All Delaware County hospitals are at capacity and diverting ambulances with nonurgent patients to other hospitals in the midst of what a top health official called “the perfect storm” – steep increases in both COVID-19 patients and in the number of employees calling out sick with the virus.
Crozer Health’s four hospitals are so short-staffed that the emergency room at Springfield Hospital will temporarily close starting Friday. And that is likely to add stress on other already crowded hospitals, such as nearby Riddle. As the omicron variant spreads rapidly, hospitals don’t have enough staff “for normal routine care,” Delaware County medical adviser Lisa O’Mahony said, a problem that has hit facilities across Pennsylvania in recent days.
“I don’t think we’ve experienced this in any recent times,” O’Mahony said.
With hours-long emergency room wait times for nonurgent care, “you don’t want to cut yourself while you’re making your bagel,” she added, “because you don’t want to need sutures at this point.”
The strain could constitute a warning sign that the surge is intensifying in the region. Other parts of the state have been experiencing high stress for weeks, with hospitals taking stopgap measures to increase bed capacity, stretch workers, and prioritize the most-urgent patients.
Now, with hospitals experiencing a tsunami of staff absences due to their own COVID-19 cases or exposures, they have even fewer workers available.
Though Philadelphia and suburban hospitals were doing slightly better in December than other parts of the state, the number of people hospitalized per day here has been climbing — quadrupling between Dec. 3, when the first omicron case was detected in Philadelphia, and Monday.
By last week, Crozer-Chester Medical Center had reached such a low level of staffing that it was allowed, per CDC guidelines, to call workers back from isolation before their five-day quarantine was over, said Gary Zimmer, the chief medical officer at Crozer Health.
The closure of Springfield’s ER will allow workers to move to other hospitals. And volunteers from the Delaware County Medical Reserve Corps are filling in for staff at all four Crozer hospitals — Crozer-Chester, Delaware County Memorial, Taylor, and Springfield, O’Mahony said.
“We expect that the next few weeks will be difficult,” Crozer spokesperson Lori Bookbinder said Monday.
We need to ‘get a handle’
The surge has brought record and near-record levels of new infections and hospitalizations.
On Monday, 6,891 patients were hospitalized with COVID-19 in Pennsylvania, 6,075 in New Jersey, and 665 in Delaware — all high numbers compared to other points in the pandemic.
Pennsylvania Gov. Tom Wolf last week pledged help for the state’s increasingly overwhelmed hospitals — but his plan didn’t say what hospitals and regions would get help or when it would arrive.
New Jersey and Delaware were similarly stressed. Four Delaware hospitals reported they were being forced to implement crisis standards of care — to prioritize the sickest patients over others because of the scarcity of staff and resources.
Newark-based ChristianaCare has never reached that point before, said chief physician executive Ken Silverstein. The system has been operating at more than 100% capacity for weeks, and with 40% of the people hospitalized suffering from COVID-19, even items like bedpans are in short supply, he said.
“This is not a sustainable model,” he said. “Really what we need is to get a handle and curb the pandemic.”
In New Jersey, officials have also sounded alarms — the last time this many people in the hospital had the coronavirus was on April 29, 2020, Gov. Phil Murphy said Monday.
More than 10,000 individuals have been hospitalized with COVID-19 over the last two weeks, Murphy said. And though the number of children hospitalized for the virus remains relatively low, New Jersey on Monday had its highest-ever number of pediatric COVID-19 hospitalizations.
Over the past two weeks, Delaware County’s virus-related hospitalizations have increased at a higher rate than any other Pennsylvania county, according to the New York Times. And it has recorded more cases per capita in the past week than any other collar county or Philadelphia, according to the Times data.
The percentage of COVID-19 tests coming back positive has skyrocketed, jumping to more than 40% from 29% last week, O’Mahony said. Statewide, that number was nearly 25% as of Thursday.
The county has raced to open more testing sites, as demand has mounted. Three opened last week, including one sponsored by the state, and another will open Tuesday.
The trends in Delaware County could be partly attributable to areas with low vaccination rates and fatigue about mask-wearing and other precautions, O’Mahony said.
“It’s definitely not just one factor,” O’Mahony said. “That’s not to say the other [regional] counties might not follow suit in the next week or two, because we’ve seen that in past surges.”
In neighboring Chester County, hospitals are under additional pressure due to the closure of two Tower Health hospitals: Jennersville, which has closed, and Brandywine, which will close at the end of the month, said county health director Jeanne Franklin.
“We do know that hospitals are trying quickly to find space for additional beds, expanding staff (even with hiring challenges), and some have activated their incident command centers,” Franklin said Monday.
Bucks and Montgomery County hospitals have been faring slightly better. Montgomery County hospitals were busy but not overwhelmed, officials said at a news briefing last week. Bucks County hospitals are feeling the pinch of staff absences, a spokesperson said Monday.
Some Philadelphia-area hospitals were taking new steps last week, like restricting visitors and delaying elective procedures. This week, others said the staff shortage was as much of a challenge, if not more than, the COVID-19 patients.
“We’re dipping into our reserve pool of clinicians. People have had to work more,” said Ron Keren, Children’s Hospital of Philadelphia chief medical officer.
“I wouldn’t say it’s a crisis,” he said. “It’s stretching us, challenging, but we’re managing.”
A spokesperson for Jefferson University Hospitals also said it was managing well and planned to continue elective procedures, though the hospital has moved around staff and the number of workers testing positive has presented “a challenge.”
In the suburbs, a recently opened testing site at Mercy Fitzgerald Hospital in Darby “will ease some of the burden” for its emergency department, said Sharon Carney, chief clinical officer for Trinity Health Mid-Atlantic.
Main Line Health, which operates in Montgomery, Delaware, and Chester Counties, is not in “crisis staffing mode,” said chief medical officer Jonathan Stallkamp. Even if the surge worsens, the system has no plans to shut down emergency rooms.
It implemented a two-week pause in elective procedures, which has been “incredibly helpful” in freeing up beds and staff, Stallkamp said.
Still, he asked people to go to emergency rooms only when necessary.
“If you’re going for something like stitches, it could be handled in an urgent care,” he said. “If you’re having a heart attack, by all means, come to the ER.”
And Delaware County’s O’Mahony cautioned that people should wear masks, socially distance, and, right now, “hunker down.”
“When you have a percent positivity of 40.1%,” she said, “you can assume anyone who is out in the public is at risk of contracting COVID.”
Staff writers Jason Laughlin and Aubrey Whelan contributed to this article.