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ER docs: 'We are on the brink of disaster'
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ER docs: 'We are on the brink of disaster'

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COVID-19 electron microscope scan

This scanning electron microscope image shows SARS-CoV-2 (yellow) — also known as 2019-nCoV, the virus that causes COVID-19 — isolated from a patient in the U.S., emerging from the surface of cells (blue/pink) cultured in the lab.

Under the current COVID-19 trend, Ravalli County's healthcare resources are in danger of quickly being overwhelmed, said a Marcus Daly Memorial Hospital emergency medicine physicians' letter to the community.

“This is a real threat, and it is getting worse daily — there is no exaggeration in saying that … We are on the brink of disaster,” the letter read.

The number of total infections has doubled in the last three weeks.

In this last week, three Ravalli County residents died from COVID-19 complications. Stevensville Schools closed its doors for two weeks after it could no longer find enough staff to fill classrooms after new COVID-19 cases were confirmed.

On Tuesday, Ravalli County Public Health reported 33 new coronavirus cases. The county currently has 452 active cases of COVID-19. Ten active cases are hospitalized.

As the number of patients ill with COVID surges, the physicians said local hospitals are reaching their bed capacities.

“That means that our ability to safely care for patients is becoming compromised,” the physicians’ letter read. “We have treated patients with life-threatening illnesses such as heart attacks that we can’t appropriately transfer because of the overcapacity of all hospitals in our region.”

In some cases, critically ill patients have been transferred out of state because there is no room for them in Montana.

“We don’t have the bed capacity, and neither do any of our regional hospitals,” the letter read. “It is our mission and passion as emergency physicians to provide unsurpassed emergency care to each and every member of our community who requires our services at the moment it is needed."

“However, it is becoming increasingly clear to us that we need your help in order to do this effectively,” said the letter. “Please help us by following the recommendations put forth by state and local health officials.”

Montana Hospital Association CEO Rich Rasmussen said people need to listen to those on the front lines.

“There is no region in our state right now that is immune to the increasing volume of coronavirus cases,” Rasmussen said. “In virtually every community, we are at capacity or near capacity.

For critical care hospitals like Marcus Daly Memorial Hospital to be able to continue to operate, they need to be able to count on support from larger urban hospitals in Missoula, Kalispell, Bozeman and Billings.

“They need to be able to have those big shoulders on which they can rely upon,” Rasmussen said.

Once those larger Montana hospitals are at capacity, then healthcare providers have to look beyond the state's borders for help.

“The challenge we have now is that virtually the entire country is under a surge,” he said. “If Marcus Daly can’t refer a patient in state, they will look out of state, but now even those out-of-state hospitals are at or near capacity.”

Rasmussen said it’s not only COVID-19 patients who are impacted.

“If we don’t buckle down, then we put at risk our ability to effectively deliver newborn babies, or treat someone with a cardiac event or someone who has a traumatic injury from an automobile accident,” he said. “When you push the system to its limits, it’s even harder to be able to deal with those routine injuries and illnesses and the joy of a new baby.”

“We can’t dismiss this as a disease that will not affect the majority of the population,” Rasmussen said. “When you put your health care system at risk, it has the potential to impact emergency services and routine services. Then it is impacting everybody.”

“People aren’t coming to the hospital unless they need to be hospitalized,” he said. “People aren’t being ventilated unless they need to be on a ventilator. People aren’t going to the ICU unless they need intensive care.”

Ravalli County Commissioner Jeff Burrows said he plans to post the ER doctors' letter on the county COVID-19 webpage.

Burrows said the physicians are asking the community to follow the same public health recommendations adopted and encouraged by the commission.

“We’re seeing the same challenge with our public health nurses,” Burrows said. “We can’t keep up with contact tracing. It’s going to fall back on our community to follow the guidelines. If they are sick, they need to quarantine. We don’t have the resources to make sure that every person who is a contact stays at home and quarantines and follows the guidelines.”

“It’s the community’s responsibility,” Burrows said. “People know what the guidelines are. They know to avoid crowds, if sick stay home, wash your hands, wear a mask. People know the message at this point. They are either going to follow it, or they’re not.”

The emergency physicians hope that people will follow those recommendations.

“We recognize that it requires real sacrifice to change one’s habits, whether that means wearing a mask when you go to the grocery store or church, or whether it means canceling a much-anticipated gathering,” their letter read. “We recognize the psychological impact these changes can have. We are also personally struggling with these choices on a daily basis."

"But we hope to appeal to our better angels, with the belief that these self-restricting choices will ultimately give us more freedoms by keeping our local businesses open and bring our beloved community back to normal as soon as possible."

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