Hospitals overwhelmed by Covid postpone cancer care and other treatments

It’s a bad time to get sick in Oregon. That’s the message from some doctors, as hospitals fill up with covid-19 patients and other medical conditions go untreated.

Charlie Callagan looked perfectly healthy recently sitting outside on his patio in the smoky summer air in the small town of Merlin in Rogue Valley in southern Oregon. But Callagan, 72, suffers from a condition called multiple myeloma, a cancer of the blood in the bone marrow.

“It affects the immune system; it affects the bones, ”he said. “I had a PET scan that described my bones as looking like some kind of Swiss cheese. “

Callagan is a retired National Park Service ranger. Fifty years ago he served in Vietnam. This spring, doctors identified her cancer as one linked to exposure to Agent Orange, the defoliant used during the war.

In recent years, Callagan has looked at maps showing hot spots where Agent Orange has been sprayed in Vietnam.

“It turns out that the air base I was in was surrounded,” he said. “They sprayed everywhere.”

A few weeks ago, Callagan was driving the nearly four-hour ride to Oregon Health & Science University in Portland for a bone marrow transplant, a major procedure that would have required him to stay in the hospital for a while. week and stay in the Portland area. for testing for an additional two weeks. On the way, he got a call from his doctor.

“They are like, ‘We were told this morning that we had to cancel the surgeries that we had planned,'” he said.

Callagan’s surgery was canceled because the hospital was full. This is the story of many hospitals in Oregon and other states where they have been inundated with covid patients.

OHSU spokesman Erik Robinson said the hospital, which is the state’s only public university medical center and serves patients from across the region, has had to postpone many surgeries and procedures to the following the delta outbreak of the pandemic. “Surgery postponements initially impacted patients who needed an overnight stay in the hospital, but more recently they impacted all outpatient surgeries and procedures,” Robinson wrote.

Callagan said his bone marrow transplant has yet to be rescheduled.

Such delays can have consequences, according to Dr Mujahid Rizvi, who heads the oncology clinic that looks after Callagan’s care.

“With cancer treatment there is sometimes a window of opportunity where you can go in and potentially heal the patient,” Rizvi said. “If you wait too long, the cancer can spread. And that can affect the prognosis and make a potentially curable disease incurable. “

These important issues for delaying treatment in hospitals currently extend beyond cancer care.

“I saw patients preparing for their open heart surgery that day. I’ve seen brain tumor patients with visual changes, or someone with lung cancer, and their procedures are canceled that day and they have to come back another day, ”said Dr. Kent Dauterman, cardiologist and co-director of the Regional Heart Center in Medford, Oregon. “You still hope they come back.”

In early September, Dauterman said, the local hospital had 28 patients waiting for open heart surgery, 24 who needed pacemakers and 22 who were waiting for lung surgery. Normally, he said, there is no waiting.

“I don’t mean to be dramatic – it’s just that there are a lot of other things killing Oregonians before that,” Dauterman said.

Right now, the vast majority of Oregon hospital patients with covid are unvaccinated, about five times more than those who received the vaccine, according to the Oregon Health Authority. Covid infections start to decline from the peak of the delta wave. But even in non-pandemic times, there isn’t much additional room in Oregon’s healthcare system.

“If you look at the number of hospital beds per capita, Oregon has 1.7 hospital beds per thousand people. It’s the lowest in the country, ”said Becky Hultberg, CEO of the Oregon Hospitals and Health Systems Association.

A new study focused on reducing non-emergency procedures looked at how Veterans Health Administration hospitals performed during the first wave of the pandemic. He found that the VA health system was able to reduce elective treatments by 91%.

He showed that stopping elective procedures was an effective tool to free up beds in intensive care units to care for covid patients. But the study did not examine the consequences for patients who had to wait.

“We have clearly, even in hindsight, made the right decision to reduce elective surgery,” said Dr. Brajesh Lal, professor of surgery at the University of Maryland School of Medicine and lead author of the study. “But we, as a society, haven’t really asked the question forcefully, ‘At what cost in the long run?’ “

He said they wouldn’t know without more long-term research.

Back home in southern Oregon, Charlie Callagan said he didn’t consider his bone marrow transplant as urgent as what some people are facing right now.

“There are so many other people who are affected,” he said. “People are dying while waiting for a hospital bed. It just makes me angry. It’s hard to stay silent now.

He said it’s hard to be sympathetic to the covid patients who fill hospitals, when a simple vaccine could have prevented most of those hospitalizations.

This story originated from a reporting partnership that includes Jefferson Public Radio, NPR and News from Kaiser Santé.

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