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Hospital strained, but not swamped

Butler Memorial in line with nat'l trends

October 8, 2021 Digital Media Exclusive

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David Rottinghaus, M.D. of Butler Memorial Hospital sheds light on county COVID-19 statistics and the state of the hospital

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With the delta variant of COVID-19 overwhelming the nation, health care systems are seeing an influx in patients needing medical attention. Butler Memorial Hospital is no different.

According to Dr. David Rottinghaus, Butler Health System's chief medical officer and emergency medical physician, there's no way to tell which variant a patient is infected with when they're tested, but the variant's contagious nature accounts for delta being 99% of the circulating virus.

“We're seeing the same story in different times and phases (throughout) the country,” Rottinghaus said. “Delta is contagious. Rural places are not being spared now like before.”

An uptick in cases resulted in Butler and surrounding counties moving from the substantial range of COVID-19 transmission to high transmission status on Aug. 15, according the state Department of Health. Butler has remained in the high status ever since.

On Aug. 15, the state COVID-19 dashboard showed an additional 26 COVID-19 cases were recorded in Butler County. On Aug. 31, there were 82 new cases added. Cases continued to trend upward into September, hitting 166 new cases on Sept. 15 in Butler County, per the dashboard. On Sept. 30, that number was 149 new cases.

Information compiled from regular news releases from the Department of Health shows 97 new cases were added in Butler County on Thursday.

Unvaccinated with preexisting conditions

Currently, 54% of Butler County is fully vaccinated. It is the 10th most vaccinated county in Pennsylvania, according to the state's COVID-19 vaccination dashboard.

Of the 53 patients battling COVID-19 at the hospital as of Thursday morning, 80% to 90% are unvaccinated with preexisting medical conditions.

Some, Rottinghaus said, may not understand how much they are at risk.

“Lots of people in the U.S. have preexisting conditions,” he said. “People assume if they're not on medication, they don't have a preexisting condition.”

Preexisting conditions vary from heart disease and diabetes to obesity.

Age can also factor into a patient's response to the virus.

According to Rottinghaus, the hospital is seeing a range when it comes to ages of those hospitalized. Similar to the rest of the country, more 30- to 40-year-olds are needing care, most with preexisting conditions.

“We're not unique,” Rottinghaus said. “Everyone is seeing this.”

The hospital has been running continuously at capacity for the past few weeks. Some other places, however, Rottinghaus said, are at full crisis operation.

Nine of Butler County's 11 intensive care patients are on ventilators, according to the state Department of Health's COVID-19 dashboard. Allegheny County has 107 patients in an ICU and 53 on ventilators for COVID-19. In Armstrong County, all four patients in the ICU are on ventilators.

“We're meeting all needs; some (hospitals) are not,” Rottinghaus said. “We can still meet demands, but we have had to delay some non-emergency surgeries to keep up.”

There are less bedside staff at the hospital than during the hospital's peak of 72 COVID-19 patients last winter. Rottinghaus said this is multifactorial, between a constant list of exposed, infected and quarantined workers as well as some who have left the medical field.

“Staff are strained. God bless them for showing up every day,” Rottinghaus said.

Battling COVID

Butler Memorial Hospital reported three COVID-19 deaths Wednesday and one on Tuesday. Patient recovery rates hold steady at 90% for Pennsylvania, but Rottinghaus said that's not the case for those who end up in the ICU.

“People have a skewed picture,” Rottinghaus said. “If you can stay out of intensive care, your chances are good. Anyone on a ventilator or in ICU, their chances of recovery are low. Your chances of making it out are 50%.”

The hospital has not had to use ventilators as aggressively as before, according to Rottinghaus.

“Once you're on one, survival is slim,” Rottinghaus said. “We're better at helping patients before that point now.”

The most common symptoms seen in patients continue to be cough, shortness of breath, fever, aches, loss of taste and smell, and nausea and diarrhea. Rottinghaus also shed light on the long-term side effects of the virus.

“We're seeing long-term heart and breathing issues, fatigue, scarring in lungs, blood clots in legs, veins and arteries, all associated with COVID,” Rottinghaus said. “Some strokes could be attributed as well. We're sending people home on oxygen ... lots who have a long recovery ahead.”

Rottinghaus reported an abundance of vaccines, but shortages of tests and multiple drugs used to treat patients.

“The trickle down is substantial,” he said. “Short supply drives up costs and means people have a harder time getting back to work.”

Vaccination frustration

The most frustrating part for Rottinghaus is seeing how much of the morbidity could be prevented with vaccinations. Getting the older population vaccinated should keep more people from getting sick, he said.

“It's hard to see people who should have been vaccinated die. Families are being fragmented,” Rottinghaus said. “We want to see people healthy. We're here to care for all.”

Vaccination rates aren't increasing much, Rottinghaus said, as some people have dug their heels in about receiving it.

According to the state's COVID-19 dashboard, vaccination rates have decreased significantly since July. On Wednesday, 30 additional Butler County residents reached full vaccination status and 473 additional were partially vaccinated. This compares to early May when upward of 1,000 Butler residents were receiving a dose of the vaccine daily.

With restrictions lifted and people gathering for the holidays, it can be projected that other illnesses will be rampant alongside COVID-19, Rottinghaus said, noting influenza could be an issue this year.

Those who are currently infected with COVID-19 should have immunity through the winter months, but there's no widespread data on antibodies in general. The vaccinated population will have a better response to infection and build necessary antibodies.

“People need to know the goal of the vaccine is to tame the virus, so it doesn't hospitalize people,” Rottinghaus said. “Even if recovery is (high), people are still sick, exposing (others) and missing work.”

Rottinghaus expressed gratitude for the tremendous amount of support the hospital and staff have received. He encouraged people to seek correct information regarding the virus and trust their care physicians. “I'd encourage people that if they want advice or to have discussions, there are lots of people willing to answer questions,” Rottinghaus said. “We're trying to make everyone well. Please continue (your support).”

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