Lourdes had fewer COVID-19 hospitalizations in third wave. Here's why.

Andrew Capps
Lafayette Daily Advertiser
Our Lady of Lourdes. Tuesday, March 31, 2020. S

As Acadiana wrestled with the worst of COVID-19’s third wave this winter, fears of overcrowded hospital rooms and burnt out medical staff spread among the region’s health care leaders.

But COVID-19 hospitalizations never reached their summer surge peaks in Acadiana, and at Our Lady of Lourdes Regional Medical Center in Lafayette, Chief Medical Officer Dr. Henry Kaufman credits a pair of key strategies that helped to keep hospital beds free and saved the lives of COVID-19 patients.

COVID-19 hospitalizations at Our Lady of Lourdes facilities in Lafayette peaked at 82 patients in July, the same time the region was experiencing its highest rate of hospitalizations during the peak of the summer surge when more than 300 people were hospitalized with COVID-19 in Acadiana.

Hospitalizations climbed again this winter as Acadiana entered the grips of a third major wave of new COVID-19 cases. The wave has surpassed the region’s massive summer surge of more than 20,000 cases to be the largest wave of reported COVID-19 cases that the region has yet experienced with more than 23,000 cases as of Friday.

But even as COVID-19 cases during the region’s third wave this winter surpassed the number of cases reported during Acadiana’s massive second wave in the summer, hospitalizations for COVID-19 never reached the same dire level, peaking at 226 people hospitalized on Dec. 2 before maintaining a high plateau in the weeks since.

What did Our Lady of Lourdes hospital do differently? 

What happened at the regional scale was mirrored at Our Lady of Lourdes Regional Medical Center, Kaufman said Tuesday, as the healthcare system saw its hospitalized COVID-19 patients peak at 76 in mid-January before dropping precipitously to an average of about 45 on a given day.

More:Louisiana expands COVID-19 vaccines to 406 providers, see map of locations

Although that peak in cases strained some of the hospital’s resources, it was far less strain than the facilities leadership was preparing for based on initial estimates, and Kaufman credited two things with helping to keep COVID-19 patients out of the hospital's beds: monoclonal antibody infusions and the hospital’s push for home health monitoring.

Medical staff at Our Lady of Lourdes Hospital are part of the essential workforce providing healthcare services. Wednesday, April 1, 2020.

Kaufman said the antibody infusions of a drug called bamlanivimab are one of few ways to confer immunity from severe cases of COVID-19 currently available, the other two being the limited supply of COVID-19 vaccines and the temporary protection of contacting and recovering from the virus.

Those antibody infusions have reduced the rate of severe COVID-19 illnesses in people who qualify for the treatment from as much as 20% of patients down to around 3%, Kaufman said, a difference that has meant dozens fewer COVID-19 patients in the hospital’s beds and fewer deaths from the disease overall.

“Probably, 450 doses of the bamlanivimab have been given to patients with COVID-19, and that probably saved us 70 to 80 admissions and somewhere between 10 and 20 deaths,” Kaufman said.

By lessening the virus’ impact on patients, the hospital was able to keep admissions down during the peak of the virus’ winter wave, Kaufman said, buying them critical capacity to care for other patients, especially given the virus’ potential for long, drawn-out deaths that can cause patients who may ultimately die to occupy critical bed space for weeks.

FOR SUBSCRIBERS:Schools, law enforcement are up next for the COVID-19 vaccine. Here's how they're preparing

“If you just take the 20 people who would have ultimately died and add that, that's 96 patients that we'd have in the hospital (at its peak),” Kaufman said. “And then you take a fraction of the ones that would get admitted of that 80 or so, and we're talking about 110 or 115 patients. You're talking about us truly reaching crisis standards of care.”

“I give huge credit to that drug at reducing the number of hospital admissions and the severity of the illness in hundreds of patients that have received that in our system, and probably thousands across the state, and likely hundreds of thousands across the United States,” he added.

Mild cases were monitored at home

Lourdes is also keeping COVID-19 patients out of hospital beds by making a push toward home health monitoring for COVID-19 patients whose cases seem to be mild but previously required some level of constant monitoring by distributing hundreds of pulse oximeters for at home use.

RN Amy Cullum. Medical staff at Our Lady of Lourdes Hospital are part of the essential workforce providing healthcare services. Wednesday, April 1, 2020.

The oximeters clip onto the patients’ fingertips to measure their blood oxygen levels, a key indicator of COVID-19’s strain on the lungs and vascular system of a patient, allowing people with mild cases of COVID-19 to keep close track of one of the less obvious, but more serious symptoms of the virus.

Kaufman said that as the hospital’s leadership was preparing for a third wave surge of COVID-19 patients around November, they determined that they could keep admissions lower if instead of admitting patients whose symptoms were limited, they could give the patients a way to monitor their own critical signs of the virus remotely.

“There were a lot of people that had to come to the hospital for a few days, but they were really kind of fine and we just watched them for a couple of days, and once we knew they weren't getting any worse, we could send them home,” Kaufman said. “But if you send them home with a pulse oximeter, you have a different way of doing that, a different mechanism. And that also helped ensure the patients in the hospital were the patients who really needed to be there.”

More news:New more contagious United Kingdom coronavirus variant gaining foothold in Louisiana

The home monitoring system lets patients monitor their blood oxygen levels so they know if they need to seek emergency treatment, typically when those levels drop below 90%, Kaufman said. But they also help the hospital free up valuable bed space by getting patients with mild cases of COVID-19 out of the hospital without cutting them off from necessary health monitoring.

“We think we probably saved dozens of people a hospital admission by putting them on home monitoring,” he added.

Donald Gagnard wearing personal protective equipment (ppe) in the ICU at Lourdes Hospital in Lafayette, LA.  Tuesday, March 31, 2020.

Mitigation measures remain important

Although the hospital has found a way to reduce COVID-19’s strain on its capacity, Kaufman said it remains vital that people adhere to the mitigation measures that have been put in place to reduce the virus’ spread since mask wearing and social distancing are the best tools to fight the virus until the vaccines become widely available, which he estimated would be months from now.

Those mitigation measures will be critically important as Acadiana and the rest of the state look ahead to Mardi Gras and the celebrations that health experts expect will trigger another surge in cases locally that will likely increase the region’s number of hospitalized COVID-19 patients.

“We anticipate maintaining similar numbers of COVID-19 patients in the hospital, until we get to the Mardi Gras holiday,” Kaufman said. “Then, as we have seen for every other major holiday that we've experienced during this pandemic, two weeks after Mardi Gras we will see another surge in cases in our community.”

Follow Andrew Capps on Twitter or send an email to acapps@theadvertiser.com.