By Liz Holland

The newest surge in Covid-19 cases on the Lower Shore has prompted TidalHealth Peninsula Regional in Salisbury to elevate itself to crisis status. 

As a result of significant increases in both Emergency Department volumes, Covid-related admissions and the ongoing national staffing shortage, TidalHealth has chosen to implement and follow CDC recommendations for crisis standards at the medical center.

A similar change in status was announced Monday at TidalHealth Nanticoke in Seaford.

TidalHealth becomes the 13th hospital in Maryland to implement crisis standards for care.

This is the first time in the 125-year history of TidalHealth that its hospitals have been operating under crisis standards of care.

The health system is experiencing occupancy levels never seen before coupled with tremendous lengths of stay, making managing the volumes of patients very challenging. The situation has been and continues to be serious not only within TidalHealth but at hospitals across the nation.

Since Dec. 1, TidalHealth has collectively experienced over a 300 percent increase in admissions for Covid-19 and record-setting numbers of emergency department visits for Covid-19 related symptoms.

Crisis standards of care are only used in time of emergency, when the demand for health care exceeds a hospital’s ability to provide it through normal means.

Although very rarely used, they are guided by best practices, the values of the organization and ethical principles. This change in status follows emergency health care declarations recently by the governors of Maryland and Delaware.

This decision comes after careful discussion and consideration, and is a move from optimal care for each person to optimized care for many.

“We remain fully committed to providing the best and safest possible care, but it is becoming extremely challenging with the anticipated holiday surge in cases now occurring,” said Steve Leonard, TidalHealth CEO. “We continue to strategize best ways to reduce hospitalizations and overcrowding with our team and with other healthcare providers in our region. However, we desperately need the help of our communities. Getting vaccinated and receiving your booster can reduce the severity of illness and will help take the pressure off our extremely busy facilities.”

Currently, TidalHealth has exceeded the peak number of admissions witnessed in previous surges. Prior to implementing this change, TidalHealth had already taken steps to reduce admissions by postponing non-urgent surgeries requiring an overnight hospital stay and continues to evaluate all non-urgent surgeries. Emergency and urgent surgeries are not affected at this time.

In crisis status, TidalHealth will keep in place its no-visitation policy at both hospitals and will also continue to relocate, as necessary, members of its team to different areas and units of patient care where they are most needed and can best benefit patients and staffing requirements. Additionally, wait times may be increased for services, in particular in emergency departments.

TidalHealth continues to ask the public to only use the emergency departments at both hospitals for life-threatening issues. People with less severe illnesses or injuries should see their provider or visit one of the many immediate or urgent care facilities on Delmarva.

Infections rise dramatically

Covid-19 infections continue to climb on the Eastern Shore and across Maryland, including in Wicomico County, where 1,158 new cases were reported in the past week.

There were 87 hospitalized Covid patients at TidalHealth Peninsula Regional as of Tuesday, compared to 77 a week ago and 42 the week before that, according to the Wicomico County Health Department.

The majority of patients are unvaccinated, while some are vaccinated, but have not yet received a booster shot, according to the Health Department.

The seven-day positivity rate for Wicomico County is 30.36 percent. Statewide it is 27.62 percent.

Statewide, hospitalizations increased from 3,057 last week to 3,452 this week. Of those patients, there were 39 pediatric cases, according to the Maryland Department of Health.

The current seven-day average for new cases in Maryland is 14,000, compared to 2,000 per week during 2021, Dr. James Trumble, Vice President of Clinical Integration for TidalHealth, said during a recent interview.

On Monday, the increase in cases caused TidalHealth Nanticoke in Seaford, along with other Delaware hospitals, to begin operating under Crisis Standards of Care protocols.

“While TidalHealth Peninsula Regional is not currently operating in crisis status, many of the same conditions exist that could lead to a change in status for the Salisbury, Maryland hospital in the very near future,” hospital officials said in a news release. 

 Vaccinations

Salisbury University and the Wicomico County Health Department will host a free Covid-19 vaccination clinic for campus and greater community members age 5 and older from 3:30 to 6:30 p.m. on Friday, Jan. 14, in the Great Hall of Holloway Hall.

Those attending will have their choice of the Pfizer/BioNTech or Moderna two-shot vaccines and will need to be available for the second shot in the coming weeks.

One-shot boosters also will be available for those eligible based on age and the timing of their most recent vaccination shot.  

To make an appointment for the SU vaccination clinic visit covidvax.maryland.gov.

The Wicomico County Health Department also offers regular Covid vaccine clinics at the Wicomico Center. Health officials are stressing the importance of getting vaccinated, including a third dose which offers even more protection against the Delta and Omicron variants. Unvaccinated people risk death or long-term effects of the virus referred to as long Covid.

The next vaccine clinics are scheduled for Wednesday, Jan. 19, from 12:30 to 3:30 p.m. and Thursday, Jan. 20, from 9 a.m. to noon.

The Health Department also offers free Covid-19 tests at the civic center on Tuesdays. For information on testing or vaccination clinics, call 410-341-4600.

Vaccines are free and available at most pharmacies or through the Health Department. To find a vaccination site visit covidvax.maryland.gov.

 Local numbers

As of Tuesday, the case count in Wicomico County now stands at 15,503 compared to 14,143 a week ago. Deaths in the county now stand at 257, an increase of six since last week.

The patient count in Somerset is now 4,223 with 61 deaths. Additional cases have also been confirmed in Worcester County, which now reports 6,860 people as having had the virus and 132 deaths.

Statewide in Maryland, 850,316 cases have been confirmed, with 12,086 confirmed deaths and 242 probable deaths. The current hospitalization totals of people with the virus stands at 3,452. The number of people in intensive care is 548, including four pediatric cases.

Across Maryland, more than 6 million people have tested negative for the virus.

As of Monday, the state has administered more than 13.7 million doses of vaccine, with more than 4.2 million people now fully vaccinated and 92.6 percent of the adult population with at least one dose.

Nationally, there are now more than 61.6 million cases with 839,936 deaths. Roughly 207.8 million people in the U.S. – 63 percent of the population -- are fully vaccinated.