If I Wasnt in the Hospital
A photo of Tony Tsantinis hangs in a collage prepare for a celebration of his life on the final day that Athens Pizza in Brimfield, Mass., was open for business. Tsantinis, who owned the pizzeria for many years, died of COVID-19 last month when efforts to find space at a hospital that could offer him a higher level of care could non be found. Jesse Costa/WBUR hide caption
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Jesse Costa/WBUR
A photograph of Tony Tsantinis hangs in a collage gear up upward for a commemoration of his life on the terminal mean solar day that Athens Pizza in Brimfield, Mass., was open up for concern. Tsantinis, who owned the pizzeria for many years, died of COVID-19 last month when efforts to discover infinite at a hospital that could offer him a college level of care could not be found.
Jesse Costa/WBUR
Fans of Athens Pizza in Brimfield, Mass., learned the restaurant's dear owner was sick via Facebook.
"The [pizzeria] will exist closed for the rest of the week," reads the post from Nov. 30, 2021. "Unfortunately nosotros have been exposed to Covid."
Go-well wishes poured in, only Athens Pizza will not reopen. Tony Tsantinis, 68, died at Harrington Hospital, in nearby Southbridge, on December. ten.
His daughter, Rona Tsantinis-Roy, is haunted by many moments from her father'southward cursory battle with COVID-nineteen. Here's ane: As a dr. delivered the news that Tsantinis was dead, he "literally looked me in the eyes and said this didn't have to happen," Tsantinis-Roy recounted.
Her notes from the conversation bear witness that this meant her father might take survived if he'd been transferred to a larger hospital. Typically, that's what happens when a patient who arrives at a community infirmary needs more specialized care. But with hospitals full — or close to it — across Massachusetts, transfers are harder and harder to suit. And some patients are dying while they wait.
For Tsantinis, the community hospital in south-central Massachusetts made two transfer attempts. According to Tsantinis-Roy, the first was on Twenty-four hours 4 in the infirmary every bit her father grew worse and needed intensive care. The intensive care unit of measurement at Harrington was full, so doctors and nurses searched for an available bed at some other facility. Tsantinis-Roy says they called 17 hospitals but couldn't detect an ICU that would take her father.
Rona Tsantinis-Roy stands behind the counter at Athens Pizza, the pizza shop her male parent owned for many years. Jesse Costa/WBUR hibernate caption
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Jesse Costa/WBUR
Rona Tsantinis-Roy stands behind the counter at Athens Pizza, the pizza shop her father endemic for many years.
Jesse Costa/WBUR
Inside a few days, Tsantinis-Roy learned that a bed had opened in Harrington's ICU and her father had been moved. But so his kidneys started to fail, and Harrington wasn't able to provide dialysis. Hospitals say nurses who specialize in dialysis are in particularly brusk supply right now.
Harrington Hospital tried to transfer Tsantinis again, simply it was too late. A few hours earlier Tsantinis died, his daughter heard that Hartford Infirmary in neighboring Connecticut would put him on its waiting listing. Past and so, Tsantinis was besides unstable to brand the journeying.
Harrington Infirmary says it won't hash out the details of Tsantinis' case. The hospital is role of UMass Memorial Health, which also declined to answer specific questions about Tsantinis. Merely the network'due south president and CEO, Dr. Eric Dickson, says there are problems at every level of care right at present.
"Everybody wants to believe that the organization is property up just fine, merely information technology isn't," Dickson says. "Information technology'south breaking downwardly. And when it breaks downwards, patients are harmed."
Like the majority of people who have died in this phase of the coronavirus pandemic, Tsantinis was not vaccinated. Tsantinis-Roy says she begged her male parent to get the shots, only "he was erstwhile-schoolhouse and didn't believe in vaccines."
Dickson, while not commenting on Tsantinis, says whether or not a patient is vaccinated does not affect efforts to transfer or have the person.
Massachusetts hospitals — as well as hospitals nationwide — are also crowded with patients who practise not have COVID-19, but who are coming in with a range of illnesses and injuries, including heart bug, strokes, diabetes complications, drug overdoses and mental trauma. Doctors say many of these patients with chronic illnesses got sicker during the pandemic because isolation or closures meant delayed medical intendance or missed medications.
The sheer number of patients is colliding with staff shortages. Many nurses and other health care workers have quit during the class of the pandemic, and others have tested positive in this current surge and take to isolate at domicile before returning to work.
