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St. Louis-area hospitals ‘running out of options’ as COVID-19 infections accelerate


Doctors Clay Dunagan and Alex Garza, co-leaders of the St. Louis Pandemic Task Force, on Wednesday, Jan. 5, 2022, discuss record hospitalizations in St. Louis over coronavirus and how they're affecting the community.

ST. LOUIS — Leaders of the region’s major health systems sounded the alarm on Wednesday, announcing that the ongoing surge in COVID-19 cases is forcing them to redeploy staff, cancel some procedures and brace for an overwhelming wave of virus patients to arrive in the coming weeks.

BJC HealthCare officials even said they were canceling all elective procedures beginning on Thursday.

“This surge is unlike any we’ve seen before,” Dr. Aamina Akhtar, chief medical officer for Mercy Hospital South, said during a press conference of the St. Louis Metropolitan Pandemic Task Force.

On Nov. 16, there were 250 patients with confirmed cases in the region’s hospitals. By Dec. 10, the number had doubled, to 501. By Tuesday the number had doubled again, exceeding 1,000 for the first time during the pandemic.

On Wednesday St. Louis-area hospitals reported 1,114 patients with confirmed COVID-19 — setting a record for the third day in a row, and well above last winter’s peak of 962.

Hospital officials said the numbers could easily double again in a matter of weeks.

Dr. Alex Garza, chief community health officer for SSM Health and co-lead of the task force, said SSM may soon also cancel elective procedures. SSM hospitals are already rescheduling some.

BJC Chief Clinical Officer Dr. Clay Dunagan, who co-leads the task force, said BJC hospital staffing is nearly at capacity. About 1,000 of the organization’s 31,000 employees are out sick, isolated after an exposure to COVID-19, or caring for loved ones. Others are putting in overtime, taking on extra shifts, or working in roles they would not normally be expected to.

The health system said in a message to staff it is expecting to bring in about 220 agency nurses in the coming weeks.

Some experts have been watching the pace of cases in South Africa, one of the first countries where the omicron variant was detected. After a steep, dramatic surge of cases, infection rates have fallen sharply. But South Africa quickly went into a lockdown when the wave hit, Dunagan said, so it is difficult to extrapolate its case rates to the St. Louis region.

“We’re preparing for January to be pretty brutal, and then hoping that in February we’ll see it recede,” Dunagan said in an interview.

BJC is categorizing procedures as “elective” if they can be delayed for more than four weeks. Spokeswoman Kendra Whittle said Barnes-Jewish Hospital is continuing outpatient procedures, which do not require overnight stays. Pediatric surgeries are rarely elective, so those are not expected to be delayed, she said.

Patients who have procedures scheduled will be contacted by BJC about postponing their appointment.

Statewide, COVID-19 hospitalizations are approaching last winter’s peak: They hit 2,734 on Sunday and 2,840 on Tuesday, according to the most recent available data from the Missouri Department of Health and Senior Services. They peaked last winter at 2,862 on Dec. 22, 2020.

‘Running out of options’

The staffing shortages at area hospitals have been exacerbated during the current surge because health care workers are having to stay home from work due to illness or exposure, officials said.

“Effectively, our bed capacity is being reduced by the virus,” Dunagan said. “We’re quickly running out of options.”

St. Luke’s Hospital is offering incentives to work extra shifts and longer hours, said Heather Thompson, senior director of nursing and interim chief nursing officer. But that is not sustainable, she said. And though in the past hospitals have been able to lean on additional workers from staffing agencies, they too are now in short supply.

A group of hospitals in the Metro East and larger southwestern Illinois region sent an open letter to the community on Monday, urging residents to get vaccinated and boosted, wear a mask and get tested.

“Our teams are strained,” the letter said. “Capacity is being pushed to the limit.”

There is a bright spot: Booster doses seem to help greatly against the omicron variant, which now makes up an estimated 95% of cases nationwide, and an estimated 77% of cases in the Midwest region that includes Missouri, Kansas, Iowa and Nebraska, according to data from the U.S. Centers for Disease Control and Prevention.

Just 1% of the COVID-19 patients in BJC hospitals had gotten boosters, according to a recent survey, Dunagan said.

And zero of 105 patients in the CoxHealth hospital system in the Springfield area had gotten boosters as of Monday, CoxHealth Springfield President Amanda Hedgpeth said during a separate briefing Wednesday.

‘Uncharted waters’

Regional testing capacity is also strained.

Missouri’s online ordering system for free at-home coronavirus testing kits was paused Wednesday to allow the provider to catch up with demand. Ordering is expected to reopen Thursday morning, but a limited supply will be available through January.

And hospitals are asking residents not to get tested at emergency rooms if they have mild or no symptoms, because ERs are required to evaluate every patient, said Dr. Alok Sengupta, chairman of Mercy’s emergency department.

The state positivity rate — the portion of tests returning positive — has ballooned in recent weeks. The seven-day average hit 28.5% on Wednesday, up from 6.5% in late October, and is even higher in St. Louis, St. Louis County and St. Charles County.

Dunagan said he suspects some people have been forgoing vaccination because they believe if they become ill they will be able to rely on treatments like monoclonal antibodies or antiviral drugs. But those treatments are in short supply, he said, and will likely only be used for people with significant risk factors for severe illness.

“We don’t want to be seen as fearmongering or panicked,” Garza said. “But clearly we’re in uncharted waters right now, when it comes to the volume of patients and the stress on the health care system.”

“Behind the scenes, we’re panicked,” he said. “We need the entire community to be helping us out.”

For help navigating the state’s online ordering system for free, at-home coronavirus test kits, call 626-434-3596. To find a state-run community COVID-19 testing site, visit, or call 877-435-8411 for assistance.

Michele Munz of the Post-Dispatch contributed to this report.

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