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As Austin Public Health waits for staffing help, hospitals get creative with capacity issues

APH said it is too early to know how many medical workers to expect from the governor's directive.

AUSTIN, Texas — On Wednesday morning, Austin Public Health Medical Director Dr. Desmar Walkes said the timeline to open an alternate care site is as soon as possible. In the meantime, the priority is getting staff to area hospitals. 

Late Wednesday afternoon, Gov. Greg Abbott announced the deployment of 2,500 medical workers via the Texas Department of State Health Services to help hospitals across the state deal with COVID-19 surges. 

DSHS has arranged for more than 2,500 out-of-state medical personnel to help hospitals across Texas care for the increasing number of COVID-19 patients. This first deployment of personnel will be fully funded by the state through Sept. 30.

Just how many of the 2,500 medical workers Austin will get is still in the works, according to APH. But Dr. Walkes said area hospitals are doing what they have to in order to deal with the COVID-19 surge.

"They start to get creative about where people are being kept and waiting. So there are people waiting in hallways, people in not conventional places, like cafeterias and lab areas, where there's space. And we start bringing in stuff from other areas in the hospital that traditionally are staffed by folks that are not providing inpatient care," said Dr. Walkes. 

The staffing issue is happening all across the state.

Cindy Zolnierek is a registered nurse and the CEO of the Texas Nurses Association. 

"Very concerned hospitals are at or over capacity. That means that if someone's in the ER with a heart attack in progress, there's no bed for them. They may be sitting in the waiting room and might even be able to get into the hospital, but to be seen in the ER, someone has a trauma accident. There is no bed for them to get the care that they need. So it's a very dire situation," Zolnierek said.

Dr. Ogechika Alozie is an infectious disease specialist and part of the Texas Medical Association's COVID-19 Task Force.

"All chief medical officers, CEOs, nursing offices, they're all aware of an acute shortage of staff,  and I think COVID exposed this. We had, depending on which hospital you're at, 20% to 30% of staff over the course of 18 months leave to the contract jobs that paid more. They're able to travel, and a lot of those people have not come back. And so the same issues that you have in the service industry, the construction industry, where you can't find staff, health care is being hit by the exact same problem," said Dr. Alozie.

The nursing shortage is nothing new. Zolnierek said the issue was around before COVID-19. The CEO of the Texas Nurses Association said the pandemic just made it worse, especially during this third wave of the deadly virus.

"One nurse said that she's seen more patients die in one day than she normally saw in a year," Zolnierek said.

Traumatic events like that, plus poor pay and working conditions, are reasons Zolnierek cite as nurses quitting and not returning. She pointed to a Texas Center for Workforce Studies that showed a shortage of nurses in the tens of thousands – a situation she thinks will likely worsen.

"So I fear that we are going to have an incredible nursing shortage," said Zolnierek.

According to Austin Public Health, our lack of ICU beds prevents our hospitals from accepting out-of-town transfers. Dr. Alozie said there's nowhere to send our patients.

"The reality now is that the South as a whole is on fire," he said.

Baylor Scott & White, St. David's HealthCare and Ascension Seton released the following joint statement: 

"Ascension Seton, Baylor Scott & White Health and St. David’s HealthCare continue to monitor and adapt to COVID-19 activity within our community. 

"Each of our hospitals has a surge plan that includes the utilization of all available patient care space within our hospitals and in other settings across our healthcare system. While we will always make emergency care available, we may also have to adjust our staffing needs and limit the services we are able to offer to patients. In some cases, we may transfer patients between facilities within our healthcare systems in order to provide the most appropriate care. 

"We continue to ask our community to help us and each other by getting vaccinated, practicing social distancing and wearing a mask."

On Tuesday, Dr. Walkes said there is not enough staff to expand ICU capacity in Austin-area hospitals.

At a joint meeting with the Travis County Commissioners Court and Austin City Council Tuesday, Walkes said ICU capacity is being maxed out. The area was down to two available beds Monday night but is back up to six.

“We could open another facility, but would we be able to staff it ... and at this point, we want to set that resource in the place where its best used and that would be in our hospitals,” Walkes said at the meeting. “So, right now we’re trying to support our hospitals and their ability to withstand the surge that we are experiencing.”

RELATED: Texas recruits 2,500 medical personnel to help hospitals with COVID-19 surge

Walkes told KVUE Wednesday that Austin has made a State of Texas Assistance Request, and local hospitals are contacting staffing agencies to help relieve the shortage.

“We’re hoping to get staff assistance into our hospitals so that they can staff more ICU beds, and if that does not come about, then we’re going to have to look at staffing an alternate care site,” Walkes said. “Our first priority, however, is for us to get staff into our hospitals so that they can expand the ICU bed capacity.”

Austin-Travis County reached its lowest point in ICU capacity since the start of the pandemic Monday with only .3% of staffed beds available.  

At least 226 COVID-19 patients were in Austin-area ICU's Wednesday, and 45% of ICU beds were occupied by COVID-19 patients.

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