Update: Banner Churchill Health nears capacity

Banner Churchill Health is almost at its normal capacity because of the current surge in COVID-19 cases.
“Rural Nevada is reportedly experiencing increased positivity rates. This has not translated, to date, into significant case counts of serious disease requiring hospitalizations,” the Nevada Hospital Association said in a release. “Some rural counties which have been flagged for elevated disease transmission such as Churchill, Douglas, Elko and Nye are experiencing stress on their hospital systems as a result of the small size of the hospital facility when compared with the relative burden of COVID-19 patients. Other rural counties such as Lander, Lincoln, and Lyon are not experiencing significant hospital demand either with admissions or ED visits.”
As on Monday, 24 of the available 25 inpatient beds (96 percent) are full and the hospital is over capacity on ICU beds. Two of the available six ventilators are in use. More than half of the patients are COVID-19 related. Banner is treating 14 confirmed cases, including six in the ICU. The ICU has only four beds.
Dr. Marjorie Bessel, Banner Health Chief Clinical Officer, said in a press conference on Tuesday that Banner Health hospitals will be able to accommodate up to 125-percent capacity. Banner Health has secured more than 1,000 staff out of state to help with the surge at all locations, including Banner Churchill, and 934 will have started by the end of the month. Bessel said that they are recruiting for 900 more staff.
“We will be doing some deployment of corporate members from Banner Health in the field. We will look at every possibility,” she said. 
During the summer peak, Banner Health secured personal protective equipment and beds in the event of another surge, but Bessel’s concern is with the staff. Risk of being exposed to the disease and the additional care needed for COVID-19 patients put additional strain on the system.
“Individuals in our hospitals who have COVID-19 are very sick,” Bessel said. “Our staff are having to wear additional PPE"
At this time, Bessel said that Banner Health can treat both COVID-19 patients and non-COVID-19 patients. Visitor restrictions are in place and elective surgeries are treated case-by-case.
“We do not forecast that when we are in a 125-percent capacity situation we will not have to triage,” Bessel added. “Our goal is to take care of you, your family and your friends. What we know from last time is cancelling surgeries has an effect on lots of people. We do medical surgeries. We do essential surgeries. They cannot wait forever or for a prolonged period of time. Those patients need us also.”
Bessel said that two of the states serviced at Banner have activated the crisis standard of care. Plans are in place to help augment staff and they also include extracted labor. Part of the plan is already in place to meet demand. Earlier this year, Banner Churchill set up triage tents.
“We have a big curve ahead of us and if we can all do our part with this significant holiday upcoming, we can help flatten that curve and keep our hospitals, our clinics, our urgent cares, our emergency departments up and running for you,” Bessel said. 
As a whole, Banner Health is experiencing numbers similar to mid-June but Bessel said this month’s situation is different. The entire country is facing a surge as opposed to single states or regions. With vaccine distribution on the horizon, she stressed the importance of flattening the current curve.
“I do want to caution that despite all the great positive news that we are receiving about the vaccine that is going to make a significant impact into 2021, it is not something that is going to change our trajectory or our surge curve in December of 2020,” she said. “So, we’re going to continue to ask everybody to pay particular attention to the mitigation activities that will help us flatten the curve while still remaining positive that a vaccine is on its way.” 
Banner Health is now treating patients with bamlanivimab, an Eli Lilly monoclonal antibody that is available in limited supplies. Bessel said that infusions began last week at Banner Health. Patients over the age of 18 with possible COVID-19 may be evaluated at a Banner Urgent Care of Banner Health Clinic to see if they may qualify. 
Bessel said that Banner Health will communicate when another treatment, Regeneron’s monoclonal antibody that received Emergency Use Authorization from the FDA this month, will become available to their patients. She also said that the pharmacy team is evaluating a new combination treatment of barcitnib and remdesivir for COVID-19 treatment and will provide risk/benefit guidance.