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Big Bend Health Providers Concerned About Statewide Growth in COVID-19 Hospitalizations

Healthcare providers in Far West Texas are bracing for a repeat of last fall, when a prior COVID-19 surge across the state left rural residents with few options for hospital transfers when they needed them.

By Travis Bubenik

Texas health officials are sounding the alarm about a sharp rise in COVID-19 cases and hospitalizations as the delta variant of the coronavirus continues to spread across the state.

"We're seeing steep increases in hospitalizations, steeper than we saw at the same point of even the first wave or the second wave," Jennifer Shuford, Chief State Epidemiologist for the Texas Department of State Health Services, told reporters on Wednesday.

The number of Texans hospitalized with COVID-19 has reached highs not seen since February. Texas reported more than 8,100 hospitalizations on Friday - and hospitals in West Texas are among those feeling the strain.

"We are in a crisis," Kit Bredimus, Chief Nursing Officer for Midland Memorial Health, said during a briefing Thursday.

In the Big Bend region, some health care providers are watching the developments with alarm, worried that the impacts of the statewide surge could trickle down to Far West Texas, just like they did last fall.

What local health experts are saying

Healthcare providers in the Big Bend region are not necessarily worried about a sharp uptick in local COVID-19 cases.

The case numbers for Brewster, Presidio and Jeff Davis Counties have remained relatively low for most of this year, generally ranging from the single digits to the teens in each county since the region's main surge in cases in the late fall and winter of 2020.

"From what I gather so far...we're okay in terms of vaccination rates and COVID rates right now," said Christie Alexander, a doctor and rural health expert from Florida who recently began working at the Marfa Country Clinic.

"But with the amount of tourism and things like that, that could change, and so we just have to be vigilant in terms of watching it all," she said.

For now, local health experts are more alarmed about the larger hospitals in West Texas — in the Permian Basin and El Paso, for instance — filling up with COVID-19 patients and not being able to take in patient transfers from more rural hospitals like Alpine's 25-bed Big Bend Regional Medical Center.

The Big Bend and other rural parts of Texas experienced that same type of situation earlier in the pandemic.

"It's just kind of starting all over again," Linda Molinar, CEO of Preventative Care Health Services, said in an interview. PCHS has clinics across the Big Bend region.

"We're starting to see that it's not as easy to transfer a patient as it was six months ago," she said. "There's no room anywhere."

Molinar said she knew of about five recent cases in the Big Bend region where patients needed to be transferred to a larger facility and "ran into problems."

As larger hospitals fill up, the risk for people living in more far-flung places like the Big Bend area isn't just about catching the virus.

"COVID patients are going to be taking those ICU beds, so somebody who has a heart attack that has nothing to do with COVID, it's going to be difficult to transfer them," Molinar said.

Still, hospital capacities are constantly in flux — often changing by the hour — so it's unclear as of yet just how much of an impact the statewide uptick in hospitalizations is having on transfers from more rural areas.

Texas health officials are not mincing words.

During Wednesday's briefing, Texas Department of State Health Services spokesperson Chris Van Deusen said that compared to last week, case numbers had grown by 92%, hospitalizations were up 49% and deaths were up 15%.

"Those are all going in the wrong direction," he said.

"Delta has erased much progress to end the pandemic," the department later wrote on Twitter alongside a plea for Texans to get vaccinated.

John Henderson, President of the Texas Organization of Rural and Community Hospitals, said this latest COVID-19 wave could prove even tougher than the last for rural hospitals already struggling with staffing shortages and worker burnout.

"Because earlier in the pandemic, there was actually state staffing assistance," he said. "They were sending nurses to COVID hot spots, and they aren't doing that this time, so I think we're going to be capped out sooner than in previous waves."

Henderson said throughout the pandemic, rural hospitals and clinics have been losing workers who are drawn to larger institutions in bigger cities that can offer better pay. That's left rural areas in an even more vulnerable situation for the latest COVID surge.

"What I'm telling [rural] hospitals to prepare for is a month of August that's similar to the month of January," he said. "And that's very frustrating for our folks, because there was reason to believe in June and July that maybe we were working our way out of those situations."

In late July, John Henderson's group wrote a letter to Gov. Greg Abbott, asking him to "immediately" send extra medical staffers to rural areas that could soon become overwhelmed by the uptick in COVID-19 hospitalizations.

The letter from TORCH noted that many rural hospitals in Texas still haven't fully recovered from the financial blow of the pandemic's onset.

While Abbott did deploy health care workers to hard-hit areas earlier in the pandemic, the state health department has not announced plans for a similar move this time around.

Instead, the department has pointed local leaders in cities and counties to a pot of $10.5 billion in federal COVID-19 relief funding - most of which has already been distributed to local governments - which could be used for beefing up hospital staff.

Texas leaders say that approach gives local communities more flexibility to staff up hospitals and clinics as they see fit.

"We are not abandoning the people of Texas," Nim Kidd, the state's chief emergency management official, told the Texas Tribune. "What we're trying to do is to help make sure those closest and with the best possible solutions to the problems are the ones that are solving those problems.”

Meanwhile, state health officials continue to urge unvaccinated Texans to get the shots, stressing that vaccines are safe and effective."The vaccines work," the state health department said this week. "They prevent hospitalization and death in nearly all fully vaccinated people."

Travis Bubenik is All Things Considered Host and Big Bend Reporter at Marfa Public Radio.