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A Dover hospital is overwhelmed as more people seek care and COVID cases rise

Annie Ropeik

COVID cases continue to rise in New Hampshire, and it’s putting pressure on the state’s hospital system. Over 300 people are currently hospitalized with the virus in the Granite State, the highest number since last January.

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Wentworth-Douglass Hospital in Dover is seeing unprecedented demand for care because of the pandemic. Now, hospital officials are urging people to only come to the emergency room if they need acute care.

NHPR’s All Things Considered host Peter Biello spoke with Jeff Hughes, Wentworth Douglass Hospital’s CEO and president, about the challenges his workers are facing as the pandemic continues. Below is a transcript of their conversation.

Peter Biello: Well, we'd love to give the community a sense of what it's like at Wentworth-Douglas Hospital right now. So if we were to walk into the emergency room right now, what would it be like? What would we see?

Jeff Hughes: You know, it's been interesting, Peter. Over the past, probably a month or two, we've been starting every day with upwards of 10 to 15 patients waiting in our emergency room for inpatient beds, along with those waiting for care in the emergency room itself. In addition to that, we started the day with well over 100 percent occupancy in our med surge unit. So we're trying to accommodate those patients that are seeking care. And we've added actually an additional 30 beds this year by renovating areas that were administrative, that were old nursing units. We've now reconditioned those. We're also doubling up patients in private rooms to accommodate the volume, and we've created also temporary holding areas, which we call surge space in our same-day surgery unit, in our cardiac [catherization] lab, and, as you said, holding patients in our emergency room.

Peter Biello: Does that mean you're staffed adequately to both handle emergency room cases and elective surgeries and whatnot?

Jeff Hughes: Well, it's almost like a perfect storm, Peter. If you think about it, we're seeing record patient volumes from just people that have maybe deferred care or seeking care. It's just been amazing. On top of that, you've got a record number of COVID cases. The volume of COVID cases that we're seeing right now are actually higher than one of the two or three peaks that we have seen earlier on in this pandemic. So for some reason, this is hitting us.

And at the same time, the third component of this perfect storm is the staffing shortages that we're struggling to get staff. What we are finding, though, is that we are able to hire. And we are really hearing from people that are coming on board that Wentworth Douglass is in the fortunate position that we are a preferred place to work. That's something about our culture, about our organization. We're able to attract and retain staff.

So we're doing the best that we can, and we're also incentivizing staff to do extra shifts when necessary. And also, because we've been so filled with patients and do have some vacancies in even non-clinical areas, such as EVS, environmental services, so traditionally called housekeeping, and also in food service that we've got our management team that is actually volunteering and setting aside hours to support those employees.

Peter Biello: You mentioned the previous surges that the state has seen of COVID-19. For this stage in the pandemic, nearly every age group has access to COVID-19 vaccines. How would you describe the COVID patients coming into the emergency room this time around?

Jeff Hughes: Well, anecdotally, what we're seeing is those that have COVID that are not vaccinated seem to be a little bit more acutely ill, and we have what they call breakthrough cases. So someone that has been vaccinated but does come down with the virus. Those are generally mild.

What's been interesting as we're trying to track the number of patients that are vaccinated versus non-vaccinated, and part of the struggle that we have in New Hampshire is that we don't have a statewide vaccine database that we can actually get a count on this. But the majority of the patients, actually, are unvaccinated that we are seeing. And the majority of those that are acutely ill that are in our ICU are unvaccinated.

Peter Biello: And Thanksgiving is coming up next week. That means a lot of indoor gatherings in the state, possibly more transmission of COVID-19. So what do you hope the public takes into consideration as case numbers continue to rise?

Jeff Hughes: Well, I would urge those individuals throughout the state that have not been vaccinated to get the vaccine. I think it's been proven. There have been, how many hundreds of millions of vaccines that have been delivered to individuals around the world. And I think that the side effects really have been minimal for the most part. So I would encourage everyone to get vaccinated. It's the vaccination, which I think will finally put this pandemic behind us. I think that's the most important message that I can deliver as a health care professional.

Mary McIntyre is a senior producer at NHPR.
Peter Biello is the host of All Things Considered and Writers on a New England Stage at New Hampshire Public Radio. He has served as a producer/announcer/host of Weekend Edition Saturday at Vermont Public Radio and as a reporter/host of Morning Edition at WHQR in Wilmington, North Carolina.

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