ST. GEORGE — The intensive care unit at Dixie Regional Medical Center nearly reached capacity this week, and is still in danger of doing so, because of a continued upsurge in COVID-19 infections and hospitalizations in the region.
The diminishing ability for the largest hospital in the region to be able to accommodate patients has the chief doctor at DRMC imploring everyone in Southern Utah to wear masks and practice social distancing.
Dr. Patrick Carroll, medical director of Dixie Regional, said Friday that the hospital’s ICU was moments away from exceeding its capacity earlier in the week. The hospital has 32 intensive care unit beds but has a contingency to create a temporary “surge” ICU that may be able to accommodate up to 89 ICU beds. But with most COVID-19 patients needing an average of 30 days in the ICU, even that surge capacity may fill quickly.
“We have more ICU patients with COVID than we’ve ever had. A third of ICU patients are in there because of COVID in addition to the normal number of patients,” Carroll said. “We came very close this week to opening a surge ICU. We want to have that ICU bed available when you are playing on that four-wheeler and get in an accident.”
It’s not just bed space that is nearing capacity at Dixie Regional. Even if there are available beds, there may not be available staff. For example, while Carroll said the hospital remains far from running out of ventilators, it nearly ran out of the availability of those who help operate them.
“Earlier this week, our number of ventilated patients started to approach the limit for our respiratory team,” Carroll said. “We have enough ventilators, but we would have needed to look at contingency staffing.”
Carroll discussed the “three Ss:” Space, staff and supplies.
“Even at a time where the entire hospital wouldn’t have been full, we can be at staffing capacity and still have supplies and space,” Carroll said.
At last check, the hospital had 79 ventilators. There are 284 total beds, with the ability to add 80-100 beds if necessary.
“The good news is, Intermountain has a number of hospitals so if Dixie becomes overwhelmed, we can send patients to other hospitals,” Carroll said.
As far as staffing, he said Dixie Regional will first try to draw from other areas of the hospital not seeing as urgent a need, then from other Intermountain hospitals. Though Carroll said it hasn’t come up for discussion yet, there is also a favor owed by hospitals in New York, where Dixie Regional and Ceder City Hospital staff traveled in April to help caregivers there treat coronavirus patients with the promise that staff there would travel to Southern Utah if the need arose. With hospitals there now seeing their coronavirus patients down to 15% capacity, it might soon be time to return that favor.
Carroll said advance planning that has been in process since the start of the pandemic is paying off, as filled beds and busy staff won’t mean patients will be turned away. There’s also plan B, C and D.
He added nonurgent, elective surgeries are likely to be postponed if they require post-op in the ICU. As of Monday, Dixie Regional is also going to ban most visitors throughout the hospital.
Carroll said the BLU-MED tents erected outside the emergency room in March are now considered plan “Z.” They won’t be used unless there is no other space in the hospital.
“I hope we don’t have to use them,” Carroll said.
“When your loved one has a stroke, they need ICU care regardless if the ICU is full. If necessary, we’ll provide ICU care in a different location,” Carroll said. “I can’t say it will be the same, but we’ve done a lot of work cross-training nurses.”
However, Carroll is the first to say he would prefer not to do that. St. George News has also heard from members of the nursing staff at the hospital expressing their own concern about dealing with patients they hadn’t been previously trained for in other areas of the hospital.
But Carroll also said it won’t be up to doctors and nurses to determine whether Dixie Regional initiates contingency plans – it will be up to the people of Southern Utah and their willingness to follow the advice of health experts to socially distance and wear face coverings.
“We need your help. I hope what I’ve projected doesn’t happen,” Carroll said. “With the help of the community, we might be able to avoid it.”
‘The science is clear’
Earlier in the week, Gov. Gary Herbert made face coverings and masks mandatory in all state-run facilities. While he has fallen short of a statewide mandate for people to wear masks, he has granted requests by Salt Lake and Summit counties to require masks there.
Harmon’s Grocery announced Friday that as of July 5, it will require all patrons to wear masks in its Southern Utah stores. Costco already requires masks in its location in St. George and masks are also required in stores in Mesquite, Nevada, where masks are now mandatory statewide.
