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hospitals Wisconsin

Wisconsin hospitals filling with COVID patients: ‘A dire situation’ – Chicago Tribune

Associated Press

Sep 30, 2020 6:43 PM

MILWAUKEE — Wisconsin set a new record for COVID-19 deaths on Wednesday and the surge in cases in the state threatened to overwhelm some hospitals.

Health officials reported 27 new deaths, breaking the state’s old record of 22 deaths set on May 27. The disease has killed or played a role in the death of 1,327 people in the state since the pandemic began.

Health officials reported 2,319 newly confirmed cases, bringing the total number of cases in Wisconsin to 122,274 since the pandemic began.

Wisconsin had the third-highest positivity rate of any state as of Wednesday. Hospital officials in some areas said they were close to being overwhelmed by COVID-19 patients — a scenario that health officials have been warning could happen since the pandemic began but that only now seems like it could happen.

The number of people hospitalized in Wisconsin reached a record-high of 737 on Wednesday, according to state health officials and the Wisconsin Hospital Association. Case spikes in northern and northeastern Wisconsin were causing many of the hospitalizations, the Milwaukee Journal Sentinel reported.

Officials at ThedaCare in the Fox Valley said they had exceeded capacity in the COVID-19 unit at their Appleton medical center and had started sending patients to Neenah and hospitals in Berlin, Shawano and Waupaca.

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“If it’s growing the way that it has for the past week or so, we’re going to be in a dire situation in two, three, four weeks,” said Michael Hooker, vice president and chief medical officer for acute care at ThedaCare. “Yes, we saw this coming, but didn’t expect it to be quite so rapid.”

Matthew Heywood, president and CEO of Aspirus HealthCare in Wausau, said that hospital has started putting patients on waiting lists, with wait times ranging from several hours to a full day. The system had 61 patients Tuesday who had or were believed to have COVID-19, which was a 30% increase from Monday, when it had 47.

“The problem is, how do we care for you when you have an accident when we have an overflow of COVID patients?” Heywood said. “There’s only so much you can do before you start to overwhelm the system.”

Officials at Bellin Hospital in Green Bay said their facility was at 94% capacity on Tuesday, with 31 patients being treated for COVID-19, up from 26 last Friday. CEO Chris Woleske said the hospital hopes to convert part of its campus into another space for beds and is teaching nonclinical workers, such as athletic trainers, how to deliver supplies and move patients so that nurses can focus on duties only they can perform.

State Health Services Secretary Andrea Palm and Dr. Ryan Westergaard, Wisconsin’s chief medical officer, said Tuesday that they hadn’t received any reports of patients being turned away from hospitals or not getting care. They said if cases don’t subside, patients could be directed to a 530-bed field hospital that the U.S. Army Corps of Engineers built on the state fairgrounds in West Allis in April.

Gov. Tony Evers’ spokeswoman, Britt Cudaback, and Health Services spokeswoman Elizabeth Goodsit didn’t immediately respond to messages inquiring about whether the administration was preparing to open the field hospital.

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hospitals regions

US hospitals in hard hit regions step up use of steroids on sickest COVID-19 patients – AOL

NEW YORK, June 19 (Reuters) – Several U.S. hospitals in states with fresh surges of COVID-19 cases have started treating their sickest patients with dexamethasone rather than await confirmation of preliminary results of a study by British researchers, who said the inexpensive steroid saves lives.

The move illustrates how the pandemic is changing the way hospitals work, at least regarding COVID-19 patients.

Traditionally, doctors wait for detailed data to be published in a peer reviewed journal – or for guidelines from medical societies – before embracing a new treatment, so they can better gauge the risks against the drug’s benefits. The urgency of the coronavirus pandemic and lack of other treatments has altered those calculations.

Dexamethasone is the first drug shown to lower the risk of death in severely ill COVID-19 patients in what researchers running the trial hailed as a “major breakthrough.”

