Omicron hospital patient DMN

An extracorporeal membrane oxygenation, or ECMO, machine pulls blood outside of a patient’s body to oxygenate and ventilate it. The ECMO machines are new tools in [hospitals’] fight against COVID-19.

North Texas is concluding yet another week of surging COVID-19 cases that are threatening to overwhelm the area’s understaffed hospital systems.

At least 160 people were hospitalized with the coronavirus in the last 24 hours on Friday, bringing North Texas’ total to 2,973, according to the Dallas-Fort Worth Hospital Council.

Friday’s COVID-19 hospitalization total is nearly four times greater than the total of 800 COVID-19 hospitalizations on Dec. 7.

The total hospital occupancy in North Texas during the last month increased from 92% to 93%, said Steve Love, president and CEO of the DFW Hospital Council. Looking at that metric alone, however, doesn’t paint a complete picture of the strains hospitals are currently under, he said.

The critical difference between what hospitals are dealing with now compared to before the omicron-variant surge is the increasing percentage of patients positive for COVID-19 — and the number of available staff members to take care of them, he said.

Some facilities, like Parkland in Dallas, the area’s largest public hospital, have always operated at 100% capacity, even before the onset of the pandemic.

“Big hospitals like us … are 100% full every single day, so [the occupancy rate] doesn’t change, with or without COVID,” said Dr. Joseph Chang, Parkland’s chief medical officer. “But occupancy rates can be helpful to understand smaller hospitals.”

COVID-19 patients accounted for more than 34% of adult ICU patients in North Texas on Friday, Love said. That percentage is troubling, Love said, because of the additional resources required to care for COVID-19 patients.

Some COVID-19 patients — about 30% at Parkland — are positive for the virus but are primarily hospitalized for something else, Chang said. With previous variants, around 10% to 20% of hospitalized patients with COVID-19 fell in that category.

“It doesn’t mean they don’t have COVID or that COVID isn’t making whatever they have worse,” he said. “It just means their main diagnosis isn’t COVID.”

Regardless of whether they are hospitalized primarily for the virus, coronavirus patients often require more work from hospital staff than the average hospital admission. They have to be isolated, and health care staff have to safely don and remove extensive amounts of personal protective equipment.

Hospitalized COVID-19 patients can also require more medications and nurse assessments, Chang said. “A typical … COVID patient is about the same as any patient. But if the COVID patient is on higher levels of oxygen, then the workload doubles,” he said. “If they go to the [intensive care unit], it’s obviously even more than that.”

Some areas of the health system are seeing more patients than others, including emergency departments, which are fielding sharp increases in the number of people coming to hospitals for COVID-19 testing, Love said.

“The good news is, we’re treating some people in the emergency room and they’re able to go home. They don’t have to be admitted,” he said. “But we’re needing extra staff in that emergency room area to handle the surge of outpatient people.”

Staffing shortages are amplifying the effects felt by increasing COVID-19 patient loads. Record numbers of nurses and other health care workers have left the field entirely because of the pandemic, and hospitals are struggling to fill those gaps.

And remaining health care workers aren’t immune to the omicron variant, which is spreading at unprecedented levels.

The North Texas trauma service area, which encompasses 19 counties, is down about 15% in staff because of COVID-19 or other illnesses, Love said.

The area’s hospitals anticipate roughly 1,000 state-supplied traveling nurses will arrive in the next week to offer some relief to the thin-stretched staffs. Still, that’s likely not enough to cover all of the shortages across the entire trauma service area.

“It’s going to be very helpful, and we’re very appreciative, but it’s not going to be enough to solve the entire staffing problem,” Love said.

North Texas pediatric COVID-19 hospitalizations increased to 131 Friday, up five patients from the day before.

Cook Children’s Medical Center in Fort Worth accounts for 39 of those patients, five of whom are in the pediatric ICU and one is in the neonatal ICU. Dallas-based pediatric hospital system Children’s Health, which updates its COVID-19 hospitalization numbers weekly, reported 67 patients hospitalized with the virus on Tuesday.

While preliminary research shows that the omicron variant appears to be causing milder illness compared with the delta variant, pediatric hospitalization numbers are still rivaling those seen in previous surges.

The increase in pediatric hospitalizations could be explained by the relatively low vaccination rate among children ages 5 and older. About 90% of children ages 5 to 10 are not fully vaccinated against the virus.

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