'We Always Seem to Make Room': Tuscarawas County ER Doctor is Concerned but Hopeful About the Winter Coronavirus Surge

An emergency room doctor at Cleveland Clinic Union Hospital in Dover is hopeful his staff can manage this winter’s coronavirus surge. The Tuscarawas County hospital is seeing on average about 40 COVID-19 patients per day. NPR’s data on hospitalizations shows the facility has 81% of its adult inpatient beds full, and more than half of those are coronavirus patients.

Dr. Nate Johnson has worked in the Union ER for 15 years and heads the hospital's stroke unit. When asked about his current level of concern about the coronavirus in his hospital, he said, "On a scale of 0-10, I’m at an 8. I don’t know what a 10 would be, but I really don’t want to see it."

From March to now

He says the number of people coming into the ER back in March when the pandemic began were lower than normal.

"Our volumes went from 125 patients per day to 60 or 70 per day. And of those patients, maybe 30 a day, especially that first week, simply were coming in for very mild upper respiratory tract infection symptoms.

He says at that point, the hospital set up tents outside to test people for the virus, and they weren't even coming in to the ER.

Because our biggest examples in the United States were New York City and Washington State, I think most people were truly afraid of the illness. People with these symptoms were afraid to physically enter the emergency department because people were so concerned about being exposed to COVID-19."

Now, the number of patients coming in is higher, but still not at the volume seen pre-COVID.

"We’re seeing about 90 patients a day. But of those patients, up to half are COVID-type patients. Either they know they have COVID and they’re coming in because they’re getting worse, or they have symptoms that most likely are related to COVID and they’re being diagnosed, or they’re being diagnosed and they’re very ill," he said.

The ER is no longer just a stopover

And Johnson says every aspect of the hospital is full, including the ICU and their step-down units. So, the ER has become a place where patients have to stay longer.

"People come into the ER for something like a sprained ankle or something, and when they look around it seems like there are patients everywhere and it seems like we’re the busiest time we’ve ever had. But it’s not a numbers issue, it’s an intensity issue. It’s really sick patients who take a really long time to work up and then take a really long time to get to a bed."

He says another concern is that many nurses and techs are out sick, creating staffing shortages. But he says the staff has been steadfast.

"When this started in March, I thought ‘We are going to have a mass exodus of nurses and techs.' And the fact that these folks show up every day, we are so blessed with some great folks in our hospital."

And while running out of space is a concern, he thinks they'll be able to handle the surge.

"Because we are now part of the Cleveland Clinic system, we get a lot of advice and best practices that trickle down. And we have been really resourceful. We have opened up beds that had previously not been used and have staffed those with administrators. We always seem to make room."

Reason for optimism

And Johnson says he has optimism. In addition to the vaccine beginning to arrive in Ohio, he says his days don't seem as daunting.

"I’ve felt better my last couple shifts and maybe the reason being is that I’m starting to see more traditional medical issues. We’re starting to see strokes and heart attacks show up. It’s not all just COVID. It’s amazing how everyday I think that next shift is going to be terrible and I show up for that next shift and it’s rough, but the ceiling doesn’t fall in."

He says he's thankful for the community support.

"When I came here 15 years ago, I really didn’t know this community. They really support us, and it really makes you feel good about coming in. And it gives you a sense of ownership."