"So far, it hasn't been anything too wild," she said.

Vaccinating the surrounding communities has been a different challenge. Kansas Department of Health and Environment data shows the vaccination rate in Cherokee County, which includes Columbus, at 31%. That mark is below the statewide figure of 45% who have gotten at least one dose.

Many residents have simply moved on from the pandemic, Saporito said, pointing to crowded gatherings throughout the spring for graduations and other events. Vaccination rates had particularly lagged among younger folks — a group of particular concern given the Delta variant.

"People just kind of took that as 'We're back at it, we can just start living life again,'" Saporito said. "And I don't think the vaccine rates were as high — people weren't getting them in (the younger) age group. But they were definitely attending events and cautions were kind of left to the wind."