Oregon hospitals are a step closer to the brink of being overrun with COVID-19 patients following another day with record-high case counts in Oregon.

On Tuesday, the Oregon Health Authority reported 2,941 new confirmed or presumptive cases of COVID-19, breaking single-day records that were set just a few days prior. And so far, this latest surge of infections shows no sign of slowing.

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It’s particularly grim news when coupled with record hospitalizations: As of Tuesday, there were 838 new cases of COVID-19 in Oregon. That’s 86 more patients than Monday, the largest single-day spike in hospitalizations seen in this pandemic. Hospitalizations tend to lag a week or so behind case counts, since it can take a little time for patients to become ill: Tuesday’s record case numbers are likely to lead to a new record in hospitalization numbers next week.

On Tuesday, there were just 275 non-ICU hospital beds available in the state. If hospitalizations continue at this pace, and more beds are not created, available beds could run out in a matter of days. According to a model released by Oregon Health and Sciences University last week, Oregon could be short as many as 500 intensive care unit beds when the surge reaches its expected peak in mid-September.

ICU beds are more limited than non ICU beds, and require training and additional equipment. Hospitals in some parts of Oregon are already at or near their ICU capacity. There are no ICU beds left in all of Oregon Region 7, which includes Crook, Deschutes, Grant, Harney, Klamath, Lake, and Wheeler counties.

Although the hardest-hit counties are in south, central, and eastern Oregon, hospitals in Northwest Oregon are also feeling the crunch.

“Metro area hospitals are filling with unvaccinated patients from Southern Oregon,” OHA spokesperson Robb Cowie told OPB.

The Oregon Health & Science University in Portland is one of two level-1 trauma centers in the state: that means they see some of the state’s sickest patients.

“Hospital capacity is a dynamic process and changes quickly based on demand and supply of available staffed hospital beds,” said OHSU senior associate chief medical officer Dr. Matthias Merkel. “Despite this, OHSU is currently operating at capacity for all patient care, based on available health care staffing.”

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To prepare for a continued increase in COVID-19 patients, OHSU has started reducing inpatient surgeries.

“We expect to reduce [surgeries] even further in the coming days, and have placed a cap on the total number of [surgeries] that can be done in one day,” Merkel said. “OHSU continues to see drastic increases in patients extremely sick with the COVID-19 delta variant.”

As of Tuesday, OHSU was caring for 29 of those patients. And COVID-19 isn’t the only reason for the bed shortage: Merkel said the hospital is also caring for “a high volume of seriously ill patients who have delayed care during the past year due to the pandemic.”

And that’s on top of the usual stream of seriously-ill patients experiencing conditions like heart attacks and strokes, and trauma patients who may have been in motor vehicle crashes.

OHA is working to free up some hospital beds by moving stable patients to long-term care facilities. Hospitals have developed surge plans, which are designed to help them provide care when there aren’t enough staff, equipment, or beds available. The reported number of beds doesn’t reflect hospital surge capacity.

Hospitals nationally are facing more than bed shortages; they also are confronting a shortage of health care workers. “OHSU does have surge capacity space, however, additional health care staff is needed to effectively and safely utilize this space for patient care,” Merkel said.

And hospitals want to avoid using their surge plans if it all possible: surge plans mean health care workers have less time to spend with each patient, and that some may need to make triage decisions about who receives care. Merkel said that at OHSU, the biggest patient impacts are in the emergency departments: wait times are up, and it can take longer for patients to be admitted from the emergency department and to the hospital’s other units.

Dr. Chris Pfeiffer, the chief of infectious disease at the Veterans Affairs Portland Health Care System, said the pace of emerging cases in this surge is different from that of previous surges during the pandemic.

”I think in the fall that was more of a 2-3 month curve,” Pfeiffer told OPB’s Think Out Loud. “Now we’re kind of at the early spike of a very sharp curve.”

The VA’s Portland-area hospital system isn’t overrun at this point, Pfeiffer said. But it has begun cancelling some elective procedures, and its ICUs are working under surge protocols.

The new surge, driven by the more-contagious and more-serious delta variant, is hitting unvaccinated people and communities with lower vaccination rates particularly hard.

Fewer than half of adults over 18 are vaccinated in Douglas County, compared to 70% for the state. Douglas County reported 300 new cases Tuesday — a single-day total that rivals much larger counties like Washington and Marion, which reported over 400 cases each, and is more than double the number reported in Multnomah County.

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