“It’s extremely stressful”: Dr. Rai on record hospitalizations and social media myths

GREEN BAY, Wis. (WBAY) - “It’s extremely stressful and we’re waiting for help to get here.” That’s what Prevea Health President and CEO Dr. Ashok Rai said about the situation in our local hospitals as COVID-19 continues to spread at high levels in Wisconsin.

Dr. Rai joined us on Action 2 News This Morning Thursday to show how COVID-19 is stressing our hospital systems and front-line workers. On Wednesday, the Wisconsin Hospital Association reported more than 1,000 people hospitalized with COVID-19 in Wisconsin.

Dr. Rai also dispelled some myths that are spreading on social media.Dr. Rai joins us Tuesdays and Thursdays on Action 2 News This Morning. Have a question for the doctor? Email news@wbay.com.

RECORD HOSPITALIZATIONS

"It’s not only just the total number of patients with COVID, but what eventually happens is the number of people needing hospital beds, and that turns into not having beds for everything else we want to do, and the emotions around that, and trying to manage that. It used to be every day you’d meet in the morning, and you’d try to figure out what you’re going to do for the day. Now it’s hour by hour. Every half hour somebody is calling trying to figure out where to put a patient. Staff is tired. Staff is getting sick because they’re going home and being exposed just because the community spread is so high. It’s extremely stressful and we’re waiting for help to get here.

“You could be a patient having a stroke, like has happened in the last week, and trying to find a bed in any of the four hospitals to recover that patient in, and spending hours trying to locate that person. It’s October, it’s Breast Cancer Month. You’ve prepared, you’ve had radiation, you’ve had chemo, now it’s time to have your breast cancer surgery--maybe it’s a bilateral mastectomy--there’s nothing for a woman that could be even harder than going through that. And then finding out the night before, the morning of, that we have to delay it because there’s not a bed for you. Those are the types of stories we’re seeing. It’s not just COVID. It’s everything. We’re looking hour by hour for a bed. We have nurses coming in from around the country that are going to start this week and next week. Scrambling to even buy beds to figure out where you can create more room and monitors for them, all of that’s being done right now to take care of our community.”

SOCIAL MEDIA MYTH - HOSPITAL BEDS

People on social media are claiming hospitals cannot be overrun because they’ve seen open rooms and beds.

“You know what, you probably did see a room open. Because you have to remember, to have a bed in a hospital you need a crew of people that are going to take care of the patient in the bed. The nurse, the physician, the nurse’s aide, the person who is going to clean that room, feed that patient, every single one of those categories, the respiratory therapist, the lab people. They all have situations where we’re short staffed because of COVID and we’re looking for help. So an empty physical space is not a hospital bed. It’s the team around you who needs to take care of it. So yeah, ‘Uncle Louie’ probably saw an empty bed and we had no reason to lie about it. We didn’t have somebody to actually take care of the person in that bed.”

SOCIAL MEDIA MYTH- HERD IMMUNITY

“It’s probably one of the most frustrating things we have to deal with is you have scientific evidence and you have people who have no science and put things out there that get spread out. In response to the herd immunity articles, 50 epidemiologists and infectious disease specialists put out a great letter in Lancet, which is probably one of the most published infectious disease journals that we read, around herd immunity, saying number one, stop talking about it. Number two, it doesn’t make any sense because we don’t know how long immunity lasts with COVID-19. Scientifically, it’s not even a concept to have a conversation about. And number three, the amount of people that would die if you truly would get it is just too great of a catastrophe. You may say just get all the healthy people in America exposed. Forty percent or more of Americans have an underlying disease that would put them at risk for death from COVID-19. How are you going to separate the other 60 percent from the 40 percent? It’s not common sense. It’s not scientific based. And I wish it would stop.”

NURSING HOME OUTBREAKS

“We talk about hospitals is where we provide care. But remember, we provide COVID-19 care in a variety of different settings. A COVID patient in a hospital or a nursing home--number one in a nursing home it’s a congregant setting so the spread can happen very quickly as we’re seeing in Waupaca [King Veterans Home], as we’re seeing locally with nursing homes having dozens of patients, almost, with COVID-19. And the resources it takes to take care of that patient are so different than a standard patient that a nursing home was built for. In a hospital, we have a lot of the things that we need, and it’s still hard to take care of a COVID-19 patient. Yesterday, I had to go see a COVID-19 patient. It took me 10 times longer to see that one patient. I could have seen 10 other patients in that time period. It’s a lot of work. We’re doing it. We’re caring for those patients to keep them comfortable and try to get them turned around them around. I think people are so focused on ‘it’s just a cold, it’s just a respiratory illness’, not realizing what it’s doing to the health care system, even well beyond the hospital.”

