MHP Incident Command Update

December 29, 2021

General Update: Indiana’s overall Covid positivity is 13.8% and Shelby County’s positivity rate has reached 16.3%, which places us in the “red” category for consecutive reporting periods. The Indiana Hospital Association and the Indiana Department of Health hosted a Covid webinar last night. The modeling predicts a grim outlook over the next 2-4 weeks. Currently, the Delta variant remains the predominant Covid strain and that continues to drive the increase in hospitalizations across Indiana. However, that is expected to change quickly over the next several days as the Omicron variant makes its way through the population. Once the Omicron strain reaches a 20% incidence rate, we will be required to change the treatments and therapeutics we are currently using because it has been determined they are ineffective against Omicron. After running out of Regeneron earlier this week, we did receive 192 doses late yesterday. This new shipment is expected to last approximately six days based on the current usage rate and we have 22 patients scheduled for infusions today thus far. The effective monoclonal antibodies for Omicron are also in very short supply. We only have 24 doses and don’t know when or if we will receive additional supply.

Supply shortages: Supply shortages are increasingly becoming a challenge; including tape, blood tubes, and essentially all items made from plastic. These supplies are continuing to be an issue due to raw material shortages, including supply chain issues, back orders, overseas factory shutdowns, and manufacturer allocations. Allocation is where the manufacturer sets a percentage of what we receive based on our normal usage; usually between 50% - 80% of our order history. This is during a time when we are experiencing up to a 100% increase over our normal patient volumes. This creates product outages and substitutions, which are increasingly difficult to secure.

Our current supply of rapid Covid tests is adequate; however, the reagent required for antigen Covid tests is in very short supply.

Inpatient unit: All 40 of our 40 beds are occupied on our 3rd-floor inpatient unit.

  • We currently have 18 critical care patients on the 3rd floor, and 12 (67%) of those patients are due to Covid. Of the 12 Covid-related critical care patients, only four are vaccinated.
  • We have seven patients on ventilators and five of those patients are Covid positive. We have ten additional patients who are on Vapotherm or BiPap, and three of those patients are Covid positive. Four patients are requiring 90%+ oxygen support and will likely be intubated and ventilated at some point soon.
  • Twenty-six (65%) of our inpatients are Covid positive, and 18 (69%) of them are unvaccinated.

Emergency Department: The Emergency Department is averaging 87 patients per day over the last four days. Twenty of those patients resulted in admissions yesterday, plus 18 admissions the day before. We were forced to hold four admissions in the Emergency Department between 10-13 hours overnight due to a lack of available inpatient beds.

Urgent Care and Walk-in visits: Priority Care and MHP Family & Internal Medicine are seeing extremely high volumes this week with anywhere between 140-160 walk-in patients per day. Diagnoses include very little seasonal flu, but an increasing incidence of Covid and strep throat, plus higher acuity than normal. Many of these visits are driving higher hospitalization rates. MHP Pediatrics is currently seeing a normal volume of acutely ill patients and not a significant amount of Covid, seasonal flu or strep at this time.