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For rural hospitals, the surge of COVID patients can have deadly consequences

ARI SHAPIRO, HOST:

Rural patients across the U.S. have always needed to travel for medical care. But now, as NPR's Will Stone reports, the overwhelming crush of COVID patients is jeopardizing their access to specialized care altogether, sometimes with deadly consequences.

WILL STONE, BYLINE: The day Katie Ripley finished radiation, her father, Kai Eiselein, made sure to be there. He took the day off work from his job in Moscow, Idaho, so he could join her at the hospital. Some cancer centers have a little ritual to mark the end of treatment.

KAI EISELEIN: She came out and hit the gong with the mallet, and everybody cheers. And then we all went out to lunch (laughter). You know, it was a good day. We were all happy.

STONE: It was the summer Ripley, in her early 30s, had been through treatment for stage 4 breast cancer. She was Eiselein's only child and, like him, had gone into journalism, working for the local paper until after her two kids were born.

EISELEIN: Just a sweetheart, you know (laughter)? I don't think she had a mean bone in her body. Great mom. Outstanding writer.

STONE: Because of her cancer treatment, Ripley's immune system was more vulnerable. And in early January, she'd come down with bronchitis, which then led to pneumonia. Eventually, she was brought to Moscow's small hospital, Gritman Medical Center.

EISELEIN: She was deteriorating quickly. No beds were available anywhere. The hospital here didn't have the facilities for what she needed.

STONE: Normally, she'd be flown out quickly to a bigger hospital. Ripley needed specialized ICU-level care, including dialysis. But hospitals all over the Pacific Northwest were swamped with COVID.

EISELEIN: Then it got to a point where it was pretty clear that even if we found a bed, she probably wasn't going to make it. Kind of a tough pill to swallow. You're fighting so hard and trying so hard to save your kid's life and, you know, you fail.

STONE: After more than 20 hours in the hospital, Ripley died in Gritman's emergency department. She was 33. The hospital wouldn't comment on Ripley's case specifically, but spokesman Peter Mundt described what they're up against during this surge. Gritman has a small ICU and limited services.

PETER MUNDT: We have to have a system that allows us to move patients from hospital to hospital. And some days that has been extremely stressed and extremely strained.

STONE: This affects all kinds of patients, whether they have a heart attack or a life-threatening infection. Mundt says they've called hospitals in Montana, Oregon, Washington, Colorado.

MUNDT: Our nurses and our health supervisors working phones like it's a commodity trading floor - multiple phone lines running, multiple computer screens up.

STONE: Gritman's situation is far from unique in rural America. Dr. Lesley Ogden oversees two rural hospitals in Oregon run by Samaritan Health Services.

LESLEY OGDEN: Those are the nail-biters. Can you find a place for these people to go before their condition harms them, you know, to the point of sort of no return?

STONE: At times, Ogden says they've had to go way outside of their comfort zone, doing surgeries they'd normally never do because there was simply no other choice.

OGDEN: If that means two surgeons coming together to do a job that normally takes one, can we just get everybody to pull together and save this patient?

STONE: But there aren't always workarounds. Back at Gritman hospital, Mari Timlin, the chief nursing officer, says it's heartbreaking for health care workers to have a critically ill patient stuck, waiting for something like dialysis.

MARI TIMLIN: It does create moral distress that they feel we're not giving the exceptional care that any patient requires.

STONE: Kai Eiselein says who knows if his daughter Katie would have ultimately survived if she had been transferred out of Gritman?

EISELEIN: But she never even had the chance. That's - you know, that's the thing that gets me - is she never got the chance.

STONE: And in the second sentence of her death notice, Eiselein made it very clear why that was the case, writing, quote, "there were no beds available thanks to unvaccinated COVID-19 patients," unquote. In fact, the latest data bears this out. Unvaccinated adults are 16 times more likely to be hospitalized than those who are vaccinated.

EISELEIN: This is the best way I can honor my daughter's life - is to get that message out there to get vaccinated, not just for you. But other people are being affected as well. I'm sure that my daughter isn't the only one.

STONE: But she's one of the few whose name we actually know.

Will Stone, NPR News.

(SOUNDBITE OF MICA LEVI'S "BLUE S***") Transcript provided by NPR, Copyright NPR.