AUSTIN (KXAN) — “If you have to think about your breathing, then you have a problem, because breathing just comes naturally.“
These words from a former instructor have taken on new meaning for respiratory therapist Shyanne Spivey, as she works to help coronavirus patients admitted to Austin-area hospitals.
She said registered respiratory therapists usually work with patients who suffer from chronic obstructive pulmonary disease (COPD), asthmatics or babies in the NICU with underdeveloped lungs. Now, they are also assisting pulmonologists in caring for COVID-19 patients, often with the help of a ventilator.
“I don’t think a lot of people know really what respiratory therapists do, until they need one,” Spivey said.
Many times, they are able to help a patient recover and begin breathing on their own again. Other times, they are there for a patient’s final breath.
“It’s been very emotional, I can say that,” she said.
She said they are often in charge of an entire floor of a hospital, and that responsibility has only increased with the pandemic.
Over the last few weeks, Austin Public Health officials have maintained their concerns about staffing our local hospitals and intensive care units.
According to Austin-Travis County Interim Health Authority Dr. Mark Escott, hospital admissions in our area are up 140% from last month. In a presentation to county commissioners, he warned beds in intensive care units were projected to run out in 10 days.
“What we experienced over the summer is nothing compared to what we will experience over the next two months, if we don’t change things very quickly,” he said.
According to a joint statement from Ascension Seton, Baylor Scott & White Health and St. David’s HealthCare, their hospital systems have enough staff and beds to care for 2,473 patients. 79% of them were occupied as of Tuesday. The statement noted the hospitals have 483 intensive care unit beds in total, and those were 88% occupied.
APH routinely uses the figure of 200 ICU beds to represent when our area could “reach capacity,” based on how much staff and resources it would take to care for those patients.
Escott has previously said he worried about a lack of staffing reinforcements from around the state, as other cities surge.
He told commissioners on Tuesday, “The entire state is in surge,” he said. “We need a substantial change in policy to more aggressively mitigate the spread, because what we’re doing right now isn’t working.”
Last week, Gov. Greg Abbott’s office said 2,100 medical personnel were in the process of being deployed to fill in the staffing gaps around the state. KXAN has requested more details on where these healthcare workers will be stationed and for how long. A spokesperson for the governor and the Texas Department of Emergency Management both directed KXAN to the Department of State Health Services. That agency has yet to respond to our request for details.
For Spivey, the situation is personal. She lost her grandmother in December to coronavirus. Then, just weeks later, her uncle passed away too.
“It’s serious, and a lot of people unfortunately won’t realize that until it affects them personally,” she said.
She went on, “It’s really frustrating when you are out in public, and you see people not social distancing and doing the masks. It’s frustrating because here we are with these patients — and they can’t breathe and they are dying, and if they do make it, they are usually in really bad shape.”
Staffing the Convention Center — or other alternate care sites
“Staffing continues to be one of the largest concerns as COVID continues to surge across metropolitan areas across Texas,” an APH spokesperson said in part.
According to the spokesperson, hospital staffing capabilities “after regional hospitals have expanded to their maximum surge capacities” was one of several criteria they will use to decide if, or when, they should open an alternate care site (ACS), such as the one set up at the Austin Convention Center. Other criteria include the total number of hospital beds available, the number of ICU beds available, and the daily hospital admissions average.
They said they were working “closely” with area hospital systems to determine the need for an ACS. If the site was activated, the intent would be to have it operational within 14 days.
When KXAN asked about staffing concerns at an alternate care site, given the staffing shortages already seen in area hospitals, the spokesperson pointed out the “lower needs of care” that would be necessary to treat patients there.
They said, “Only patients who require basic care would be transferred and admitted to the ACS, allowing additional staffing hires that may not be accessible and needed for traditional ICU care.”
The spokesperson also said the number of staff needed would depend on the number of patients transferred there.