There has been resistance by some who say they do not need to wear masks for reasons ranging from discomfort to feeling it is taking away their freedom.
This includes Washington County Commissioner Victor Iverson who said earlier in the week that he will “never wear a mask.”
Carroll said the best response he can give is knowledge.
“From a medical standpoint, my response is, the science is clear,” Carroll said. “My hope is people wear masks not because someone says they have to, but because you want to protect your community. Wearing a mask is not a sign of weakness – It is a show of respect and compassion for our neighbors and ourselves.”
There are several studies showing that wearing a face-covering can sharply drop the number of coronavirus infections the more people wear them.
An Ipsos/Axios poll released Friday determined the Middle Atlantic region of New York, New Jersey and Pennsylvania have the highest use of masks in the nation. The same region is currently the only one in the United States seeing a reduction in its case rate, according to Johns Hopkins University.
Meanwhile, the Utah Department of Health reported the state hit a new one-day high of 679 cases Friday, coming close to exceeding New York’s total for the day.
“Each one of these cases represents a household that will now be required to quarantine. This means parents will be unable to go to work and children will be unable to see their friends,” State Epidemiologist Dr. Angela Dunn said in a statement. “We need large-scale behavior change on the part of all Utahns to reverse this trend. Everyone, whether it’s required in your county or not, needs to be wearing a mask in order to help protect those around you.”
Southern Utah hit its one-day high in new infections Thursday with 57 new cases. That number had been down to 44 new cases Friday.
Washington County passed its 1,000th person infected with the virus since the pandemic began.
At the start of the month, Washington County had 374 cases, but it now has 1,011 for a 270% increase this month with four more days to go. After having no cases until June 15, Beaver County has now surpassed Kane County in coronavirus cases despite Kane having its first case in April.
Carroll said of the people Intermountain Medical has tested in Washington County who don’t have any symptoms, 1% have come back positive for the virus. While Carroll said that may sound like a small number, he said it is safe to say that one out of every 100 people in Washington County have the virus, are able to transmit it and don’t know it.
“If we walk into the grocery store and there are 100 people there, that means one person has COVID,” Carroll said. “Hopefully that’s not you, and hopefully you and the people you are coming into contact are wearing masks.”
Carroll has seen the claims in social media that wearing a mask can’t possibly stop the virus, comparing it to trying to stop a mosquito with a chain-link fence.
The chief doctor said that isn’t a true comparison.
“Although the viral particle is small, it is passed by a respiratory droplet. It’s more like a mosquito is on a baseball hitting that chain link fence,” Carroll said, adding that wearing a mask decreases the chance of others getting the virus by 85%. “It doesn’t take it to 0, but 85% is pretty impressive.”
Carroll also discounted those who say wearing a mask can cause carbon dioxide poisoning, citing a recent Intermountain study that showed little oxygen loss inside masks.
“You cannot get CO2 poisoning from wearing a mask,” Carroll said. “Oxygen travels through the mask easily. An oxygen molecule and CO2 is much smaller than a virus particle.”
Editor’s note: Story has been corrected to indicate Dixie Regional Medical Center has a 32-bed ICU and 284 available beds total.
COVID-19 information resources
St. George News has made every effort to ensure the information in this story is accurate at the time it was written. However, as the situation and science surrounding the coronavirus continues to evolve, it’s possible that some data has changed.
We invite you to check the resources below for up-to-date information and resources.
- Centers for Disease Control and Prevention
- World Health Organization
- Utah Department of Health
- Información sobre coronavirus en español
- Intermountain Healthcare
- To Donate and Volunteer to Help
Southern Utah coronavirus count (as of June 26, 2020, one-day increase in parentheses)
- Washington County: 1,011 (34 new)
- Iron County: 265 (9 new)
- Garfield County: 12
- Kane County: 6
- Beaver County: 8 (1 new)
- Washington County: 8
- Iron County: 1
- Garfield County: 1
Hospitalized: 20 (3 less)
Tested: 17,765 (0 new tests)
Recovered: 812 (5 new)
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