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Inside UW Hospital's growing COVID-19 unit, patient fates are uncertain

November 9, 2020. Summarized by summa-bot.

As of Friday, 57 COVID-19 patients were at UW Hospital, including 16 in intensive care, quadruple the volume from six weeks earlier, causing space and staffing challenges.

Deb Dalsing, nurse manager of a COVID-19 treatment area at UW Hospital, helps nurse Ainsley Billesbach don protective equipment before entering a patient room.

Monitors beep and intravenous poles line the hallway on an eight-bed wing in UW Hospital’s ever-expanding COVID-19 unit. Tubes deliver high-powered oxygen to patients who can barely breathe, many of whom were healthy just days ago.

If Wisconsin’s coronavirus surge doesn’t turn around, the hospital may soon have to place infected patients in pre-op waiting areas or operating rooms, said Dr. Jeff Pothof, chief quality officer for UW Health. “Every time we go to the next thing, it becomes less ideal space,” Pothof said.

“I wish I had a rosy feeling that things are going to get better here shortly, but I don’t know that we have anything in place to say this gets better before it gets worse. ”Wisconsin is reporting an average of 5,500 new COVID-19 cases each day, more than eight times the rate from early September, when the state became one of the nation’s coronavirus hotspots.

Deaths from COVID-19 keep mounting, too, with a total of 2,312 around the state and a daily average of 38, nearly triple the peaks from early in the pandemic, when treatments weren’t as plentiful and hospitals weren’t as prepared. Different outcomesThe eight-bed wing on the fifth floor of Madison’s largest hospital provides intermediate care, for patients with lungs weakened by the virus who need significant help breathing but not ventilators, or breathing machines.

The heart rates, blood pressure levels and oxygen levels of COVID-19 patients are closely tracked in an intermediate care wing of UW Hospital's COVID-19 unit, which has been expanding to keep up Wisconsin's surge in cases.

“They’re just a normal Joe off the street, and then two days later they’re paralyzed and laying on their stomach, not breathing well,” nurse Ainsley Billesbach said of some patients. “I would just hope that people would be taking it more seriously,” said Billesbach, who has been caring for COVID-19 patients since March.

With rare exceptions, COVID-19 patients at UW Hospital can't have visitors, and workers must change and clean protective gear each time they go from room to room.

Nurse educators who normally would teach patients about topics such as wound care aren’t allowed in COVID-19 patient rooms, so the regular nurses do that too. Whenever nurses go from one room to another, they must change gowns and gloves and clean their face shields or PAPRs. To minimize the time with patients, nurses put monitors and IV poles, normally kept in rooms, in the hallway so they can check them without entering.

Many patients don’t want to go there, and the 530-bed field hospital is set up for patients who are recovering well. “They’re not staffed for people who have a lot of mobility needs, and that’s what we’re starting to run into,” Pothof said. St. Mary’s and MeriterMadison’s two other general hospitals are facing similar situations. SSM Health St. Mary’s Hospital, which had 35 COVID-19 patients as of Friday, including three in intensive care, opened a second space to treat them a week ago and may need to expand the footprint again, said Dr. Amy Franta, regional chief medical officer for SSM Health.

Nurses and other staff at UW Hospital must wear powered, air-purifying respirators, or PAPRs, or N-95 masks and face shields, when treating COVID-19 patients.

UnityPoint Health-Meriter had 54 COVID-19 patients as of Friday, including 16 in intensive care, and has been admitting 10 to 12 infected patients each day, said Nathan Bubenzer, manager of emergency preparedness.

It has three areas for coronavirus patients, but may need to reschedule more procedures for other patients to accommodate those with COVID-19, Bubenzer said. The hospital, which hasn’t sent any patients to the West Allis facility, has turned to nurse staffing agencies for help, but they’re having a hard time keeping up, too, he said.

Dr. Andrew Braun, a critical care specialist and pulmonologist who treats patients in UW Hospital's COVID-19 unit, said it's hard to communicate with families when they can't visit their loved ones in the hospital.

Dane County Executive Joe Parisi said Wednesday that Public Health Madison and Dane County is moving to a "crisis model" for contact tracing for COVID-19 because it can't keep up with increasing cases.

