Oregon Gov. Kate Brown is extending last month鈥檚 state of emergency as a surge of respiratory illnesses strains the state鈥檚 hospital systems.
The calls on the Oregon Health Authority and other state agencies to deploy emergency volunteer health care workers and designate emergency health centers. It also allows state agencies to develop new procedures or waive existing ones in order to alleviate the public health threat.
OHA is pursuing supplemental nurse staffing contracts of up to $25 million to help address critical workforce shortages, according to Brown鈥檚 statement. That鈥檚 in addition to the for nurse staffing the Oregon Legislative Emergency Board approved in September.
Hospitals have begun treating some infants at neonatal ICUs, which are typically reserved for premature newborns. As a result, NICUs have seen a dwindling supply of available beds. At a briefing Wednesday, OHA Director Patrick Allen told legislators that an Oregon infant born prematurely was recently treated in an adult intensive care unit because no neonatal ICU or pediatric ICU beds were available in Oregon, Washington or Idaho.
Statewide, fewer than 5% of hospital beds are currently vacant.
鈥淚t鈥檚 far and away the most critical lack of capacity we鈥檝e had to this point,鈥� Allen said.
Dana Braner, the chair of pediatrics at Oregon Health & Science University鈥檚 Doernbecher Children鈥檚 Hospital, said the state is running out of pediatric ICU beds on a daily basis, and that in addition to setting up beds in surge spaces, at one point, OHSU鈥檚 pediatric unit had two children occupying a single PICU bed.
OHSU and other hospitals are taking measures similar to steps they took during the delta wave of the COVID-19 pandemic. They鈥檙e also cancelling surgeries except for the most urgent ones, like those for cancer or 鈥渓ife and limb.鈥�
鈥淚t literally constitutes the greatest threat to children鈥檚 health in our state that we have seen in the last 30 years,鈥� Braner said.
The acute capacity crisis is being driven by an unusually early and severe RSV 鈥� respiratory syncytial virus 鈥� season that has hospitalized more than 150 kids since October, as well as an early flu season and a small increase in COVID-19 hospitalizations.
But hospitals have struggled with too many patients 鈥� and too few staff to treat them 鈥� for much of 2022, as nurses frustrated with their working conditions have left bedside and acute care jobs, and patients have shown up on average sicker due to delayed care during the pandemic.
Allen said the state is working as quickly as possible to line up contracts with temporary employment agencies that provide travel nurses, and said that some had arrived at OHSU this week.
In response to questions, Allen acknowledged those travel nursing contracts are an expensive and short-term solution to the problem. OHA estimates it will cost about $25 million for contracts to cover 10 weeks of temporary staffing support for the state鈥檚 hospitals.
鈥淭ravelers are faster than a long-term strategy,鈥� Allen said.
Meanwhile, Brown鈥檚 new executive order today extends one issued on Nov. 14, which was a response to the rising number of children and infants falling critically ill with respiratory viruses. Brown鈥檚 order says hospitals are now being by adult cases of influenza and COVID-19.
In the order, Brown says hospital conditions 鈥渉ave continued to deteriorate due to ongoing surges in respiratory infections, including but not limited to RSV, Influenza, and COVID-19 in Oregon, and now, adult hospital capacity, in addition to pediatric hospital capacity, are both critically strained.鈥�
The declaration says COVID hospitalizations have skyrocketed, returning to levels last seen in July. Rates are expected to continue rising through mid-December.
The Oregon Association of Hospitals and Health Systems released a statement expressing appreciation for the 鈥渟taffing flexibility鈥� the governor鈥檚 order allows. But it goes on to say that hospitals need such flexibility 鈥渁ll of the time鈥� and that the situation shouldn鈥檛 have been allowed to get so critical.
鈥淲e have critically ill children in adult units and boarding in Emergency Departments who should be in pediatric intensive care units in Portland, but there are few available beds,鈥� said Lisa Goodman, the association鈥檚 vice president of communications. 鈥淲e鈥檝e been saying it for more than two years: Our system is failing. The unfortunate position we find ourselves in today could have been prevented, and it wasn鈥檛.鈥�
In a , Brown called on Oregonians to take extra precautions this holiday season.
鈥淪tay home if you are sick, stay up to date on your vaccinations, and consider wearing a mask in crowded indoor situations 鈥撯�� especially if you are at higher risk for severe illness from RSV, the flu, or COVID-19,鈥� she said.
Most RSV infections go away on their own in a week or two and can be managed with proper nutrition, hydration, sleep and use of over-the-counter medication. Oregon hospitals are discouraging people from visiting emergency rooms for illnesses that can be treated at home.
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