Dr. Kathleen Kerrigan, president of the Massachusetts College of Emergency Physicians, says moving any patient who needs higher-level care is difficult right now if not well-nigh incommunicable.
"It's very unfortunate when we can't transfer patients," she says. "Information technology means that our arrangement is broken somewhere in the procedure."
Massachusetts Gov. Charlie Baker's part responded to a request for an interview with an email containing bullet points about activating National Baby-sit members to aid staff health intendance facilities and helping to organize daily regional calls with hospitals. The calls are supposed to promote collaboration amongst hospitals, help rest the patient load and flag urgent cases.
Some hospital staff members say it'due south time to impose the crisis standards of intendance, a set up of guidelines that help decide who receives care when the medical system is so overwhelmed by a crunch that doctors and nurses tin't intendance for everyone. Some states, such every bit Idaho and Alaska, were forced to enact their guidelines last year. Massachusetts' standards were drafted by country hospital leaders early in the pandemic. If access to ICU beds or dialysis is express, for example, the guidelines would help hospitals decide who gets that care based on who is almost likely to survive.
There are some concerns almost using the guidelines now. Despite revisions, they may even so give white patients with no physical challenges easier access to limited medical resources. And they were drafted when the focus was on too few ICU beds and ventilators. Now there are many more shortages throughout hospitals, including staff shortages.
"It's not as uncomplicated as not enough ventilators or ICU beds. It's now a much more than complicated environs compared to two years ago," says Michael Wagner, the chief doc executive at Wellforce, the hospital chain anchored by Tufts Medical Middle in Boston. Wagner co-chaired the land's Crisis Standards of Care Advisory Committee.
Wagner says the guidelines may need to be amended to address this surge. Fifty-fifty if they are, Dickson, of UMass Memorial Health, says asking hospitals to offset using the crunch standards right now would impose more stress on wearied staff.
"We have to have a conversation amongst wellness care leaders and the state nigh what that would hateful and how we would implement it," he says. "Simply at some level, care is already being rationed because we don't accept enough intendance for all of the patients who are coming in with COVID."
Dickson says information technology'due south well-nigh like a lottery for care. Tsantinis wasn't the only patient affected. At hospitals in the greater Boston area, doctors draw patients who've died while waiting to be transferred for more specialized care: A gunshot victim and a man with heart failure are amidst them. A adult female who needed surgery to stop a stroke waited viii hours before she was transferred to a stroke middle; the emergency room staff that sent her doesn't know if she survived. Infirmary employees did non accept permission to hash out the details of these cases.
It's not clear when the omicron surge will subside for hospitals in Massachusetts.
Kerrigan says the claiming of transferring patients is getting worse. Hospitals in neighboring states are then full they are endmost to out-of-land transfers.
"This was the pandemic we were agape of when the governor close downwardly the state back in March of 2020," Kerrigan says.
This translates to fright that more families similar Rona Tsantinis-Roy and her children volition lose beloved parents and grandparents. Tony Tsantinis was able to call once, from the hospital. His daughter says she put him on speaker and then he could talk to her kids. He assured them he'd be home soon.
"He said, 'I'm good. I'm groovy. I dear you guys,' " Tsantinis-Roy says. "He hung upward with them, and obviously, they were over the moon."
Only to Tsantinis-Roy, her dad'due south optimism seemed too good to be truthful.
"We never heard from him once more after that," she says. "It felt like a skilful-bye."
Tsantinis-Roy is however struggling to sympathise how her dad'due south expiry could accept happened in a state with health care that is supposed to be among the finest in the earth. Dr. Melisa Lai-Becker, who runs a hospital ER merely north of Boston, CHA Everett, shares that sense of dismay.
"This feels completely surreal," she says. "I'm practicing inside spitting distance of at least five globe-class medical centers in Boston, Massachusetts, which is considered i of the globe's medical meccas ... and withal they've often had to turn down to have these patients."
For Kerrigan, information technology is non as well belatedly to ask again for everyone to get vaccinated. If more people made that decision, she says, "we'd be in a amend situation — nosotros'd have fewer critically ill patients."
This story is from NPR's reporting partnership with WBUR and KHN .
Source: https://www.npr.org/sections/health-shots/2022/01/18/1073881763/patients-are-dying-while-waiting-for-specialized-care-because-hospitals-are-full
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