Madison residents Evelio Mancera and his daughter Jennifer Mancera fill out their ballots on the first day of the state's in-person absentee voting window for the Nov. 3 election outside the City-County Building on Tuesday.

Elizabeth Quirmbach, right, helped UW-Madison sophomore Ayuka Sinanoglu, center, register to vote on Wednesday, the last day to register by mail or online.

UW-Madison freshman J. J. Post, of New Jersey, spent 10 days in isolation in Humphrey Hall after testing positive for COVID-19.

Nursing assistant Monica Brodsky hands a funnel and vial to Janet Legare, of Middleton, for a new saliva test for COVID-19 on Monday at the UW Health administrative office building in Middleton.

A sign along Linden Drive on the campus of UW-Madison in Madison, Wis. directs visitors to a COVID-19 testing station Thursday, Aug. 20, 2020.

JOHN HART, STATE JOURNAL (Published on 8/22/2020) A sign along Linden Drive directs visitors to a COVID-19 testing station.

UW-Madison freshman student Julia Bink of Oconomowoc, Wis. moves her belongings into Sellery Hall with a hand from her mother, Joan Bink, on the campus in Madison, Wis. Thursday, Aug. 27, 2020.

JOHN HART, STATE JOURNAL (Published on 8/31/2020) UW-Madison freshman Julia Bink, of Oconomowoc, moves her belongings into Sellery Hall.

UW-Madison philosophy professor Harry Brighouse leads a discussion with students in an Ingraham Hall lecture room in Madison, Wis. Tuesday, Sept.

Students entering the Memorial Union on the campus of UW-Madison in Madison, Wis. show their ID's at a checkpoint in the building Wednesday, Sept.

JOHN HART, STATE JOURNAL (Published on 9/6/2020) Only UW-Madison students and employees are allowed into Memorial Union and Union South.

UW-Madison sophomore and Wisconsin Union worker John Lloyd applies an anti-bacterial cleaning agent to hand rails in the Memorial Union on the campus in Madison, Wis. Wednesday, Sept.

JOHN HART, STATE JOURNAL (Published on 9/6/2020) UW-Madison sophomore and Wisconsin Union worker John Lloyd applies an anti-bacterial cleaning agent to handrails in the Memorial Union.

The Wisconsin Union Terrace on the campus of UW-Madison in Madison, Wis. is uncharacteristically quiet on the first day of the 2020 fall semester Wednesday, Sept.

UW-Madison Child Development Lab instruction specialist Laura Feist joins preschoolers at the center as they encourage horn honks from passing trucks during a break outside the school on the campus of UW-Madison in Madison, Wis. Monday, Sept.

JOHN HART, STATE JOURNAL (Published on 9/16/2020) UW-Madison Child Development Lab instruction specialist Laura Feist joins preschoolers, Feven Smithka (from left), Wren Zentmyer-Gragg and Julius Oberley at the center as they encourage passing trucks to honk their horns during a break outside the school on the campus of UW-Madison Monday.

Deynah Thao, 7, gets a close look at a grizzly bear during a trip to Henry Vilas Zoo on the first day of the reopening of the zoo since it closed due to COVID-19 in Madison, Wis. , Thursday, June 18, 2020.

AMBER ARNOLD, STATE JOURNAL (Published on 6/19/2020) Deynah Thao, 7, gets an up-close look at a grizzly bear as Vilas Zoo reopened Thursday after closing March 17 due to COVID-19.

Adhering to protocols put in place due to the ongoing coronavirus pandemic, members of the UW-Madison marching band wear face coverings and play instruments with bell covers during a limited capacity practice session on the campus in Madison, Wis. Thursday, Aug. 27, 2020.

JOHN HART, STATE JOURNAL (Published on 9/6/2020) Members of UW-Madison’s Marching Band wear face coverings and play instruments with bell covers during a limited-capacity practice session to adhere to COVID-19 protocols.

Mask use is already common in Madison, including congested State Street, above, after Dane County began requiring masks in enclosed buildings July 13.

Several county departments and local community groups are working to help ensure all Dane County residents have access to face masks during the COVID-19 pandemic by distributing 100,000 free cloth masks.

Merta Maaneb de Macedo talks to an individual on the phone as she does contact tracing for COVID-19 in an office at Public Health Madison and Dane County in Madison, Wis. , Tuesday, July 14, 2020.

