As some states set Covid-19 hospitalization records, many overwhelmed hospitals are outsourcing patients on planes, helicopters, and ambulances to distant cities and states for treatment, Heather Hollingsworth and Jim Salter write for the Associated Press.

Transfers hundreds of miles away

As of last week, the number of Covid-19 patients in most hospitals remained below winter surge levels, Hollingsworth and Salter report. However, Florida, Arkansas, Oregon, Hawaii, Louisiana, and Mississippi recently set pandemic hospitalization records.

And unlike in the winter surge, many hospitals were already strained this summer due to patients catching up on previously deferred care, according to Hollingsworth and Salter.

"We are seeing Covid patients and we are seeing car accidents and we are seeing kids come in with normal seasonal viral infections. And we are seeing normal life come into the emergency department along with the extra surge of Covid patients, so it is causing that crisis," said Mark Rosenberg, president of the American College of Emergency Physicians.

Amid the influx of patients, many of these overwhelmed hospitals are looking to neighboring cities and states for relief. For instance, in Arizona, a Covid-19 hotline is receiving calls from hospitals in Wyoming, Arkansas, Texas, and California in search of bed space, Hollingsworth and Salter report—although the hotline often cannot provide any help.

In Kansas, officials at the Wilson Medical Center in Kansas had to call 40 other facilities in several states seeking a bed for a Covid-19 patient before finally finding an available bed about 220 miles away. Across the state, according to Motient, a company contracting with Kansas to manage transfers, Covid-19 patients generally have to wait an average of 10 hours before being flown to another hospital location, which could be in Wisconsin, Illinois, Colorado, or Texas.

"That is just the worst day that you can have in the emergency room as a provider," Richard Watson, Motient's founder, said, "to be taking care of a patient that you are totally helpless to give them what you know they need."

Similarly, in Washington state, the 25-bed Prosser Memorial Hospital, doesn't have an intensive care unit, so critically ill patients are being sent as far as eastern Idaho—600 miles away.

Staffing shortages, low vaccination rates add to the problem

Finding a hospital to take in patients has become more difficult due to recent staffing shortages, according to Robin Allaman, CNO at the Kearny County Hospital in Kansas.

"Most [hospitals] are saying it isn't that they don't have an open bed, it is that they don't have nursing staff to care for them," he said. Officials at his hospital called health systems in Nebraska, Oklahoma, and New Mexico before one in Colorado Springs, Colo.—200 miles away—agreed to take a recent patient.

Watson said these delayed transfers can have dire consequences for patients, especially those who need to see specialists, who often are available only in larger hospitals. "Imagine being with your grandma in the ER who is having a heart attack in western Kansas and you are saying, 'Why can't we find a bed for her?' We are watching this happen right in front of us. 'This is America. Why don't we have hospital bed for her?' Well, here we are," he said.

And while experts had hoped that the vaccines would prevent hospitals from becoming overwhelmed again, Justin Lessler, a professor of epidemiology at Johns Hopkins University, said there hasn't been the reduction in hospitalizations that officials had hoped for. That's in part because the delta variant seems to be more severe, particularly in younger people, whose vaccination rates are lower.

Steve Edwards—CEO of CoxHealth, whose hospital in Springfield, Mo., is treating patients from as far away as Alabama—added, "Just imagine not having the support of your family near, to have that kind of anxiety if you have someone grow acutely ill." (Hollingsworth/Salter, Associated Press, 8/18)