Misinformation, Nursing Shortage Causes Problems in Southwest VA

As COVID-19 cases spike, Ballad Health officials say it’s partly due to people simply believing bad information.

KINGSPORT, Tenn. – Emily Nichole Egan is tired and frustrated. She watched with gratitude as her community responded to the pandemic when it first reached the region back in March. People were willing to sacrifice and stay home to protect their neighbors. But no longer. 

“Now, I guess people are tired of it,” she said. “They want to get out and be social again.” 

The registered nurse, who works in the COVID-19 ICU at Kingsport’s Holston Valley Medical Center, spoke during Ballad Health’s press conference on Wednesday. She said healthcare workers understand the importance of maintaining mental health. But the unwillingness of folks to adhere to public health guidelines is having catastrophic effects.

“This fight is getting out of hand…it’s getting worse. It’s spreading,” she said in desperation. “We’re losing more [patients] than we’re keeping. I put an ungodly amount of people in body bags.” 

Ballad Health CEO Alan Levine said Egan speaks for many other healthcare workers who are similarly fatigued, frustrated and disheartened. He expressed fears that an already-severe nationwide nursing shortage will get worse in the coming months, as dedicated nurses decide they simply can’t bear the tragedy.

Ballad Is Nearly at Capacity

Due largely to this nursing shortage, Ballad Health is nearly at capacity. The system is at 93% patient occupancy, including 92% of all ICU beds. Furthermore, more than 200 staff members are currently isolated or in quarantine due to confirmed or potential infection. 

The health system serves a 21-county region in the Appalachian Highlands, and has attracted national media coverage for its recent surge in coronavirus infections. The region’s 20% positivity rate is near the highest in the country. Levine didn’t mince words during Wednesday’s press conference.

“There is nothing more dangerous than misinformation,” he said, when it comes to mitigating the spread. Locals’ flat refusal to follow expert advice and respect the virus has directly contributed to the crisis at Ballad.

The region has lost 723 people so far. Hospital officials project that even after taking precautionary measures, the system likely won’t be able to accommodate the number of coronavirus patients the region will see. Levine announced one such measure on Wednesday. Effective Dec. 7, the health system is ceasing all non-emergency, elective procedures for at least 30 days in an attempt to free up capacity. The health system took similar steps in March, and simultaneously furloughed 1,300 staff. Levine said no further furloughs are planned, especially with the nursing shortage.

The health system is hoping to increase capacity to 460 beds specifically for COVID patients, said Chief Physician Executive Clay Runnels. However, given the rate at which the virus is spreading in the region, Ballad is heading for a peak of more than 500 people hospitalized by the end of December. Currently, there are less than 15 ICU beds available across the entire system. 

Planning for the Worst-Case Scenario

Levine thanked the governors in both Virginia and Tennessee for helping the health system respond to the surge. National Guard units were deployed to the Tri-Cities region to replace clinical staff conducting COVID-19 testing. This enabled clinical staff to return to patient bedsides. 

Ballad has also brought in refrigerated mobile morgue trucks, a move Levine said was necessitated by the “grim reality” of the data on expected deaths. 

Over and over again, officials at Wednesday’s press conference begged people in the region to simply follow advice to wear face masks, maintain distance from others, avoid indoor gatherings and wash their hands. It could make a tremendous difference.

Typically, health experts can project viral spread by assuming that each infected person will infect 1.2 other people. In Ballad’s coverage area, that number has been closer to 1.4. That seemingly trivial increase means the difference between a peak of 350 people hospitalized at one time to more than 500, Levine said. One in six people hospitalized in the region are dying, partially due to the fact that there is a higher incidence of comorbidities among its population.

Levine sounded quietly furious at media companies, public officials and politicians who have knowingly spread misinformation about the severity of the virus. It makes people think it’s actually safe to go to mask-less sporting events and throw large holiday parties. Referring to Ballad, Levine said, “Our goal in this has always been to be a source of truth. We have nothing to gain by sharing information that’s not true.” Levine said it has been “very hurtful” to hear people suggest that doctors profit by diagnosing folks with COVID. He said people lying about the virus being fake is “one of the most cynical things” he’s witnessed in his 30-year career. 

Where Do We Go From Here?

Levine was very clear. Ballad Health has the supplies it needs to treat coronavirus patients. It has the bed space and ventilators. But capacity is determined by the staff availability. Given the nursing shortage the system is facing, the key at this point is to keep as many people as possible out of the hospital.

Ballad’s Chief Infection Prevention Specialist Jamie Swift offered several suggestions for how to achieve that. First of all, she said, Ballad can test virtually anybody who wants a test. She urged anyone with even mild symptoms, or which they think may indicate the flu or a cold, to get tested anyway. Those with positive tests need to properly isolate, she said. Swift also recommended that everyone get a flu shot as soon as possible. The flu can escalate to the point where folks need to be hospitalized, she said. Emergency rooms in the region may not be able to accommodate these sick people.

Swift was also emphatic about the safety of the imminent COVID vaccine, which Ballad is already preparing to distribute efficiently. Swift said as a nurse and a mother, she has absolutely no qualms about taking the vaccine as soon as it’s available. She also explained that because the virus is manufactured using viral mRNA that builds a synthetic version of the virus, the vaccine cannot give you COVID.

Finally, Runnels urged those who have recovered from COVID to consider donating plasma. The plasma can be used in the treatment for future patients. To date, Ballad has received 1,452 plasma donations and administered 1,253 units to COVID-19 patients. To see if you’re eligible to donate, call Marsh Regional Blood Center at (423) 408-7500.

Ashley Spinks Dugan is a freelance reporter for Dogwood. You can reach her at [email protected].