Frederica Freyberg:

As Delta COVID cases continue to spike, hospitals across the state are bumping up against capacity. Hospitals like the Marshfield Medical Center in Beaver Dam. Its a small rural hospital in Dodge County, a place where cases are on the rise and the percentage of residents fully vaccinated is ten points below the state average. The hospital is nearly full up now and staff there worry for the start of school and the winter months ahead. For more on the situation at Marshfield Medical Center in Beaver Dam, we turn to Angelia Foster, chief administrative officer at the hospital. Thanks very much for joining us.

Angelia Foster:

Thanks for having me this afternoon.

Frederica Freyberg:

So what impact have newly spiking COVID case numbers had on your hospital and its capacity?

Angelia Foster:

So I wish I had better news. We hit 92% our inpatient capacity, and that’s a real uptick from where we’ve been in the last few months. We are seeing a greater need for respiratory care for our patients that are coming in. It is on average — our average daily census is 150% up over what it was just two weeks ago. So we’re feeling the pressure. We’re feeling the strain and we’re just so incredibly sad that we’re back here again this fall.

Frederica Freyberg:

And so I guess it goes without saying that those patients needing respiratory care and the capacity situation is due to patients who come in COVID-positive?

Angelia Foster:

Correct. Yes. Directly tied. We had a point last weekend where we were about 30% of the patients we had in the house were COVID-positive, and 100% of those in ICU on ventilators were COVID-positive.

Frederica Freyberg:

So how concerned are you and your hospital staff about projections of even further surging COVID cases into the fall and winter, especially in a county with lower vaccination rates?

Angelia Foster:

We’re very concerned. You know, Dodge County, new cases are up 53% since last week, school starts back this week. The fair was about two weeks ago, so we’re really anticipating additional surges. And the challenge for us is, last year we weathered the storm, my team here is incredible, the clinicians and providers who take such good care of our community showed up, but we have 20% fewer this year working. They chose to retire or leave healthcare because the post-traumatic stress is so intense. So I’m nervous not only about the surge that’s coming and the fact that we don’t see any let-up in the numbers, and also not having enough staff to be able to meet that need.

Frederica Freyberg:

What are you doing about the shortage of staff? Are you having to go, say, out of state to contract with staff?

Angelia Foster:

So we have some contracted labor but even that pool is small. And so we’ve really turned to a team model. So we’re asking folks who are not traditionally in clinical environments to come in and help. I’m not clinical, but I can stock a PPE cart for them, or I can take a water to a patient, and our staff is showing up and doing incredible things in order to meet the needs of the patients.

Frederica Freyberg:

What about for patients who may be in your hospital for things like heart attacks or stroke, what does this capacity and the needs of these newly incoming patients do to the care for those patients?

Angelia Foster:

Well, of course we always, always, always strive to take care of our patients, and do the very best we can for them. But I can tell you that across the state, we’re all spread thin, so even if I will accept patients, we’ll continue to try to care for the community, but if we need to transfer out even other facilities are not in a position to take folks right now. So it is a strain. And we don’t ever want to get to the point where we have to decide who gets services and who doesn’t, but if we don’t slow down on the trajectory, we could find ourselves there again this fall.

Frederica Freyberg:

And do you find yourselves close to that at this moment?

Angelia Foster:

I think it’s coming in the next few weeks to months, yes, especially if we can’t get folks to get the vaccine or to mask up or to social distance as kids return to school and, you know, I was at the grocery store yesterday, and in this small town here, there were only a handful of us wearing masks. As we all start to transition inside and be more around each other, the Delta variant is much more contagious, and we’re going to have bigger issues this fall.

Frederica Freyberg:

Do you have an indication from the patients who are coming in who are COVID-positive whether or not those were people who had been vaccinated?

Angelia Foster:

So I can tell you that last month at Marshfield Clinic Health System, 94% of those who were hospitalized with COVID had not been vaccinated. And so that’s very concerning for us, not only here in Beaver Dam but across the state. What it shows me is that the vaccine works, right? With only 6% those being hospitalized having had a breakthrough case, what concerns me more is those who have not had that coverage from the vaccine having to be hospitalized and placed on vents and seeking additional respiratory support.

Frederica Freyberg:

What would you want from state or federal officials by way of any help with this?

Angelia Foster:

I think, you know, quite honestly, we need to quit making it a political issue. We need to make it a public health issue and that’s when I need my colleagues and leadership both at state and federal levels to help us with. Most of them have been vaccinated. Most of them are willing to wear masks, and yet when it comes to publicly saying it, they won’t. We need a break. This hospital will have been here a hundred years next year. I am very concerned that it will not look the same. The way we care for our patients will not look the same. Because if we keep going this way, we’ll lose more staff, we’ll be in a worse position and not know what it’s going to look like in the future, so I need my publicly elected officials to step up to the plate with us and help the communities to see, we need to vaccinate, we need to mask up and we need to social distance to get this under control.

Frederica Freyberg:

Because you and your staff are on the front lines of this and seeing it every day.

Angelia Foster:

Yes, yes. And you know, my staff, I had one of my ICU nurses stop me and she said, “I’ve been a nurse for five years, and five years prior to COVID, I had only lost four patients. And in the last year, I’ve lost over 10 that I’m caring for.” She said that is not acceptable when there’s a solution and a vaccine that could very well help my community, because in these rural areas, we really are family, friends and neighbors taking care of our family, friends and neighbors. And it breaks our heart when we see them come in and need the kind of help that they need to recover from COVID if they can recover from COVID.

Frederica Freyberg:

We leave it there, Angelia Foster, we hear it in your voice. Thank you, and thank you for your work.

Angelia Foster:

Thank you, and thank you for helping us to get the message out. Please, get the vaccine.