31 PHOTOS

States reopen, relax guidelines to prevent coronavirus spread

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NEW YORK, NEW YORK – MAY 06: An employee wearing a mask cleans the inside of the restaurant, Blue Stripes Cacao Shop as it prepares to reopen for takeaway and delivery orders after being closed for over a month amid the coronavirus pandemic on May 6, 2020 in New York City. Governor Andrew Cuomo made the announcement that all bars and restaurants must close by on March 16th unless it was takeout or delivery. COVID-19 has spread to most countries around the world, claiming over 263,000 lives with over 3.8 million cases. (Photo by Alexi Rosenfeld/Getty Images)

NEW YORK, NEW YORK – MAY 06: An employee wearing a mask cleans the inside of the restaurant, Blue Stripes Cacao Shop as it prepares to reopen for takeaway and delivery orders after being closed for over a month amid the coronavirus pandemic on May 6, 2020 in New York City. Governor Andrew Cuomo made the announcement that all bars and restaurants must close by on March 16th unless it was takeout or delivery. COVID-19 has spread to most countries around the world, claiming over 263,000 lives with over 3.8 million cases. (Photo by Alexi Rosenfeld/Getty Images)

THOUSAND OAKS, CA – MAY 06: A Cadillac Dealership displays a sign stating its reopened during the Coronavirus Pandemic on May 06, 2020 in Thousand Oaks, California. The coronavirus pandemic worldwide has claimed over 263,000 lives and infected over 3.7 million people. (Photo by Josh Lefkowitz/Getty Images)

HOUSTON, May 5, 2020 — Customers shop at a shopping mall in Frisco, on the outskirts of Dallas, Texas, the United States, May 5, 2020. After closed for several weeks due to the outbreak of COVID-19 pandemic, the shopping mall reopened with shortened business hours on Tuesday. (Photo by Dan Tian/Xinhua via Getty) (Xinhua/ via Getty Images)

HOUSTON, May 5, 2020 — Cars are parked in front of a shopping mall in Frisco, on the outskirts of Dallas, Texas, the United States, May 5, 2020. After closed for several weeks due to the outbreak of COVID-19 pandemic, the shopping mall reopened with shortened business hours on Tuesday. (Photo by Dan Tian/Xinhua via Getty) (Xinhua/ via Getty Images)

Dawson Padilla (L), owner of a protein shakes store, works behind the bar on May 5, 2020 in Stillwater, Oklahoma. – In the face of intimidation against employees and the threat of an armed attack by local residents wielding their individual liberties, the mayor of Stillwater had to give in: he gave up imposing the wearing of masks on customers in shops. This demand was included in a 21-page document that was supposed to accompany the gradual reopening of restaurants and shops from 1 May, as authorized by the state of Oklahoma. “About three and a half hours after the law came into effect” of the text, “we started receiving calls from stores claiming that employees were being threatened and insulted, and threatened with physical violence,” said Norman McNickle, the city’s director of services. (Photo by Johannes EISELE / AFP) (Photo by JOHANNES EISELE/AFP via Getty Images)

A worker of the Aspen Cafe wears a mask as she makes coffee on May 5, 2020 in Stillwater, Oklahoma. – In the face of intimidation against employees and the threat of an armed attack by local residents wielding their individual liberties, the mayor of Stillwater had to give in: he gave up imposing the wearing of masks on customers in shops. This demand was included in a 21-page document that was supposed to accompany the gradual reopening of restaurants and shops from 1 May, as authorized by the state of Oklahoma. “About three and a half hours after the law came into effect” of the text, “we started receiving calls from stores claiming that employees were being threatened and insulted, and threatened with physical violence,” said Norman McNickle, the city’s director of services. (Photo by Johannes EISELE / AFP) (Photo by JOHANNES EISELE/AFP via Getty Images)

Kelly Lyda, owner of the Aspen Cafe, stands in his Cafe on May 5, 2020 in Stillwater, Oklahoma. – In the face of intimidation against employees and the threat of an armed attack by local residents wielding their individual liberties, the mayor of Stillwater had to give in: he gave up imposing the wearing of masks on customers in shops. This demand was included in a 21-page document that was supposed to accompany the gradual reopening of restaurants and shops from 1 May, as authorized by the state of Oklahoma. “About three and a half hours after the law came into effect” of the text, “we started receiving calls from stores claiming that employees were being threatened and insulted, and threatened with physical violence,” said Norman McNickle, the city’s director of services. (Photo by Johannes EISELE / AFP) (Photo by JOHANNES EISELE/AFP via Getty Images)

