The inside of the Sky Lakes COVID-19 ICU is eerily quiet on a Tuesday afternoon. A few nurses filter through wearing scrubs. Patients are shut in private rooms and folding tables are covered with boxes of gloves, disinfectants and respirator hoods.

“There’s a lot of clutter,” says ICU Director Christie Wiles. “By nature, ICU nurses are very neat and tidy and a little bit OCD, so this drives everyone crazy. But it’s really necessary to have everything right where they need it.”

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Their ICU is set up for 14 patients. Currently, they have eight, Wiles says.

Sky Lakes Medical Center is located in Southwestern Oregon. It serves a roughly 10,000 square mile area, according to staff. People come here from rural counties in Oregon and northeast California.

Sky Lakes Medical Center in Klamath Falls, Ore.

Sky Lakes Medical Center in Klamath Falls, Ore.

Courtesy of Tom Hottman / Sky Lakes Medical Center

While this region was hit late in the COVID-19 pandemic, the hospital’s coronavirus unit reached capacity for the first time in mid-January.

“For us to feel like we’re strained or at capacity or even in a surge here at Sky Lakes in a small community hospital is much different than what would strain a larger facility with more resources,” Wiles says. “We feel it differently.”

Unlike a larger facility, reaching capacity in Klamath Falls is related more to staffing than bed space. It’s harder to get extra staff help in a rural community, Wiles says, and people with COVID-19 simply need more care than other ICU patients.

“These patients require what we call a proning, which is flipping them,” she says. “Sometimes if they’re on a ventilator, it takes five or six people to do that. And then not to mention we have also have ICU patients in our non-COVID ICU.”

Julie Bowen has been nursing at Sky Lakes for about 17 years. These days she spends her 12-hour shifts in the COVID-19 ICU. She says the coronavirus patients are the sickest patients she’s ever cared for.

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“In the past, you come in with a heart attack or a stroke, [and] we have a plan of care. We know how to treat you. These guys, we have some plans, but it’s all supplemental. To watch people trying to breathe and there’s nothing you can do that really help them, has been difficult,” she says through tears. “We’ve lost a lot of people that we bonded with. And so, staffing has their own issues with stress and just trying to get through every day.”

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Quickly regaining her composure, Bowen starts joking about how people in her small community respond to her because she works with highly infectious COVID-19 patients.

“I feel like Typhoid Mary,” she laughs. “You come into a store and they know who you are and they just, kind of, back away.”

The COVID-19 isolation unit and a PPE hood at Sky Lakes Medical Center.

The COVID-19 isolation unit and a PPE hood at Sky Lakes Medical Center.

Courtesy of Tom Hottman / Sky Lakes Medical Center

The hospital staff says vaccinations are the way to turn the pandemic around. So far, Klamath County has done vaccination events in long-term care facilities and for teachers. But getting enough vaccine has been hard, according to Klamath County Public Health Director Jennifer Little.

“Really, the big barrier is a sufficient supply and a consistent supply of doses,” she says. “It’s really tough to plan for an event going forward when you may or may not get a certain number of doses.”

In the meantime, those running the vaccination events say lots of people want to get vaccinated in Klamath County. Dr. Grant Niskanen is the vice president of medical affairs at Sky Lakes. He saw the response when teachers first became eligible.

“My wife is actually in charge of the COVID city school response and she was getting dozens of calls. Like ‘I can’t get through, should I just go up there?’ There’s a tremendous demand for the vaccine,” Niskanen says.

Sky Lakes ICU director Wiles says the patient numbers are manageable at the hospital right now. Since the pandemic started, their staff has adapted and adapted again. But at a small hospital like this, there’s not a huge distance between being strained and being overwhelmed.

With several new strains of COVID-19 spreading in the U.S., including one that’s known to be more contagious, those numbers could change quickly.

“You relax a little bit, but you’re afraid to really exhale fully because it could just be right around the corner,” she says.





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