With a steady influx of ill patients coming in from the nearby Navajo Nation, Flagstaff Medical Center has become a busy locus of COVID-19 care in Northern Arizona, and health leaders see no signs of a slowdown.
While some hospitals in Arizona have reported lower COVID-19 activity than what was once projected, that is not the case in Flagstaff. The hospital got hit early and hard by COVID-19, which is the disease caused by the new coronavirus. Per capita, it is likely one of the busiest hospitals in the state right now for COVID-19 care, officials said.
Most of the patients are coming from the Navajo reservation, which as of Thursday was reporting 1,042 positive cases and 41 deaths from COVID-19. The American Indian reservation includes land in three states — Arizona, Utah and New Mexico. Sixty-two percent of the positive cases reported on the reservation reported as of Thursday were in Arizona.
“As the state anticipates and has seen a flattening of the curve and anticipates their peak towards the end of April, we are not confident that our peak is going to follow that same trajectory,” said Flo Spyrow, the CEO for Northern Arizona Healthcare, which includes both the Flagstaff hospital and the Verde Valley Medical Center in Cottonwood.
“We have not seen a flattening of the curve…The patients coming from the reservation are very, very ill and they need the support of our intensivists and larger critical care teams at Flagstaff Medical Center,” Spyrow said.
When the Flagstaff hospital gets more critically ill COVID-19 patients than it can handle, they are transferred to hospitals in Phoenix, she said.
Spyrow and other Northern Arizona Healthcare leaders said they are coordinating with other health systems and hospitals statewide to make sure they do not get overwhelmed.
Flagstaff Medical Center. (Photo: John Burcham/Northern Arizona Healthcare)
As of Thursday, 31 patients hospitalized in Flagstaff Medical Center were on ventilators, chief administrative officer Josh Tinkle said. The hospital’s census has been rising in recent days, but the number of patients needing critical care has been holding steady, he said. The hospital, which had 147 inpatients on Friday, has 215 inpatient beds and its ICU capacity is 50.
Friday’s numbers showed 57 patients who were positive or suspected positive with COVID-19, down from 73 the previous day. The hospital has brought in a refrigerated truck in case it’s needed for use as a temporary morgue.
And the National Guard has approved a site in a Flagstaff warehouse that if needed, in all likelihood will be used as a site to care for patients who have been discharged from Flagstaff Medical Center and are unable to go home, Spyrow said.
The Verde Valley Medical Center as of Thursday was caring for five patients who had tested positive for COVID-19 and four patients were on ventilators, said Ron Haase, hospital chief administrative officer, adding that the hospital’s overall patient count had been going up in the past week.
Flagstaff Medical Center’s 50-bed intensive care unit had 37 patients as of Friday, and most of the ICU patients at the hospital are ill with COVID-19, officials said.
The average length of stay for COVID-19 patients at the hospital is 7½ days, said Dr. John Mougin, who is Northern Arizona Healthcare’s chief quality officer. The average length of stay in the ICU is eight days, he said.
Patients who need a ventilator to help them breathe spend an average of 9.3 days on the device, Mougin said.
The recovery process for patients who have been on a ventilator can vary, but patients who have been ventilated can develop a condition called critical illness myopathy that may require post-discharge care in a skilled nursing facility, said Dr. Derek Feuquay, chief medical officer for Flagstaff Medical Center.
While there have been multiple deaths from COVID-19 at Flagstaff Medical Center, leaders stressed that there are hopeful stories of recovery. At least 69 known COVID-19 positive patients from within the Northern Arizona Healthcare system have already been discharged home, plus others who were suspected positives.
The health system is also working on developing a program to identify patients who have been COVID-19 positive and potentially have them donate plasma to assist with treating patients who are currently ill. The immune systems of COVID-19 patients develop antibodies in their blood to fight the virus, and using the plasma of those patients may help others fight off the disease, the U.S. Food and Drug Administration says.
“We’re proud to say we did have a ventilated patient who we discharged in good health and we have a number of other patients who are now off the vent and recovering,” Spyrow said.
Modeling projections of illness and death in Arizona had been predicting 1,005 deaths from COVID-19 statewide by Aug. 4. That number was downgraded significantly on Friday to a much lower 267. As of Friday, the state reported 169 known deaths and 4,507 cases overall.
In a letter to Gov. Doug Ducey on Thursday, the Arizona Hospital and Healthcare Association said that social distancing appears to be working, and requested that he relax two of his executive orders that called for hospitals to halt elective surgeries, and to increase their bed capacity by 50% by April 24.
Association president Ann-Marie Alameddin wrote that hospitals have already increased bed capacity by 25%, and that based on current projections, that will be enough.
Reach the reporter at Stephanie.Innes@gannett.com or at 602-444-8369. Follow her on Twitter @stephanieinnes
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