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Arizona health officials warn of consequences of delayed care

Hospitals overwhelmed with COVID-19 patients delay screenings

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At Copper Queen Community Hospital in Bisbee, the operating room in the 13-room health care center closed its doors temporarily, canceling 17 routine colonoscopies as a result, and the hospital entered crisis standards of care, according to Chief Medical Officer Dr. Edward Miller.

The cause was an exhausting number of severe COVID-19 cases that overwhelmed the rural hospital and further delayed care for those who needed it, including one patient on dialysis and another with congestive heart failure.

Those patients were transferred out of Copper Queen. Miller said two advanced cases of colon cancer were found last week — a potentially fatal outcome of delayed care.

“We are having problems down here,” Miller told reporters during a news conference Tuesday. Colonoscopies at the hospital are now booking out into May.

Urban Phoenix-area hospitals with more resources, such as staff and ICU beds, aren’t faring much better, and hospital leaders are pleading with the community to help lessen the burden.

“Less COVID patients allow us to take care of non-COVID patients as well,” said Dr. Marjorie Bessel, chief clinical officer at Banner Health, who added that 130 patients were awaiting transfer to hospitals that can best serve them. “What we know is that vaccine prevents disease, hospitalization, need for intensive care and need to be placed on a ventilator. The vaccine will also keep you healthy and help you not miss out on the holidays.”

Bessel said about 80% of patients hospitalized with COVID-19 at Banner hospitals are unvaccinated and are overloading the already stretched system. Of those patients, 55% are on ventilators. That means others are delaying care and presenting with late-stage disease, she said.

“Do your part to help us,” said Bessel. “Colonoscopies are medically necessary procedures.  Surgeries are medically necessary. [They] can be put off for a short period of time but they can’t be put off indefinitely.”

Data from the Arizona Department of Health Services reported 3,322 new COVID cases and four additional deaths Friday across the state. Arizona’s population is now 62% vaccinated, though there are only about 100 open ICU beds in the state.

Dr. Richard Carmona, a former U.S. Surgeon General and pandemic adviser to Gov. Doug Ducey, said the combination of snowbird season — an influx of typically older residents from the northern U.S. and Canada — and the upcoming holidays are worrisome.

“We’re worried because snowbirds come in, holidays mean people coming together,” he said. “It can precipitate transmission of disease. Snowbirds come with heart disease, hypertension and end up in the ICU. It’s much more difficult because COVID patients are taking up beds.”

Carmona said hospital leaders believe they could manage the winter season much better if COVID weren’t so prevalent in the community.

Mayo Clinic Hospital Medical Director Dr. Alyssa Chapital said the situation at its two Arizona facilities is dire, calling the balance between COVID and non-COVID patients a “careful dance.”

“Yes, we are seeing patients in hospitals that have had delayed care,” she said, adding that equates to longer stays, more complications and the need for more attention from an overworked staff. “[COVID is] preventing us from caring for other patients that have medical needs that if we don’t attend to them now, then they will become patients that get delayed later.”

Carmona said there have been discussions about using the state’s surge line, the system in which hospitals statewide can assist one another with transfers, for non-COVID patients. But even the surge line is currently “overwhelmed” with COVID-19 patients.

Medical officers from nearly every health care system in Arizona meet twice a week to discuss strategies to combat the virus and all that comes with it, including impacts of delayed care and screenings.

“We’re worried about rural hospitals with a paucity of resources,” he said. “We’re working with them to help but not overwhelm urban hospitals, which are already overtaxed. We are working on it every single day.”

Carmona and the other state health leaders urged Arizonans to continue COVID-19 mitigation efforts as the region heads into the holidays in order to help with hospital capacity. Get vaccinated, get booster shots, get a flu shot, mask up and stay home if you’re feeling sick, they pleaded.

“Cases are rising again, even before Thanksgiving get-togethers,” said Carmona, “[We are] asking Arizonans to help us in this battle against an invisible enemy.”

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