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UPDATED: RMC warns ambulances away as COVID-19 fills ICU beds

RMC ER

The outside of the emergency department at Regional Medical Center in Anniston.

Regional Medical Center in Anniston is urging ambulance crews to take patients to other hospitals because COVID-19 has filled the hospital’s intensive care facilities to capacity, the hospital’s CEO said Monday.

“Our ICU, based on the ability to staff, is full,” said Louis Bass, CEO of RMC.

For the past two weeks, Calhoun County has recorded more than 100 new cases of coronavirus per day, according to the Alabama Department of Public Health. It’s the fastest the virus has spread here since the pandemic began. 

The effect of that spread is clear at RMC, where on Monday there were 60 COVID-19 patients in hospital beds and several more being treated in the emergency room waiting for a space on one of the hospital’s COVID wards, Bass said.

At the height of the summer surge, the hospital never treated more than 60 patients.

Bass said the hospital is now in “diversion” status, which means the hospital has put emergency responders on notice that there is no room for intensive care patients.

“If someone has a heart attack and EMS providers think the best option is to come to us, they can,” Bass said. “If they pull up on our ramp, we won’t turn them away.”

Still, Bass said, “diversion” status means ambulances will likely go elsewhere.

It may be difficult, though, to find an Alabama hospital less stressed than RMC. More than 2,200 COVID patients lie in hospital beds statewide — well above the roughly 1,600 the state saw during the summer peak, when COVID strained the capabilities of many Alabama hospitals. 

Nursing shortage at RMC

Local officials in spring explored plans to set up the equivalent of a field hospital if the pandemic filled RMC to capacity. But it’s not more buildings or beds that the hospital needs; it’s nurses to staff any additional COVID treatment facility.

Bass said that if the number of COVID patients continues to rise, the hospital may consider transferring some patients to other hospitals. He said there is an eight-bed “chest pain center” in the emergency room that could be converted for COVID treatment. If that isn’t enough, he said, it’s likely the hospital will restrict surgeries in order to free up personnel to deal with the pandemic.

Alabama’s Medical Licensure Board announced Monday that it was easing some restrictions to allow emergency licensing for doctors from other states or from Canada to work in Alabama.

Bass said that is unlikely to help RMC with its immediate needs.

“For us, physicians have not been an issue,” he said. He said emergency licensure could help if some of the current staff of doctors get sick themselves and can’t work.

RMC won’t get first round of vaccines

State health officials have said that medical professionals who work with COVID patients will be the first in line to get the COVID vaccine. Federal officials approved a vaccine made by drug company Pfizer over the weekend.

Alabama Department of Public Health announced that the Pfizer vaccine had arrived at three Alabama hospitals Monday, with another dozen expected to get doses Tuesday. ADPH officials have declined to name the hospitals receiving the vaccine, citing “security and logistical concerns.”

RMC officials already knew they wouldn't get Alabama’s first round of shots. The hospital hasn’t yet been allocated any doses of the Pfizer vaccine, which requires special refrigeration capabilities, several local officials have said.

Bass said Monday that RMC last week applied for a shipment of the Moderna vaccine. Not yet approved by the federal government, the Moderna vaccine has less stringent storage requirements. State health officials have said Moderna will likely be the option for most of the state’s rural counties.

Bass said he expects approval of the Moderna vaccine soon.

“We’re hoping to get it by the end of the month,” he said.

Vaccine challenges in rural counties

With a population of more than 100,000, Calhoun County doesn’t usually fall into the “rural” category by most government definitions — particularly where health care issues are concerned. Several of the state’s least-populous counties have no hospital at all, and at least one, Coosa County, doesn’t have a county health department.

In a Zoom teleconference with reporters Monday, University of Alabama Birmingham associate dean Dr. William Curry outlined some of the reasons the Pfizer vaccine isn’t likely to be used in the most rural areas of the state.

In addition to the cooling requirements, he said, the Pfizer vaccine comes in batches of nearly 1,000 doses, which must be used soon after delivery. It’s a two-dose vaccine, he said, and following up with rural patients for a second shot could prove challenging.

“There’s more concern than there would be where the distances are short and the points of access are many,” he said.

Even so, Curry said he hoped there would be little difference in the pace of vaccine distribution in rural counties compared to urban counties. 

Capitol & statewide reporter Tim Lockette: 256-294-4193. On Twitter @TLockette_Star.

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