As Virus Stresses Texas Hospitals, Rural Patients Face Greater Risks

By Travis Bubenik, Courthouse News

In the rural Big Bend region of Far West Texas, there have been signs lately of life returning to some kind of normalcy despite the coronavirus pandemic’s resurgence here and across the country.

Tourists are once again flocking to the region’s friendly small towns for a breath of fresh, high-desert air, campsites are filled with travelers and locals alike seeking a break from the monotony of work-from-home routines and Netflix binges.

But with local virus cases surging beyond their previous peaks in the summer and early fall and the region’s closest major hospitals overwhelmed by an influx of Covid-19 patients, some are warning residents here and in other rural parts of Texas of a newly heightened risk that may at first sound unthinkable in the world’s richest nation: If you get deathly sick with Covid-19, it might be hard to find a hospital bed.

A sign at a ranch supply store in rural Marfa, Texas, encourages people to mask up. (Courthouse News photo/Travis Bubenik)

“I’m hearing stories out of Lubbock and Amarillo that they were actually transferring patients to Arizona, Denver and Kansas City,” John Henderson, president of the Texas Organization of Rural and Community Hospitals, said in an interview. “Our rural hospitals in northwest Texas and West Texas are desperate to find accepting urban hospitals, and they just can’t do it.”

Since the pandemic began, public health experts have warned that people in rural areas with small hospitals – or no hospitals at all – could face particularly risky situations if they get sick with Covid-19, as small-town facilities may not have the equipment or expertise to sufficiently battle the disease.

As larger hospitals in places like El Paso, Lubbock and the twin oilfield cities of Midland and Odessa struggle with surges in Covid-19 patients, that warning has become a reality.

“This past weekend, we actually called 27 hospitals in four states to get one [Covid] patient transferred out,” said Holly Holcomb, chief operating officer of the 39-bed Childress Regional Medical Center in Childress, Texas, a Panhandle town of about 6,000 people.

Holcomb said her team did eventually find a bed for that patient at a larger facility, where she was promptly put on a ventilator. But it took persistence.

“We’re to the point where we’re having to reach out for personal favors to physicians in the area, calling their cellphones, saying, ‘please help us save this person, here’s a picture of who we’re trying to save, can you help us secure a bed,’” Holcomb said.

Others, and not just Covid-19 patients, haven’t been so lucky. Holcomb told of a 54-year-old man who recently came to the hospital after his gallbladder burst and needed to be transferred out. They couldn’t find a bed for him.

“He actually died in our ER while waiting for someone to take him,” she said. “In this day and age, for somebody to die of a ruptured gallbladder.”

The bigger hospitals insist they do everything they can to make room for patients who need to be brought in from smaller facilities – waiting lists for transfers are ticked through as soon as beds open up – but some say the strain from local influxes of Covid-19 patients has kept their doors virtually closed to transfers from farther away towns.

“We’re turning down requests every day, and people are having to go farther and farther, mostly to the east, to find the place that will take them,” Russell Meyers, CEO of Midland Memorial Hospital, said during a Thursday news briefing. “We opened yesterday for two minutes, and in the course of that two minutes we accepted two patients, and then we closed again.”

“This is definitely something we’re starting to hear from smaller hospitals,” said Chris Van Deusen, a spokesperson for the Texas Department of State Health Services.

Deusen said the department has been in touch with statewide hospital associations, reminding them that hospitals can ask the state for emergency resources. That kind of help has been deployed to El Paso, Lubbock and Amarillo in recent weeks, along with specialized medical teams sent to El Paso from the U.S. Department of Health and Human Services and even the Defense Department.

Being transferred from small to major hospitals in parts of rural West Texas can involve hours-long drives or expensive helicopter flights. (Courthouse News photo/Travis Bubenik)

Texas as a whole reported a record-high daily number of 12,293 new virus cases on Thursday, while statewide Covid-19 hospitalizations have grown to about 70% of their all-time peak in late July.

Still, Texas Governor Greg Abbott has maintained that he will not bring back the kind of business closures he instituted earlier this year to tackle the previous surge in virus cases and hospitalizations.

“Statewide, we’re not going to have another shutdown,” Abbott said during a press conference Thursday in Lubbock.

The governor was in Lubbock to detail a state-led effort to distribute weekly supplies of a new Covid-19 antibody drug that the federal government authorized for emergency use last week. The goal of the distributions, Abbott said, is to give the drug to Covid-19 patients in the early stages of the disease in the hopes of keeping them out of hospitals altogether.

“People need to understand how consequential this is,” he said. “The future number of people going to hospitals should be on the decline going forward with the receipt of this drug.”

Still, some local officials have been frustrated by their lack of power to implement stricter public health measures in the face of the governor’s push to keep the state’s economy open.

Last week, a state appeals court dampened any immediate prospects for more restrictive local lockdowns in Texas when the court blocked a temporary shutdown order in El Paso County, finding that the county’s top official overstepped his authority in issuing the order. The official, Ricardo Samaniego, said he would not appeal the decision.

Brewster County Judge Eleazar Cano, the top elected official in the Big Bend county, said during a commissioners meeting Wednesday that he had thought about instituting a curfew to fight a local spike in virus cases, but was advised against it after consulting with a lawyer.

“He’s like, judge, hold off,” Cano said. “Because if you do anything, there’ll be a lawsuit filed opposing it.”

The judge acknowledged it has been a struggle to get some people to wear masks, even with a statewide mandate still in place.

“I go into businesses and I see people, half them are wearing them, half of them aren’t,” Cano said. “What’s it going to take?”

It’s hard to get an exact picture of just how many people from rural Texas have been turned away from larger hospitals, as the state’s health department doesn’t track that kind of data.

J.P. Schwartz, a doctor and appointed local health authority in rural Presidio County, said his office was aware of at least one recent example of a patient at the 25-bed Big Bend Regional Medical Center struggling to find a hospital bed at a larger facility.

“We had one case where it took five days to get transferred to Houston,” he said. “Didn’t have room any other places.”

Houston is more than 500 miles away from where that patient was first hospitalized.

Schwartz cautioned that even when patients are transferred from rural areas to bigger cities, it’s no small task. Often, the transfers happen via helicopter with a bill that can run into the tens of thousands of dollars if the person doesn’t have specialized insurance that covers emergency flights. And, he said, when Covid-19 patients get to the point where they have to be transferred to bigger hospitals, they’re often already in a pretty serious condition.

“It’ll be close,” he said.

Hospital officials and others say in the absence of new government restrictions on business and social activities, the public simply has to double down on basic safety precautions like wearing a mask, staying home when possible and practicing social distancing.

Speaking alongside the governor Thursday, Texas Division of Emergency Management Chief Nim Kidd warned Texans to not view the new antibody drug and hopes of vaccines starting to roll out by the end of the year as an excuse to let their guard down.

“Just because you have a seatbelt in your car does not mean you should speed and drive reckless,” he said.

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