Nearly six weeks after Governor Tony Evers first activated the field hospital at the state fair grounds on October 7 (with the hospital opening to patients on the 14th), the facility remains largely empty even as hospitalizations increase across the state.
The number of COVID-19 patients across Wisconsin has nearly tripled since early October; the alternative care facility was opened to handle the surge when hospitalizations were still fewer than 900 across the state. On Tuesday, data from the Wisconsin Hospital Association dashboard showed 2,277 COVID-19 hospitalizations in Wisconsin.
Built in April with the intention of helping manage a surge of coronavirus patients if necessary, the facility has 530 beds with an expansion capacity of more than 700. Tuesday, just 23 patients were being treated there.
Doctors at hospitals across south central Wisconsin point to a few key factors hindering their use of the field hospital–and it’s not a lack of patients. UW Health has expanded to six COVID-19 units (which include one or more wings) with many of them opening in the past month; UnityPoint Health Meriter Hospital in Madison is treating more than 60 patients for COVID-19, with more of them in the ICU than at any point previously. Rural hospitals, too, are overwhelmed. Sauk Prairie Healthcare sent a plea to the community to help them as they battle the pandemic; they’re looking for other places to send patients as beds continue to fill up.
But few are sent to the field hospital. The challenge, doctors say, begins with the patients themselves. There’s uncertainty about how an alternative care facility functions, and for patients in Dane County or the surrounding area–it’s far from home.
“When we say, ‘Hey, we’re busting at the seams; we’ve got patients who’ve got much more severe disease than you do, you would do great at the alternative care facility–are you okay if we transfer you there?’ They say no,” Dr. Jeff Pothof explained, UW Health’s chief medical officer. “It puts us in a bit of a pickle as a health system.”
Essentially, Dr. Pothof explained, convalescing patients aren’t yet ready to go home, but they’re not comfortable with the field hospital. And in the meantime, sicker patients need the care.
“They have a choice to say no,” a spokesperson for Meriter noted. Like UW Health, their recovering patients are declining the field hospital.
But doctors cite another concerning factor when determining whether patients would be eligible for the field hospital: most are just too sick. The facility is only equipped for low acuity care, and is primarily designed for health monitoring and support.
“You actually have to be fairly healthy to go to the field hospital. You can not be severely ill; you can not be requiring ICU level care to be transferred there,” Sauk Prairie Healthcare surgeon and chief innovation officer Dr. Nathan Grunewalk said. “It’s great that we have it; unfortunately, who’s appropriate for care there is somewhat limited.”
Patients essentially need to be able to take care of basic needs and move around on their own in order to qualify for the facility, Dr. Pothoff said. They’re patients who still need medical support and aren’t quite ready to go home–but not serious enough to need high levels of help. The care is highly specialized for COVID-19 care, SSM’s health regional chief medical officer Dr. Amy Franta said.
“Once a patient gets admitted to the hospital, it’s very difficult to ask them to leave once they’re settled with their care team,” Dr. Franta explained.
As of mid-afternoon on Tuesday, just four patients from Madison’s UW Health, SSM Health St. Mary’s Hospital, and UnityPoint Health Meriter combined had received care at the field hospital.
“It’s a matter of having enough staff to care for those patients,” a spokesperson for Meriter said. “Transitioning patients to the field hospital would help lessen the capacity strain for patients who are closer to discharge or not as ill. Right now, however, we’re seeing a growing number of patients who are very sick.”
The Wisconsin Department of Health Services hasn’t responded to questions regarding the facility’s daily cost and the patients being treated. Doctors say the facility is working to refine current restrictions and make modifications that could allow for more patients to be treated at the facility, like time constraints on when new patients can be admitted.
The facility is funded through a $445 million surge reserve fund set aside by the governor to help cover the costs of response to surging COVID-19 cases in health care systems and the community. The reserve fund also covers the state’s coronavirus testing, and is funded by the federal CARES Act which is set to cover COVID-19-related activities through the end of the year.
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