Computer specialist Toby Angel drinks his coffee on May 5, 2020 in Stillwater, Oklahoma. – In the face of intimidation against employees and the threat of an armed attack by local residents wielding their individual liberties, the mayor of Stillwater had to give in: he gave up imposing the wearing of masks on customers in shops. This demand was included in a 21-page document that was supposed to accompany the gradual reopening of restaurants and shops from 1 May, as authorized by the state of Oklahoma. “About three and a half hours after the law came into effect” of the text, “we started receiving calls from stores claiming that employees were being threatened and insulted, and threatened with physical violence,” said Norman McNickle, the city’s director of services. (Photo by Johannes EISELE / AFP) (Photo by JOHANNES EISELE/AFP via Getty Images)

WESTPORT, CONNECTICUT – MAY 05: A cafe along a shopping street in the affluent community remains mostly empty of pedestrians and open stores on May 05, 2020 in Westport, Connecticut. A growing number of states have begun reopening parts of the economy amid demonstrations like the one yesterday that targeted the Connecticut state capital and the governor’s mansion in Hartford. (Photo by Spencer Platt/Getty Images)

WESTPORT, CONNECTICUT – MAY 05: A cafe along a shopping street in the affluent community remains mostly empty of pedestrians and open stores on May 05, 2020 in Westport, Connecticut. A growing number of states have begun reopening parts of the economy amid demonstrations like the one yesterday that targeted the Connecticut state capital and the governor’s mansion in Hartford. (Photo by Spencer Platt/Getty Images)

LAGUNA HILLS, CA – MAY 05: Customers maintain safety protocols at The BarberHood in Laguna Hills, CA, on Tuesday, May 5, 2020. The shop is one of the first to re-open and defy the state”u2019s stay-at-home order during the COVID-19 (coronavirus) lockdown. (Photo by Paul Bersebach/MediaNews Group/Orange County Register via Getty Images)

SAN CLEMENTE, CA – MAY 05: Visitors walk on the beach south of the pier in San Clemente, CA on Tuesday, May 5, 2020. The city opened its beaches for daily active use after coordinating with Gov. Gavin Newsom”u2019s office to maintain social distancing during the COVID-19 (coronavirus) lockdown. (Photo by Paul Bersebach/MediaNews Group/Orange County Register via Getty Images)

SAN CLEMENTE, CA – MAY 05: Surfers were back on the waves at T Street in San Clemente, CA on Tuesday, May 5, 2020. The city opened its beaches for daily active use after coordinating with Gov. Gavin Newsom”u2019s office to maintain social distancing during the COVID-19 (coronavirus) lockdown. (Photo by Paul Bersebach/MediaNews Group/Orange County Register via Getty Images)

KENMORE, WA – MAY 05: Lynette Fisher-Charles and her dog Gracie, a two-year-old springer spaniel, go for a hike in Saint Edward State Park on May 5, 2020 in Kenmore, Washington. The first phase to reopen the state begins today easing some restrictions including opening some parks, that were put in place during Governor Jay Inslees Stay Home, Stay Healthy order last March to help reduce the spread of COVID-19. Kenmore, WA is located northeast of Seattle. (Photo by Karen Ducey/Getty Images)

KENMORE, WA – MAY 05: Daryl Kline, a park ranger at Saint Edward State Park removes a sign saying the park is closed on May 5, 2020 in Kenmore, Washington. The first phase to reopen the state begins today easing some restrictions that were put in place during Governor Jay Inslees Stay Home, Stay Healthy order last March to help reduce the spread of COVID-19. Kenmore, WA is located northeast of Seattle. (Photo by Karen Ducey/Getty Images)

LAGUNA BEACH, CA – MAY 05: Lifeguards keep a lookout at Laguna Beach, CA after officials reopened access to the sand on Tuesday, May 5, 2020. The beach has been closed since March 23, 2020 due to the COVID-19 (coronavirus) outbreak. City parks along the beach are still closed and people cannot sit or linger on the sand. (Photo by Paul Bersebach/MediaNews Group/Orange County Register via Getty Images)

