OSCODA – While the numbers of positive coronavirus disease cases in Iosco County seem to be on the rise, there has also been an upswing in testing for COVID-19. Ascension St. Joseph Hospital Administrator, Shane Hunt, says it tends to get reported that there are higher numbers. But when looking at the actual rate of positive cases, it might suggest that this is really a bit lower, due to the increased testing.
Either way, the hospital – located in Tawas City – appears to be well-prepared to respond, should there be an influx in cases.
Roughly seven months into the pandemic, the Ascension St. Joseph facility is still in stage one of a three-stage surge plan, in terms of the inpatient demands that COVID-19 is putting on the hospital. “We’ve been very fortunate so far and we are hopeful that with the public health initiatives that are out there, and all of us taking the precautions that we need to take in our own lives, that the inpatient demands will not exceed our capacity here,” Hunt said. “And so far, that’s the state we remain in.”
At the request of Oscoda Township Superintendent Dave Schaeffer, it was during the most recent board of trustees meeting when Hunt gave a synopsis of the pandemic situation in Iosco County.
Schaeffer said that he had a couple questions about some of the data, so his first stop was at District Health Department No. 2 (DHD2). “And my contact at DHD2 recommended I just reach out to the hospital directly.”
With that, he said he was able to speak with Hunt and request that he provide details on what’s going on specifically in the local area. “And he was good enough to be able to participate tonight on the Zoom call. So, I very much appreciate him participating and being able to provide the township board with an update on some of the figures he’s seen here at the county and at the hospital.”
*It should be noted that the information given by Hunt was as of the evening of Sept. 28. Therefore, the statistics may have changed since the board meeting was held.
At that time, Hunt said it looked like there were 183 confirmed coronavirus cases in Iosco, and 11 reported deaths. “I think there are a handful of other unconfirmed cases, and maybe one additional unconfirmed death that’s being looked at for Iosco County.”
He said that Ascension Health began to learn of the first cases, at the hospital and in the county, around the middle of March. “We certainly started to see a few smattering of outpatient cases. We actually had our first inpatient in the hospital on March 22nd.”
Prior to this, in the mid-April time frame, there was a peak in both outpatient and inpatient activity at the hospital. There was then a mix of cases, between May and early September; some involving outpatient care, and very few inpatient cases.
Since approximately Labor Day, Hunt says there has been a jump in the amount of tests being performed, an increase in the number of positive results and, in the past two weeks, a hike in the number of patients who would require admission to the hospital.
However, he noted that throughout the summer, the majority of patients who came through the system and tested positive did not require admission to the hospital.
In the early stages of the pandemic, he said the number of individuals who were admitted seemed to be linked to patients who were in an extended care facility or other similar setting. “We have not seen that recently.” Instead, what has been observed is older segments of our population, who are not in extended care facilities, requiring admission.
“If we look at just demographics, what we see at the hospital sort of matches what you can find out there on the state website, as well,” Hunt continued.
For the two largest populations of cases in Iosco County – involving just patients who have tested positive for the coronavirus – those under the age of 39 represent almost 38 percent of all positive cases. “About 29 percent of the positive cases in our county here would be over the age of 70,” according to Hunt.
As for the patients who require admission, he says that those older than 60 account for about 28 percent. People over 70 years of age represent approximately 50 percent of all the admissions.
In terms of being positive, Hunt says the disease itself doesn’t discriminate against the traditional genders of male and female; although, data indicates that female patients tend to have a higher rate of positivity. “Male patients, however, tend to require hospitalization more often than female patients.”
Hunt notes that people with such ailments as chronic lung disease, cardiovascular disease and diabetes often require hospitalization – and stays which run a little bit longer – as opposed to those without such medical conditions.
He further noted that the coronavirus does seem to follow somewhat of a normal pattern of that which is seen with the seasonal flu. And those who are impacted greatest by seasonal flu, typically fall into those same categories of patients who have other underlying diseases.
In general, Hunt says they are seeing positive numbers that appear to be on the increase. He cautioned, though, that total testing and the trends in total testing have also really ramped up since Labor Day. “But what gets reported is a number.”
He remarked that the pandemic has been quite an experience for those at Ascension St. Joseph Hospital. “I think that, as a country, we’ve learned a lot and clearly, as a health system, we’ve learned a lot.”
He says he has been very thankful that the local facility is part of a larger system, with Ascension Health representing 15 hospitals throughout Michigan.
According to Hunt, they were in an incident command type of structure across the state, for a period of about 130 days or so, where they were sharing information – as well as sharing resources with other areas that were hit harder by the virus than Iosco County.
He said he thinks that by having that ability to secure personal protective equipment, exchange information, share best practices and so on, it has really helped to support the situation here locally. “And we were very, very thankful for the response from Ascension Health, as well as our local provider.”
“What’s the name of the machine that helps people breathing, and is kind of an end-stage machine that is used?” asked Trustee Jim Baier.
Hunt said he believes the name of the device being referenced, is a ventilator. “There are multiple stages in which a patient might progress,” he elaborated.
Hunt explained that those being treated for COVID-19 would typically require supplemental oxygen. “And that can just be done by nasal cannula.”
A step up from that, essentially, would entail use of a high-flow nasal cannula. “The majority of our inpatients require a high-flow type of nasal cannula,” he pointed out.
“Then a step up from that would be called a BiPAP machine, or a CPAP machine. These would be similar to what individuals may be using in their homes, if they have sleep apnea,” Hunt went on.
“And then progressing on up from that, would be a ventilator,” he said. This basically involves hospital staff taking over the function of breathing for a patient.
Hunt says there are enough ventilators on site at the hospital in Tawas City. This is on top of the facility also having access to additional machines – throughout the Ascension organization across the state – that could be redeployed. “And in fact, we were able to redeploy some of our ventilators and anesthesia machines to Detroit and to the southeast Michigan markets when they were surging there in April and March, as well.”
Hunt adds that there is a second phase, of sorts, with this also. What has happened, is there have been a lot of emergency use orders. So, anesthesia machines – which are typically utilized when someone has a surgical procedure – can actually be used in these other scenarios. “They are a little bit different than a ventilator, but certainly can provide many of the same functions as a ventilator.”
He said that, along with the ventilators that are on site, he believes the hospital also has 10-15 anesthesia machines which could help support patients in the event that the county experiences a surge.
“We have about a three-phase surge plan. We have been in Phase I of our surge plan ever since the initial response to the pandemic, and we remain in Phase I at this time,” he said, regarding the inpatient demands that COVID-19 is putting on the hospital.
Hunt said he appreciated the opportunity to address the board of trustees. He added that if there are any other questions in the future or things that they would require of Ascension, as the hospital in Iosco County, that staff would be happy to help.