On Jan. 11, the Cleveland Clinic in Weston, Florida, was treating 80 COVID-19 patients — a tenfold increase since the end of December. Nearly half were hospitalized for other medical reasons.

The surge, fueled by the highly contagious variant of the omicron, helped push the 206-licensed-bed South Florida hospital to 250 patients. The rise in cases comes as hospitals face severe staffing shortages, while nurses and other caregivers are out with the virus.

Chief Medical Officer Dr Scott Ross said the challenge was finding space to safely treat all COVID patients while keeping staff and other patients safe.

“It’s not a PPE issue,” he said, referring to personal protective equipment like masks, “it’s not an oxygen issue, it’s not a ventilator issue. It’s a volume issue and making sure we have enough beds and paramedics for patient use.”

Nationwide, the number of new coronavirus cases and hospitalizations highest level since the beginning of the pandemic. Unlike previous COVID surges, however, most COVID patients are coming to the hospital for other reasons. These infections are exacerbating some medical conditions and making it more difficult to reduce the spread of COVID in hospitals, especially when patients are present in the earlier, more contagious stages of the disease.

Although the omicron variant typically produces milder cases, adding the sheer number of these “incidental” hospitalizations to COVID-induced hospitalizations could be a tipping point for the healthcare system, one that is expected to continue as the fight against the pandemic continues. The system is faltering. Rising rates of COVID-19 in the community have also translated into higher rates among hospital staff, causing them to call in record numbers of sick days and further straining an overwhelmed system.

Caring for infected patients who need other medical services is challenging and sometimes requires different protocols, officials and staff at 13 hospital systems across the country said.

PhD.Robert JensenThe chief medical officer of the Grady Health System in Atlanta said the infection rate in his community is unprecedented. Grady Memorial Hospital increased from 18 COVID patients on Dec. 1 to 259 last week.

About 80 to 90 percent of patients either have COVID as their primary diagnosis or have a health condition worsened by COVID, such as sickle cell disease or heart failure, Jensen said.

Even though their patients have had fewer cases of pneumonia caused by COVID than at the main peak early last year, Grady’s leaders are grappling with a large number of health care workers in relation to COVID. At one point last week, 100 nurses and as many as 50 other staff members were out, Jensen said.

At Atlantic Health System, one of New Jersey’s largest hospital systems, about half of all COVID patients enter the system for other reasons, not all patients with an incidental COVID infection can be transferred to a COVID ward, CEO Brian Granoratti Say. They require specialized services for other diseases, so hospital staff take special precautions, such as wearing higher levels of personal protective equipment when treating COVID patients in areas such as the heart wing.

At Jackson Memorial Hospital in Miami, where about half of the COVID patients are there primarily for other health reasons, all patients admitted for COVID — whether they have symptoms or not — are in the portion of the hospital reserved for COVID patients, Dr. Hany said. receive treatment. Atala, Chief Medical Officer.

Says patients are still taxed on the hospital’s ability to operate regardless of whether they are admitted to the hospital for COVID-19 Dr. Alex Garza, Incident Commander for the St. Louis Pandemic Task Force, a collaboration with the region’s largest healthcare system. He estimates that 80 to 90 percent of patients in hospitals in the region are hospitalized with Covid-19.

In Weston, Florida, the Cleveland Clinic also struggled to send COVID patients to nursing homes or rehabilitation facilities because many locations couldn’t handle more COVID patients, Ross said. Hospitals also struggle to send patients home because they fear they will put those who live with them at risk.

All of this means there’s a reason hospitals are telling people to stay away from emergency rooms unless it’s really an emergency, says Dr. Jeremy Faust, an emergency physician at Brigham and Women’s Hospital in Boston.

Faust said the number of patients who showed up during this surge and didn’t know they had COVID was frightening. As more incidental cases pour into hospitals, they pose a greater risk to staff and other hospital patients, Faust said, because they are often at a more contagious stage of the disease — before symptoms begin. In previous waves of COVID, people were hospitalized in the middle to late stages of the disease.

In Faust’s analysis federal dataHe said Jan. 7 had the second-highest number of COVID cases since the pandemic began, behind the October 2020 outlier. But Faust said the figures only include people who were hospitalized for the 14 days before testing positive for COVID, so they may be underestimated.

One KHN Survey Series Reveals multiple gaps in the government’s ability to hold hospitals accountable for the high rate of undiagnosed COVID patients on admission, including the federal reporting system’s failure to publicly record COVID found at individual hospitals.

“People in hospitals are vulnerable for a number of reasons,” said PhD.Manoj Jainism, an infectious disease specialist in Memphis, Tennessee. “All of their existing underlying diseases are accompanied by multiple diseases — all of which put them at greater risk.”

Emergency rooms in particular are a potentially dangerous area amid the current surge in cases, Garza said. He recommends that patients wear high-quality masks, such as KN95 or N95 respirators.according to Washington post, the Centers for Disease Control and Prevention is weighing whether to recommend that all Americans upgrade their masks during the omicron surge.

“It’s physics and math,” Garza said. “If you have a lot of people concentrated in one area and you have a high viral load, you have a much higher chance of being exposed to something like that if you don’t have enough protection.”

If patients cannot tolerate N95s throughout the day, Faust urges them to wear upgraded masks when in contact with hospital staff, visitors or other patients.

Dr. Dallas HolladayEmergency physicians at Oregon’s Samaritan Health Service said more patients are being concentrated in wards because of a shortage of nurses. This increases their risk of infection.

PhD.Abral KaranInfectious disease researchers at Stanford University believe that, given the rising risk of exposure to COVID, all healthcare workers should be required to wear N95s every time they interact with patients, not just surgical masks.

But in the absence of a higher-quality mask requirement for employees, he advised patients to require their providers to wear N95s.

“Why do we make it a duty for patients to protect themselves from healthcare workers when healthcare workers won’t even do it?” he asked. “Too backwards.”

Some hospital workers may not know they’re sick — and it’s contagious.Even though they know that in some states, including Rhode Island and California, due to staff shortages, asymptomatic healthcare workers can be recalled to work.

Faust would like to see improved testing capabilities for medical staff and other workers.

At Stanford, regular testing is encouraged, and employees can do it at any time, Karan said. But it’s an exception to the rule: Jain said some hospitals refuse to conduct routine employee testing — either for the drain on lab resources or for possible results.

“Hospitals don’t want to know,” he said. “We just don’t have staff.”