Patrons of Colectivo on State Street in Madison, Wis. converse while wearing masks Tuesday, July 7, 2020.

Janel Heinrich, director of Public Health Madison and Dane County, said wearing masks, which will be required indoors starting Monday, can help curb the COVID-19 pandemic.

Tutankhamun "Coach" Assad, CEO and founder of the Mellowhood Foundation, visits a neighborhood COVID-19 testing site Tuesday that he helped set up to serve residents on Madison's Southwest Side.

See Yang is tested for COVID-19 by Jane Peace, a nurse practitioner with University Health Services, as part of a new neighborhood testing site that opened on Madison's Southwest Side.

Masks and acrylic dividers are now part of the experience at Ho-Chunk Gaming Madison, the first of six Ho-Chunk casinos to reopen after the COVID-19 pandemic.

Many State Street businesses say they won't reopen after the COVID-19 pandemic and recent vandalism.

While nicer weather is on the way Thursday and Friday, public health officials are urging people to stay safe by enjoying the outdoors at a distance from others to help contain COVID-19.

Following a Wisconsin Supreme Court ruling allowing for the re-opening of businesses closed during the coronavirus pandemic, patrons and workers at the Cork Down Saloon in Blanchardville, Wis. gather at the bar of the business Thursday, May 14, 2020.

Dane County Executive Joe Parisi announces a new county public health order Wednesday after the Wisconsin Supreme Court struck down the state's stay-at-home order.

Amy Moore, owner of Little Luxuries on State Street in Madison, tends her business Monday as area retailers prepare for a gradual reopening of their businesses.

Workers wearing protective equipment get samples from people in their vehicles during a free drive-thru community testing for COVID-19 operated by the Wisconsin National Guard at Alliant Energy Center's New Holland Pavillion Monday.

Workers gather information from people wanting to be tested for COVID-19 at a free drive-thru community testing site that started Monday at Alliant Energy Center's New Holland Pavilion in Madison.

UW-Madison graduates, from left, Jacob Tottleben, of St. Louis, Lindsey Fischer, of La Crosse, and Olivia Gonzalez, of Milwaukee, open bottles of champagne at the State and Park Street crosswalk to celebrate after watching their virtual spring commencement ceremony on the rooftop of Fischer's apartment, on campus in Madison, Wis. , Saturday, May 9, 2020.

A statue of Abraham Lincoln, a traditional gathering spot for UW-Madison graduates to take "selfies" and other photographs, was fenced off to visitors just before Saturday's online commencement ceremony to avoid further spread of COVID-19.

Normally bustling in the spring, the UW-Madison Terrace in Madison, Wis. is largely deserted as the university campus remains closed during the ongoing coronavirus pandemic Monday, May 4, 2020 JOHN HART, STATE JOURNAL

Memorial Library on UW-Madison's campus is closed Wednesday.

A statue of Bucky Badger on UW-Madison's campus dons a makeshift face mask Monday, a reminder to stay safe and socially distant during the COVID-19 outbreak.

Ani Weaver, from Dodgeville who has been a registered nurse in Madison for 17 years, speaks to the media after helping install roughly 1,300 battery operated candles to recognize people in Wisconsin that have been hospitalized due to COVID-19 in Madison, Wis. , Thursday, April 23, 2020.

Roughly 1,300 battery operated candles are on display outside the Wisconsin State Capitol to recognize people in Wisconsin that have been hospitalized due to COVID-19 in Madison, Wis. , Thursday, April 23, 2020.

Health care providers with a SSM Health Dean Medical Group Clinic on North High Point Road send a message of thanks from the roof of their building after the clinic's entire staff received lunches from Capitol Bank, one of their neighbors, in Madison, Wis. Wednesday, April 22, 2020.

Lisa Wilson, a UW Health Clinic medical technologist, processes patient samples to be tested for the COVID-19 virus in UW-Health's Molecular Diagnostic Clean Room on UW-Madison's campus.

Gov. Tony Evers has closed 40 state parks, forests and recreational areas to address public health concerns during the COVID-19 coronavirus outbreak.

Braiya Nolan, 17, records an entry last week in her journal on the back deck of her family's home in Williams Bay. The high school junior is among more than 800 people of all ages taking part in the Wisconsin Historical Society's COVID-19 Journal Project.

