National Guard troops screening visitors at the entrances.
Nurses working so many 12 hour shifts in a row the days become a blur.
A children’s ward turned into a makeshift intensive care unit, the rooms cleaned and filled so quickly there is no time to grieve.
Douglas County is experiencing an unprecedented surge in new COVID-19 cases, and in turn, hospitalizations. The number of COVID-19 patients hospitalized tripled in August, to more than 90. That has put CHI Mercy Medical Center — and specifically its intensive care unit — at the center of the storm.
Longtime employees at Mercy say nothing comparable has ever happened at the hospital. Many fear the situation will get worse before it gets better.
“This is real, it’s spreading like wildfire,” said Allison Williams, an 18-year veteran at the hospital who heads up the ICU. “I’ve never seen anything like it.”
The numbers are startling, scary and depressing all at once.
In August alone, there have been more than 5,000 new cases reported in the county and 37 COVID-19 related deaths.
The explosion of new cases, hospitalizations and deaths is not just happening here. This past week, the number of Oregonians who were in the hospital due to COVID-19 surpassed 1,000 cases for the first time. More than 93% of the hospital beds in the state, including those in ICU units, are occupied, according to the Oregon Health Authority.
On Friday, there were 3,207 new confirmed and presumptive cases in the state, the highest single-day total ever.
Over the past couple of months, Douglas County has had the distinction of being among the leading counties when it comes to new cases. And those grim numbers translate to daily new patients at Mercy, which is already stretched to its limits.
This week the hospital had a total of 116 patients, out of 140 beds available. Of those patients, 63% had the coronavirus, meaning parts of the hospital have been turned into mini COVID-19 wards.
“It becomes a challenge sometimes if you don’t have enough places to put people,” Williams said.
The steep increase in COVID-19 cases has disrupted operations throughout CHI Mercy. Appointments for routine care like physical therapy are being canceled and even some more serious procedures are postponed due to a shortage of available medical personnel.
But no unit has been more affected, or come under more strain, then intensive care.
If there is a war raging against COVID, as some say, the staff in the ICU are on the front lines.
The ICU has 16 rooms, full of course, with every patient sedated into silence. The sedation is needed because they each have breathing tubes down their throats; the sedatives keep them still.
The ICU is quiet; the only sounds come from the chatter of the nurses and the beep beep of the machinery in each room.
There are about a dozen nurses and other staff in the main ICU unit at any one time.
Each room is glassed in and the glass doors are kept shut as an extra precaution against COVID-19. That means the staff has to be alert to any alarms that may go off in a room, signaling a patient needs attention.
The desire to keep the rooms closed and limit traffic in and out has led the staff to write notes in black marker on the outside of the glass, indicating dosages and other patient information.
With the ICU completely full, Mercy had to get creative. It turned a section known as a Progressive Care Unit into an overflow ICU. The PCU unit initially had 16 ICU care beds, then added four more. That amounts to a total of 36 ICU care beds.
Unlike the standard ICU rooms, the PCU rooms had solid doors; glass slits had to be added to the doors to help the nurses keep a better eye on their patients.
Part of the PCU unit served as a small pediatric ward. There is a sign on a door warning parents not to add extra water to infant formula. A wall holds a poster showcasing a half-dozen cartoon characters, including Bugs Bunny, Daffy Duck and Porky Pig.
There is also a banner painted along the walls with Mickey Mouse smiling and posing. A hand-drawn poster tacked onto the nursing station features red hearts and the note: “Thank you Doctor’s, Nurses and Staff.”
When it comes to fighting COVID, and boosting morale among the staff, every little bit helps.
When they lose a patient, and there have been more and more losses of late, there’s scant time to mourn. Other patients are waiting.
“In this unit, when a bed is empty, it’s cleaned and filled right away,” Williams said.
Finding qualified nurses was a challenge before COVID-19, Wiliams said. Now it’s become an around-the-clock concern. That staffing shortage is compounded when a staff member tests positive for the coronavirus and had to be pulled off the rotation, she said.
“You think you have a plan, then you have three or four staff who call in. Then you need a new plan,” Williams said.
The nurses and other staff are working 12-hour shifts, five and six days a week, sometimes more.
Every day they come in not knowing exactly what they’ll face, just knowing it won’t be pleasant.
Williams said she sees the tension, fatigue and worry in the eyes and on the faces of her staff.
“Everyone has their game face on,” she said. “It’s completely different.”
To help ease the staffing shortage, Gov. Kate Brown has committed to bringing in out-of-state medical professionals to help fill the staffing shortages, like the one at Mercy.
Sarah Baumgartner, spokesperson for Mercy Medical Center, said the hospital has asked for 82 medical personnel from the governor’s program, including 41 total clinical staff and 24 nurses. The details are still being worked out, she said.
“We will know more next week,” Baumgartner said. “We have not received confirmation of what we are receiving, but it is in the works.”
One bright spot in the fight against COVID is the way the community has rallied around Mercy, and pitched in in ways big and small. Other hospitals and medical care providers have shared supplies, and occasionally staff, with Mercy. On Friday, the Ford Foundation paid for two food trucks to serve meals to the weary staff, providing a brief respite.
Then there was the person who walked in and handed over $500 worth of gift cards to give to the staff. They didn’t leave their name, Baumgartner said.
Workers, too, are going above and beyond in an effort to help. Williams said she knew of one 67-year-old employee who postponed their retirement to remain on the job.
Troy Wilder, an administrator at the VA Medical Center in Roseburg, also stepped up. Wilder is a respiratory therapist, skills that are in great demand in the fight against COVID-19.
So he took a leave of absence at the VA, and for the past several weeks, has volunteered his time at Mercy. Wilder is matter-of-fact about it all.
“I have the skills and they need my help,” he said. “I grew up here. I’m part of this community.”
Part of the worry among staff at the hospital is that at the moment there is no end in sight. One study released his week by the Oregon Health & Science University in Portland said models show the current record high levels of hospitalizations could likely continue until Labor Day.
The hospitalizations will begin to taper off after that, the study found, but will not return to earlier, lower levels until around Halloween.
Williams said the only situation she can compare this to is when swine flu swept through in 2009. That was estimated to have killed about 300,000 people worldwide. COVID-19 is much worse, she said.
“We have younger patients, “ Williams said. “It’s never easy when anyone dies, but when you have a 25-year-old die versus a 90-year-old, it’s a little harder.”