NEW YORK, May 4, 2020 — Photo taken on May 4, 2020 shows Times Square in New York, the United States.
Amid the ongoing COVID-19 pandemic, New York Governnor Andrew Cuomo on Monday outlined additional guidelines regarding when regions can reopen.
According to the Governor’s Press Office, the state will monitor four core factors to determine if a region can reopen: number of new infections, health care capacity, diagnostic testing capacity and contact tracing capacity. (Photo by Wang Ying/Xinhua via Getty) (Xinhua/Wang Ying via Getty Images)

NEW YORK, May 4, 2020 — A worker cleans a cafe’s signboard at Times Square in New York, the United States, May 4, 2020.
Amid the ongoing COVID-19 pandemic, New York Governnor Andrew Cuomo on Monday outlined additional guidelines regarding when regions can reopen.
According to the Governor’s Press Office, the state will monitor four core factors to determine if a region can reopen: number of new infections, health care capacity, diagnostic testing capacity and contact tracing capacity. (Photo by Wang Ying/Xinhua via Getty) (Xinhua/Wang Ying via Getty Images)

ASBURY PARK, NJ – MAY 4: People walk near the closed boardwalk due to the outbreak of COVID-19 in the state on May 4, 2020 in the Jersey Shore in New Jersey. Some towns at Jersey Shore expect the reopening of beaches soon. (Photo by Eduardo MunozAlvarez/VIEWpress/Corbis via Getty Images)

NORTH ANDOVER, MA – MAY 4: Although all golf courses in Massachusetts are still ordered to stay closed by governor Charlie Baker, workers at the North Andover Country Club in North Andover, MA work on the grass on May 4, 2020, getting the course ready for when they eventually are allowed to re-open. (Photo by Jim Davis/The Boston Globe via Getty Images)

LOS ANGELES, CA – MAY 04: Gov. Gavin Newsom announced select retail businesses will be allowed to reopen starting Friday in California during the coronavirus pandemic on Monday, May 4, 2020 in Los Angeles, CA. (Jason Armond / Los Angeles Times via Getty Images)

SANFORD, UNITED STATES – MAY 04, 2020: Customers enjoy a meal at Racks Billiards Sports Bar and Grill on the first day that retail stores and restaurants in all Florida counties except Palm Beach, Broward, and Miami Dade were permitted to reopen as COVID-19 restrictions are eased. Under phase one of the plan to reopen the state, stores and restaurants are limited to 25 percent of their indoor capacity.- PHOTOGRAPH BY Paul Hennessy / Echoes Wire/ Barcroft Studios / Future Publishing (Photo credit should read Paul Hennessy / Echoes Wire/Barcroft Media via Getty Images)

SANFORD, UNITED STATES – MAY 04, 2020: A customer leaves a Books-A-Million store on the first day that retail stores and restaurants in all Florida counties except Palm Beach, Broward, and Miami Dade were permitted to reopen as COVID-19 restrictions are eased. Under phase one of the plan to reopen the state, stores and restaurants are limited to 25 percent of their indoor capacity.- PHOTOGRAPH BY Paul Hennessy / Echoes Wire/ Barcroft Studios / Future Publishing (Photo credit should read Paul Hennessy / Echoes Wire/Barcroft Media via Getty Images)

BOZEMAN, MT – MAY 04: Sales staff wear masks at the reopened Schnee’s Boots, Shoes and Outdoors on Main Street on May 4, 2020 in Bozeman, Montana. Wyoming health officials today reported that the state’s confirmed coronavirus cases grew by nine to a total of 444. (Photo by William Campbell/Getty Images)

BOZEMAN, MT – MAY 04: Signs for restaurants and stores announce their reopenings on Main Street on May 4, 2020 in Bozeman, Montana. Wyoming health officials today reported that the state’s confirmed coronavirus cases grew by nine to a total of 444. (Photo by William Campbell/Getty Images)

