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Rural Wash. hospitals transfer hundreds of patients to metro areas

Swamped by the fifth wave of COVID-19, Washington is taking action to protect rural hospitals from being overwhelmed


More than half of all rural Washington patients being transferred to metro areas are being sent to King County medical facilities.

Joseph O’Sullivan
The Seattle Times

OLYMPIA, Wash. — Swamped by the fifth wave of COVID-19, hospitals across rural Washington have transferred hundreds of patients to metro areas since July 1, according to statewide data.

More than half of those 414 transferred patients have gone to King County hospitals, according to data by the Washington Medical Coordination Center.

Run out of Seattle’s Harborview Medical Center, the MCC serves as a clearinghouse for placing patients around the state when the hospital where they arrive can’t take them, according to Dr. Steven Mitchell, medical director of the MCC.

Healthcare officials formed the MCC in the wake of the outbreak at Life Care Center of Kirkland in February 2020, according to Mitchell, which quickly strained the nearby hospital.

“If one nursing home could overwhelm a single hospital, we had to come up with a solution to prevent that from happening,” he said.

A hospital that can’t take a patient and can’t find a bed at a nearby facility can call the MCC to help find a spot somewhere else in the state. The MCC then works with hospitals around the state to find a bed elsewhere, something that Mitchell calls a “backstop” to help when the regional health care systems are too strained.

Transferred patients can have either COVID-19 or an unrelated medical issue, said Mitchell.

As the more contagious delta variant began spreading widely this summer, the MCC began seeing its highest workload of the pandemic, according to Mitchell, who is also medical director of Harborview’s emergency department.

“Nearly all the calls that we have received have been from small, rural and critical access hospitals, from those rural areas,” Mitchell said.

Data on 414 transfers facilitated by MCC between July 1 and Sept. 23 shows hundreds of patients transferred out of rural Washington facilities.

The counties transferring the most patients elsewhere span Central, Eastern and Southwest Washington. They include: Okanogan (46), Lewis (43), Stevens (39), Grays Harbor (33), Yakima (29), Grant (28) and Pacific (26).

More than half of all patients transferred (229) came to King County medical facilities, according to the data.

More than three-quarters of Washingtonians 12 years and older have gotten at least one COVID-19 shot as of Monday. But that overall rate obscures the fact that many rural counties have much lower rates of vaccination.

State health officials have said that more than 94% of patients hospitalized for COVID-19 between Feb. 1 and Aug. 3 were not fully vaccinated.

Hospitals – like they did before the pandemic – routinely coordinate transfers among themselves, according to Beth Zborowski, a senior vice president of the Washington State Hospital Association.

For that reason, the MCC data “shows real stress in the system” and also “won’t capture all the movement of patients that might be happening on a regional basis,” Zborowski wrote in an email.

The number of transfers and how far away patients are being sent is unique to the pandemic, Mitchell said, and is another indicator of a strained medical system. Rural communities may only have a handful of ambulances, and might have to drive from far Eastern Washington to Pierce County to move a patient.

“That’s an all-day event for that ambulance, which then is not available to their community,” he said. Helicopters are moving people too – and more quickly than ambulances – but they are also much more expensive.

The MCC probably won’t shut down soon, and can be useful to handle other emergencies, like an earthquake or mass shooting.

“We’re working towards making this something that can be a good legacy from the pandemic,” he said.

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