TRICK OR TREAT

"I think with a lot of things this year, we need to get very creative, especially with our children. As we get that creativity going, understand that we want to get them active, we want to celebrate another holiday, but figure out how to do it safely. So you want to minimize interaction with people you don’t live with or know. If you can avoid that, so the best you can do that is probably not door-to-door trick or treating. But everybody’s got to make their own individual decision around that. But try to find other activities as well, safe in the home, different things that we can do, or different ways to distribute candy that’s safer. I think we need to get creative on this issue. But really, interacting with people on a regular basis that you don’t live with only creates more risk right now in our current spread.

SCHOOLS REOPENING

West De Pere announced it was sending children back to the classroom after a period of all-virtual learning.

"As a local health care provider, we don’t have a true recommendation. We provide data, we help people interpret that data. But as somebody who did a pediatric residency and would refer to the American Academy of Pediatrics, which I have right in front of me right now.

“The American Academy of Pediatrics has a bullet-point list of things you need to do. And the number one thing is we want kids back in school. We know they learn better, they socialize better. But we also want to make sure they’re safe. So there’s no doubt about it that we want people back in school. But they do have a bullet point here, ‘Although the American Academy of Pediatrics strongly recommends and advocates for in-person learning for the coming school year, the current widespread circulation of the virus will not permit in-person learning to be safely accomplished in many jurisdictions.’ It’s important to understand that we live in one of the worst jurisdictions when it comes to COVID-19, not only in the country, but in the world. We need to look at local numbers and make decisions based on that. Obviously, they looked at numbers and made their decision, and every school board’s going to need to do that. But the American Academy of Pediatrics is strongly in favor of in-person learning, when it’s safe.”

FLATTENING THE CURVE

"I used to go with my hands here--this was hospital capacity and this is the amount of patients that we can take care of--and when the COVID numbers and the total admissions get over that, that’s when we’re in crisis mode. Here’s the flatting line of hospital capacity, and now we are over that. It’s a hill, it’s a mountain, however we want to describe it. But we’ve now crossed that threshold that we were trying not to cross back in the spring. So the point is now, let’s reduce the total spread. That in effect will reduce the total number of hospitalizations and allow us to take care of the entire community, those that have COVID, those that don’t.

POST-COVID WORKOUTS

A viewer who had COVID is experiencing tightness in his chest and a cough during a work out. Should he go to a doctor?

“Most definitely. Any time you’re having those types of symptoms, whether you have COVID or not, if you have tightness in your chest when you’re exercising, we need to see you. It’s important to understand that we’re starting to learn about this virus more and more. We’ve got eight months. That’s not a whole lot of time behind us. But the things that we’re working about some of the sequela, the things that happen after you’ve recovered, one of the things that scares is us myocarditis, the inflammation of the heart. We saw that in athletes who actually had COVID-19, did not have any symptoms, and in some studies a third of them had evidence of heart damage. So if you’re having symptoms after you’ve had COVID-19 while you’re exerting yourself, stop exerting yourself. See your doctor. There’s a certain set of things we need to do to make sure you’re safe to work out again.”

EXPOSURE AND SMALL GATHERINGS

“I think we would all love to get together with our families, me especially right now. But it’s important to understand that if you don’t live with somebody and they’re out interacting with other people, every interaction they have is an interaction you’re now having. It becomes exponential. Just a gathering with six people you don’t live with, you’re now actually exposed to many more than six people. Because those six people were exposed to six people that were exposed to six other people. Now you’ve been exposed to 180 people as you start doing the math and multiplying that out. So it’s important to understand that when you are not going to work and not being safe in a mask-type situation, that you should not be gathering.”

WHY ARE HOSPITALS CHARGING FOR COVID TESTS?

“It really depends on the health system and how their contract works. They will bill insurance. If insurance doesn’t cover it, the federal law says we shouldn’t be billing you at all for that. Either way it should be covered. At Prevea, we have a state contract. So I’d say 90-something percent of our tests are covered by the state. There’s a smaller portion that we have to bill to our insurance that are pre-procedural. But every system has a way to make sure you get tested and it’s not a financial burden.”

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