JENSEN BEACH, FLORIDA – MAY 04: Cole Hunter carries Harper Hunter, 1, as Holly Hunter,4, follows along as they arrive at the beach on May 04, 2020 in Jensen Beach, Florida. Restaurants, retailers, as well as beaches and some state parks reopened today with caveats, as the state continues to ease restrictions put in place to contain COVID-19. The counties of Palm Beach, Broward and Miami Dade continue to maintain restrictions. (Photo by Joe Raedle/Getty Images)

JACKSONVILLE BEACH, FLORIDA – MAY 04: People are seen dining outside at Cruisers Grill as the state of Florida enters phase one of the plan to reopen the state on May 04, 2020 in Jacksonville Beach, Florida. Restaurants, retailers, beaches and some state parks reopen today with caveats, as the state continues to ease restrictions put in place to contain the coronavirus (COVID-19). (Photo by Sam Greenwood/Getty Images)

JACKSONVILLE BEACH, FLORIDA – MAY 04: People are seen at a department store as the state of Florida enters phase one of the plan to reopen the state on May 04, 2020 in Jacksonville Beach, Florida. Restaurants, retailers, beaches and some state parks reopen today with caveats, as the state continues to ease restrictions put in place to contain the coronavirus (COVID-19). (Photo by Sam Greenwood/Getty Images)

SAINT AUGUSTINE, FLORIDA – MAY 04: A mask is seen on the statue of Henry M. Flagler as the state of Florida enters phase one of the plan to reopen the state on May 04, 2020 in Saint Augustine, Florida. Restaurants, retailers, beaches and some state parks reopen today with caveats, as the state continues to ease restrictions put in place to contain the coronavirus (COVID-19). (Photo by Sam Greenwood/Getty Images)

A man works on power lines in Los Angeles, California on May 4, 2020, amid the coronavirus pandemic. – California governor Gavin Newsom earlier today announced the gradual reopening of the state later this week as dismal US employment figures are expected with the release of figures Friday May 8 for April’s US jobs report, as 30 million Americans filed for unemployment in the last six weeks. (Photo by Frederic J. BROWN / AFP) (Photo by FREDERIC J. BROWN/AFP via Getty Images)

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The Oxford University researchers said in a news release that dexamethasone reduced death rates by around a third among COVID-19 patients requiring mechanical breathing assistance or oxygen. Britain’s health ministry has already approved its use in the state-run health service.

“It almost feels unethical not to use the drug,” said Dr. Kartik Cherabuddi, an infectious diseases specialist at the University of Florida’s (UF) medical school.

UF’s Gainesville hospital updated its COVID-19 treatment guidelines as of Tuesday to include using dexamethasone. It previously used the extremely cheap generic medicine sparingly for those patients.

Cherabuddi noted that his hospital – and many others – similarly started treating COVID-19 patients with Gilead Science’s antiviral drug remdesivir based on data from a news release.

That drug, which unlike dexamethasone was not yet approved by regulators for any other conditions, shortened hospital recovery times in a clinical trial. It did not have an effect on mortality.

Several hospital systems, including New York’s Northwell Health and the University of Washington (UW) had not been using steroids on COVID-19 patients. There was some concern it could lead to worse outcomes because it suppresses the immune system.

“For us, the case numbers are low and so there is not much pressure to do something new,” said UW’s Dr. Mark Wurfel, who is eager to see the final data. Places like Florida and Oklahoma, where COVID-19 hospitalizations are rising, are under more pressure, he said.

“The urgency of having hundreds, maybe thousands of very sick COVID patients in hospitals and ICUs changes the calculus. Many lives could be saved if the trial results are real,” Wurfel added.

AdventHealth, which has nearly 50 hospitals in nine states, has been using dexamethasone for COVID-19 patients on ventilators with success since early April, said Eduardo Oliveira, executive medical director for critical care for AdventHealth’s central Florida region.

At its eight hospitals in the Orlando area, Oliveira said the mortality rate for patients requiring ventilators was about 26%, “lower than almost every other reported mortality in the literature right now.”

He noted it was difficult to know whether that success was due to the use of steroids.

After reviewing the British study release and trial protocols, Advent expanded its dexamethasone use to also include patients receiving supportive oxygen but not on ventilators.

