COVID 19: A Health Care Perspective

As the primary medical facility providing health care to so many in our area, the goal of Cascade Medical Center is to deliver not only the best health care for the communities we serve but to educate residents with the most accurate, up-to-date information reflecting the greater consensus of the medical profession, so they may make informed choices to stay healthy and avoid unnecessary illness. 

It is for these reasons we are conveying our deep unease and reservation regarding the content of stories and editorials concerning COVID -19 in the November 18, 2020 edition of the Leavenworth Echo. In that issue, amongst other things, we read assertions that “the danger (of COVID) is not as serious as one thought”, comparisons of community adherence to proper mask wearing and protocols to “an IQ test” (one you would fail if you complied), and arguments asking rhetorically how dangerous a disease really could be if many can carry the virus without exhibiting any symptoms.   

From Cascade Medical Center’s perspective, these assertions are inaccurate, defy medical consensus, and are likely to encourage actions that will increase COVID infections and put increased strain on our regional health care system which is already stretched too thin. We would like to thank the Leavenworth Echo for offering us the opportunity to share this perspective and the reasoning for it below. 

First, let’s be absolutely clear: the danger COVID poses, both to our communities as well as to our health care system, is very real. Many who downplay the threat COVID-19 poses to our community point to lowering fatality rates and better processes of care for those affected. It is true – we now know better how to care for those afflicted by COVID than we did in March. However, numbers and statistics can be weaponized on both sides, and we can argue those numbers all we want to fit the individual narratives we wish to pursue. From a medical perspective, we have no argument with looking at data with a critical eye. What we can’t argue, though, are the actual experiences of the people walking through our doors seeking care and the providers who care for them.  

Before we get into the nitty-gritty of why we are so concerned, a quick explanation of how we all work together as a health care system is warranted. No one clinic or hospital in our state operates in a vacuum. Rather, facilities are interconnected. Hospitals rely on each other to accept and treat patients relative to the level of care they require. When one center becomes overloaded with the sickest patients, they are transferred to other facilities that can care for those people in an appropriate way. When all of those facilities become overloaded, the effects trickle down to health care centers now tasked with providing for patients with care better suited for facilities with more resources.   

We saw this issue rear its head just a couple weeks ago. Cascade had a situation where we had patients in our acute care hospital in need of surgical intervention. Usually this results in a timely transfer to a hospital with robust surgical facilities. Instead, the transfer of these patients from CMC was delayed up to five days. We simply had no place to move them. Why? Because the hospitals we rely on to transfer patients to were on “diversion” (a term for when a hospital can’t take any more incoming transfers because of bed space/staffing issues). Treatment of increased number of COVID positive patients factored into those hospitals being on diversion and unable to accept patients that normally could have been admitted for care.  “In my 20 years of practicing at Cascade Medical Center, I have never seen a situation like we experienced where we were taking care of patients who, frankly, had no business being here and needed an intensive care environment, but there was simply no room. No one could take them. That was a wake-up call. This situation is starting to get very real for providers. We simply can’t argue the realities of space, or lack thereof. What we are describing is the very beginning of a trickle-down effect we are going to see if Central Washington Hospital, Harborview, Swedish, Deaconess, and the other hospitals we count on for the highest-intensity care, start getting inundated with the very sickest patients,” explains Dr. Geoff Richardson. 

What people need to understand is that the very sickest affected by COVID can be a comparatively small portion of the population, yet when we have too many sick at the same time the ability to provide care for all in need is compromised. This is beginning to happen. Unfortunately, we anticipate we will see more of it as we move deeper into the holiday season with people who may be experiencing COVID “fatigue” and desire to keep holiday traditions alive despite the risk. 

What can you do to help? Continue to be vigilant with prevention measures. Make sure you wear your mask over your mouth and nose. The virus loves to hang out in your nasal cavity, and if you leave that uncovered, it’s almost as unhelpful as not wearing one altogether. Be careful with your bubble of contacts. Meet outdoors whenever possible.  

And please, think of these measures not some nefarious plot or effort to subvert your individual liberty, but rather as a gift we collectively offer each other. Our health rests literally in our neighbors’ actions. So, let’s commit to being the best neighbors we can be.  

Dr. Geoff Richardson is Cascade Medical Center’s Chief of Staff and has been treating our community as a Family Practice Physician since 2000.  

Clint Strand is Cascade Medical Center’s Director of Public Relations.