Kansas City emergency rooms at capacity from tripledemic: 'We're just nervous about what's to come’
COVID-19, RSV and the flu cases are filling up emergency rooms in the metropolitan area. Many area hospitals are at capacity, with some even putting beds in the hallways. All of this is overwhelming nurses already stretched thin.
If you have to go to the emergency room in the Kansas City area right now, chances are you’ll have a long wait.
The combination of COVID-19, RSV and the flu has created a “tripledemic” filling up hospital beds across the metro. According to the Mid-America Regional Council (MARC), more than 82% of all area hospital beds are currently full.
The CDC reports that flu activity in Missouri and Kansas is very high. During the week of Nov. 27-Dec. 3, Kansas City, Missouri, and surrounding counties had 1,486 laboratory-confirmed flu cases. MARC has reported a 17% increase in COVID cases from the week of Nov. 26.
This increase is especially pressing in emergency departments.
Children’s Mercy reported last week that its downtown hospital was at capacity due to the strain of respiratory infections. An overflow of emergency care patients and admitted patients needing beds in the emergency department has pushed Saint Luke’s and The University of Kansas Hospital to put patients on beds in the hallways.
Dr. Steve Stites, chief medical officer at The University of Kansas Health System, said the hospital has had no choice but to temporarily use hallway beds.
“We try not to do that, but if we have more sick folks than we have beds, then we have to put them someplace,” Stites said. “We really try to avoid the hallway — there's not a lot of privacy and it's not real personal. But sometimes we have to do that while we wait for beds to open up.”
Stites said the health system tries to use “alternate care locations,” transferring patients to another floor, like the recovery unit, once they’re stable enough. But that’s not always possible. Stites estimates that the hospital admitted 40 patients with influenza in the past week and more than 60 patients with COVID just on Friday.
In all, about 10% of the hospital’s beds are taken up by flu, RSV and COVID patients.
The hospital is also currently under construction. Once completed its emergency department will have 78 beds — 25 more than it currently has.
“Our case mix index numbers indicate to us we're over our projections for how sick our patients are right now,” Stites said. “One of our challenges is that there still are a lot of COVID patients. We're concerned about that because the new variants are a little more immune evasive.”
Emily Hohenberg, director of media relations for the Saint Luke’s Health System, said patients are currently having to wait in the hospital’s emergency department for longer because of the influx of patients with respiratory illnesses.
“Metro Saint Luke’s Hospitals currently are operating near capacity,” Hohenberg said. “We currently do not have any beds out of service due to staffing. Our EDs (emergency departments) have seen record volumes in many locations, and those not setting records are seeing higher volumes than expected for this time of year. As a result, some (admitted) patients must be held in the ED temporarily.”
The increase in patients has had an effect on nurses, as well. Heidi Lucas, executive director of the Missouri Nurses Association, said the early surges of respiratory illnesses combined with a nursing shortage have had a negative impact.
“There is a little bit of pile-up in our hospitals right now,” Lucas said. “Add this on top of the nursing shortage that we're already having in the state, and it's just hitting a little bit harder than usual – but it's not something that was entirely unexpected.”
The Missouri Nurses Association reported state turnover and vacancy rates of about 22% and 20%, respectively, for registered nurses. The Kansas City area has a higher vacancy rate of about 24%, according to the association’s 2022 workforce report. Lucas said this could be the “new normal” over the next few years as more nurses leave the field.
“It's kind of almost like the snake eating its own tail,” Lucas said. “We have a nursing shortage — which causes a strain on the nurses that we already have — and that's causing them to work more hours, longer shifts and having less opportunities to take the time off that they so desperately need. When you're in a situation like that, it's causing people to leave the field, which then exacerbates the problem.”
According to Lucas, staffing ratios, workplace conditions and pay all have to be improved for nurses to stay in the field. She said nurses are also facing increased violence in the workplace from patients and their families.
“Nurses know the good places to work,” Lucas said. “Those places are also still having issues but not nearly the type of crisis that some of our other facilities have. It's a big problem that doesn't have one solution to it.”
Hospitals around the area are urging people to get tested for RSV, COVID and the flu at an urgent care or walk-in clinic, reserving the emergency room for life-threatening conditions.
Lucas said the easiest way to help healthcare providers facing overcrowded hospitals is to keep yourself healthy. One way to do that, according to Stites, is to get fully vaccinated and boosted for COVID and get the annual flu shot.
“We know nobody wants mask mandates, we know that nobody wants to be forced to get vaccinated,” Stites said. “That's all great until people get really sick and the hospitals get really full. If you think of the (fact) that these new variants are more immune evasive, then having had COVID won't be as protective. I think we're just nervous about what's to come.”