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
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
- 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.