Dr. Brent Brown, medical director of University of Oklahoma’s intensive care unit, said his hospital added the steroid to its treatment guidelines for patients in the ICU this week. Oklahoma is one of several U.S. states with rapidly rising coronavirus cases.

“We changed our practice completely. It was kind of an about face,” he said. “But we’re delighted to have something that looks so promising.” (Reporting by Michael Erman, editing by Peter Henderson and Bill Berkrot)

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Categories
hospitals regions

U.S. hospitals in hard hit regions step up use of steroids on sickest COVID-19 patients – Reuters

NEW YORK (Reuters) – Several U.S. hospitals in states with fresh surges of COVID-19 cases have started treating their sickest patients with dexamethasone rather than await confirmation of preliminary results of a study by British researchers, who said the inexpensive steroid saves lives.

FILE PHOTO: An ampoule of Dexamethasone is seen during the coronavirus disease (COVID-19) outbreak in this picture illustration taken June 17, 2020. REUTERS/Yves Herman/File Photo

The move illustrates how the pandemic is changing the way hospitals work, at least regarding COVID-19 patients.

Traditionally, doctors wait for detailed data to be published in a peer reviewed journal – or for guidelines from medical societies – before embracing a new treatment, so they can better gauge the risks against the drug’s benefits. The urgency of the coronavirus pandemic and lack of other treatments has altered those calculations.

Dexamethasone is the first drug shown to lower the risk of death in severely ill COVID-19 patients in what researchers running the trial hailed as a “major breakthrough.”

The Oxford University researchers said in a news release that dexamethasone reduced death rates by around a third among COVID-19 patients requiring mechanical breathing assistance or oxygen. Britain’s health ministry has already approved its use in the state-run health service.

“It almost feels unethical not to use the drug,” said Dr. Kartik Cherabuddi, an infectious diseases specialist at the University of Florida’s (UF) medical school.

UF’s Gainesville hospital updated its COVID-19 treatment guidelines as of Tuesday to include using dexamethasone. It previously used the extremely cheap generic medicine sparingly for those patients.

Cherabuddi noted that his hospital – and many others – similarly started treating COVID-19 patients with Gilead Science’s (GILD.O) antiviral drug remdesivir based on data from a news release.

That drug, which unlike dexamethasone was not yet approved by regulators for any other conditions, shortened hospital recovery times in a clinical trial. It did not have an effect on mortality.

Several hospital systems, including New York’s Northwell Health and the University of Washington (UW) had not been using steroids on COVID-19 patients. There was some concern it could lead to worse outcomes because it suppresses the immune system.

“For us, the case numbers are low and so there is not much pressure to do something new,” said UW’s Dr. Mark Wurfel, who is eager to see the final data. Places like Florida and Oklahoma, where COVID-19 hospitalizations are rising, are under more pressure, he said.

“The urgency of having hundreds, maybe thousands of very sick COVID patients in hospitals and ICUs changes the calculus. Many lives could be saved if the trial results are real,” Wurfel added.

AdventHealth, which has nearly 50 hospitals in nine states, has been using dexamethasone for COVID-19 patients on ventilators with success since early April, said Eduardo Oliveira, executive medical director for critical care for AdventHealth’s central Florida region.

At its eight hospitals in the Orlando area, Oliveira said the mortality rate for patients requiring ventilators was about 26%, “lower than almost every other reported mortality in the literature right now.”

He noted it was difficult to know whether that success was due to the use of steroids.

FILE PHOTO: A pharmacist displays a box of Dexamethasone at the Erasme Hospital amid the coronavirus disease (COVID-19) outbreak, in Brussels, Belgium, June 16, 2020. REUTERS/Yves Herman/File Photo

After reviewing the British study release and trial protocols, Advent expanded its dexamethasone use to also include patients receiving supportive oxygen but not on ventilators.

Dr. Brent Brown, medical director of University of Oklahoma’s intensive care unit, said his hospital added the steroid to its treatment guidelines for patients in the ICU this week. Oklahoma is one of several U.S. states with rapidly rising coronavirus cases.

“We changed our practice completely. It was kind of an about face,” he said. “But we’re delighted to have something that looks so promising.”

Reporting by Michael Erman, editing by Peter Henderson and Bill Berkrot

Read More