ANN ARBOR, Mich. - As COVID-19 cases and hospitalizations for kids and adults hit record levels in the latest Omicron surge, leaders at University of Michigan Health, Michigan Medicine, say the overwhelming strain on resources has led to delays in lifesaving surgeries.
“Rising COVID cases in children and adults, combined with staffing shortages, have overwhelmed Michigan Medicine resources,” said Marschall Runge, M.D., Ph.D., CEO of Michigan Medicine, dean of U-M Medical School and executive vice president for medical affairs at the University of Michigan. “Although Omicron infections tend to be less severe and perhaps cause fewer serious COVID cases, it’s the sheer number of people infected that is overwhelming our resources. Once again, we, and other hospitals, are having difficulty delivering needed care for other patients who have serious non-COVID illnesses.”
On Jan. 10, U-M Health had 128 hospitalized COVID-19 patients, 33 of them in the ICU and 20 on ventilators. The steep rise in cases and hospitalizations has led the hospital to cancel more than 250 surgeries since the surge began in December.
“We needed those hospital beds for kids and adults who are coming down with serious cases of COVID-19,” said David Miller, M.D., M.P.H., president of U-M Health. “What this means is that many people are not receiving potentially lifesaving care because Michigan Medicine and other hospitals are full.”
To protect patients and employees, U-M Health is instituting a two-week pause on any visitors to its adult hospitals effective Jan. 12. The U-M Health C.S. Mott Children’s Hospital policy of allowing two visitors per pediatric patient will remain.
“People are visiting loved ones and may unknowingly be passing on the virus,” Miller said. “We believe pausing visitors is the safest step for our patients — especially those who are in semi-private rooms, as well as for our team members. There will, of course, be exceptions allowed when a family caregiver is considered critical as determined by the nursing unit.”
Impact on children
This time around, pediatric hospitalizations across the state are hitting record-highs. In the last week, U-M Health saw its highest number of patients who are 17 or younger admitted to the hospital. These rising numbers impact pediatric providers’ ability to care for both COVID and non-COVID patients, said Erika Newman, M.D., pediatric surgeon at Mott.
“We have never seen this many children hospitalized with COVID-19,” Newman said. “Our current pediatric COVID-19 hospitalization number has more than doubled since the surge started in December. We are seeing younger kids and teens with COVID-related respiratory illnesses, pneumonia and a serious COVID-related complication - multisystem inflammatory syndrome, or MIS-C.”
In early December, around 3.5% of children coming into the emergency room at U-M Health tested positive for the virus. That number jumped to 18% last week, with the majority being symptomatic. If the spread of Omicron continues to increase, there is a very real chance there won’t be enough beds to care for critically ill children, said Luanne Ewald, FACHE, M.H.A., chief operating officer of Mott and U-M Health Von Voigtlander Women’s Hospital.
“We’re worried about that perfect storm of numerous kids getting seriously ill at the same time our staff is catching COVID-19 and can’t come to work,” Ewald said. “This is a population tremendously vulnerable to this surge. There are only a few places in the state that can handle specialized pediatric care. We are struggling, and we do not want this to get worse.”
“Our kids are going to school and participating in activities; this is good for them, but they are exposed to risk,” Newman said. “We also ask that you think of the most vulnerable kids in your communities – a child with cancer, or one who has recently had a transplant and those under five who can’t get vaccinated. We, as a society, must protect our children. Not getting vaccinated hurts us all.”
A plea to the public and steps to take
The weight of the surge is aggravated by statewide staffing shortages and rising cases among employees at Michigan hospitals. Over 700 U-M health employees have tested positive for COVID-19 since the start of 2022.
“This Omicron variant has spread throughout Michigan at striking speed, resulting in positivity rates of 39% among symptomatic patients at Michigan Medicine and 8% among those who are not symptomatic but happen to be tested prior to procedures or admission to our hospital,” said Laraine Washer, M.D., U-M Health’s medical director of infection prevention and epidemiology.
Of patients hospitalized at U-M Health for COVID-19, the majority – 61.7% of total patients and 78.8% in the ICU – are unvaccinated. Only a small number of vaccinated patients hospitalized for COVID-19 have received booster doses.
“I cannot stress enough the importance of vaccination, including booster doses to everyone in eligible age groups,” Washer said. “Vaccination is important whether or not you have had a prior COVID infection. Reinfection occurs more commonly with Omicron, and ‘natural immunity’ after infection is not reliable protection.”
During the surge, Washer recommends people wear masks consistently when they are outside their homes in indoor public places and to consider upgrading to a medical-style mask or KN95. Both offer more protection than a cloth mask.
When considering a trip to the emergency department, understand that they are operating at full capacity almost constantly, leaders note, and people shouldn’t use the ER as a testing site for adults or children.
“However, if you have an illness or accident that threatens your life, your limb or your organs, please seek out emergency care – our doors are always open,” Miller said. “But if your symptoms aren’t that severe, we need your help. Please consider options other than the ED that may be available, including calling your physician and making an appointment, scheduling an e-visit or visiting an urgent care.”
Despite the highly infectious nature of Omicron, Washer does not recommend people try to become infected with COVID-19 to “get it over with.” The serious disease affects multiple systems in the body, and long COVID brings about persistent symptoms that last six months or longer, including brain fog, fatigue and other symptoms.
“Our health systems are overburdened, and, depending upon your risk factors and vaccination status, you may develop severe disease,” Washer said. “We don’t know enough about the lasting effects of this disease. While we hope we will soon hit the peak for this surge, if the residents of Michigan can help us by assuring you are up to date with COVID vaccination, wearing your mask and isolating with symptoms or after exposure if you are not up to date with vaccination, we can weather this COVID-19 storm together.”