Election workers outside the Madison Municipal Building wear protective medical equipment while assisting voters with curbside voting during the state's spring election Tuesday.

Starship robots wait to cross Park Street on UW-Madison's nearly deserted campus last week.

Matt Nolan, who works for UW Health, has been the main doctor recently in UnityPoint Health-Meriter's intensive care unit, which is seeing more COVID-19 patients.

UW-Madison senior Amy Shircel, who recently recovered from COVID-19, outside her Downtown Madison apartment where she spent nearly two weeks battling the infection alone.

Playgrounds in Wisconsin, including the one next to Emerson Elementary on Madison's East Side, are among the public facilities closed during the COVID-19 crisis.

All of Madison's public libraries have closed due to the COVID-19 pandemic.

Health care workers at UW Health are using face shields and masks to help stop the spread of COVID-19, but whether the general public should wear masks has become more of a topic for debate.

A "rent strike" sign hangs from a balcony outside a home on Williamson Street in Madison, Wis. , Tuesday, March 31, 2020.

Motorists are offered a $10 car wash on Williamson Street in Madison, Wis. , Tuesday, March 31, 2020.

Independent Living, which runs the dinner program in Madison, and SSM Health at Home, which runs the lunch program, have been serving more people during the COVID-19 pandemic.

Hanah Jon Taylor plays the saxophone Saturday outside his jazz club, Cafe Coda, on Williamson Street that was ordered to close earlier this week along with bars and restaurants across the state due to the spread of COVID-19.

A near empty State Street and Library Mall in Madison Thursday March 19, 2020.

UW-Madison graduate student Bryan Luu walks down Bascom Hill on campus in Madison, Wis. , Tuesday, March 17, 2020.

Visitors walk through UW's Memorial Union Terrace in Madison, Wis. , Tuesday, March 17, 2020.

Here, Sol Kelley-Jones of Madison, Wis. shares a moment with her son, Reyah, 2, during a trip to the UW-Arboretum in the city Tuesday, March 17, 2020.

Hawk Sullivan, owner of Hawk's Bar & Grill on State Street in Madison, said people who care about local restaurants and bars need to write their elected representatives and urge them to bail out small businesses that have been swamped by new limits on public gatherings.

Madison Mayor Satya Rhodes-Conway talks Sunday about "aggressive" action city and county officials are taking to prevent the spread of the COVID-19 coronavirus, including immediately closing all Dane County schools, banning gatherings of 50 or more people and reducing restaurant capacities by half.

UW-Madison freshman Megan Beaulie, right, chats in her dorm room in Waters Residence Hall with fellow freshman Cristina Dombrowski, who lives down the hall, as the two on March 12 prepare to move off campus because of the COVID-19 coronavirus pandemic.

Madison interim Superintendent Jane Belmore takes questions Friday from reporters about the district's plans for when all Wisconsin schools are required to close by 5 p. m. Wednesday.

Tuesday will be the last day of classes for students in the Madison School District.

Dukmo Key, with UW-Madison Housing Services, cleans a door inside Elizabeth Waters Residence Hall on campus Thursday as students prepare to move out temporarily because of the COVID-19 outbreak caused by the new coronavirus.

Students at UW-Madison prepare to board a bus as they depart for spring break from the campus in Madison, Wis. Friday, March 13, 2020.

Under the emergency declaration he announced Thursday, Gov. Tony Evers has directed the state Department of Health Services to "use all the resources necessary to respond to and contain the outbreak" of the COVID-19 coronavirus.

University Health Services executive director Jake Baggott, right, is spearheading UW-Madison's response to COVID-19.

Dane County Executive Joe Parisi, behind the podium, said at a news conference Wednesday that local officials are preparing for the likelihood of community spread of COVID-19, the disease caused by the new coronavirus.

Dr. Nasia Safdar, medical director of infection control at UW Health, left, joins Madison Mayor Satya Rhodes-Conway and Dane County Executive Joe Parisi in talking about how local government, health and hospital officials are preparing for potential community spread of the new coronavirus.

Wisconsin health officials on Sunday reported 11 new deaths and more than 4,000 new cases of COVID-19 coronavirus, a day after the state set a new daily record with more than 7,000 positive tests.

by summa-bot

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