‘Such Dire Straits’: Hobbled Texas Hospitals Are Filling Dialysis Needs

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AUSTIN, Texas — Some hospitals, short on heat or water, urgently raced to transfer their most critically ill patients elsewhere. Other hospitals were overflowing with patients injured in the winter storm or sickened during it, boarding them in hallways. At one hospital, the pipes burst, sending water spraying through the emergency room, while at another, patients were told to clean themselves with hand sanitizer and to stop showering in a desperate bid to conserve water.

Chaotic scenes were playing out all over Texas on Thursday as hospitals faced an onslaught of problems from the brutal storm: wintry indoor temperatures, a dearth of generators, acute water shortages and a spike in emergency room visits by patients in desperate need of dialysis treatment and oxygen tanks.

“We’re hauling in water on trucks in order to flush toilets,” said Roberta L. Schwartz, an executive vice president and the chief innovation officer at Houston Methodist, which operates seven hospitals around the country’s fourth-largest city. Water, she said, was in such short supply that health workers were using bottled water for chemotherapy treatments.

“We actually had a rainstorm after the ice storm, so we collected the rainwater because we needed it,” Ms. Schwartz added.

The tumult comes at an already vexing juncture for hospitals in Texas, nearly a year into a pandemic that has stretched many to their limits. While new coronavirus cases in Texas have fallen sharply, from an average of more than 20,000 a day a month ago to less than half that in recent days, much of the state is struggling as the virus continues to spread and as vaccine distribution was slowed by this week’s storms.

The Odessa, Eagle Pass and Huntsville areas have been reporting new virus cases at some of the highest rates in the country. And state officials have warned that case numbers this week were likely to be artificially low because of reporting gaps during the storm. In Travis County, which includes Austin, officials had not provided new case data since last Friday and said they did not expect to do so again until the weekend, citing the effects of the storm on their staff.

Hospitals such as St. David’s South Austin Medical Center said they were transferring some patients to other facilities as they desperately tried to conserve resources. In a statement, David Huffstutler, the chief executive of St. David’s HealthCare, said the hospital was working to get water trucks and portable toilets as quickly as possible.

In Dallas, parts of the ceiling collapsed at the Baylor University Medical Center after a pipe burst, spraying water directly into the emergency room. Julie Smith, a spokeswoman for the hospital, said workers had made initial repairs that allowed patients to continue getting treated there.

The scenes took place in a state where health care workers have grappled with repeated crises in recent years: Hurricanes. Floods. Tropical storms. Blackouts. Pandemic surges.

Dr. Sarah Olstyn Martinez, an emergency room doctor in an Austin hospital, bluntly described the situation on Facebook: “There is no where to put anyone.”

“I don’t want to incite panic but I also want people to understand the severity of the situation in hopes that people will stay at home,” Dr. Martinez wrote, adding, “We are bunking patients 2 to a room and boarding patients in hallways.”

“I’ve never seen a city medical system in such dire straits as we are in Austin right now,” Dr. Martinez continued. “COVID surges were nothing compared to the current situation.”

In a telephone interview, Dr. Martinez said her hospital was operating with skeleton staffing. Doctors and nurses, she said, have been staying over at some hospitals, “sleeping in whatever open nook and cranny there is.”

Some of the challenges facing Texas hospitals are tied to problems cascading through the state’s beleaguered health care system since the storm and power grid crisis. An influx of dialysis patients, for instance, is placing stress on hospital emergency rooms because many dialysis centers — which require electricity, heat and large amounts of filtered water to properly provide care — are temporarily closed.

At one of Houston Methodist’s hospitals, doctors turned an old intensive care unit into a makeshift dialysis unit, transferring 42 patients out of the cramped emergency room on Wednesday. And in parts of East Texas, health care workers are growing so alarmed about patients going without dialysis treatment over the past week that they are asking local police departments to do welfare checks.

“This can be a death sentence for some of our patients,” said Kara McClure, a social worker in the Tyler area. She said dialysis clinics in Tyler, Athens and Palestine were closed because of a lack of water, and a clinic in Jacksonville closed because staff members could not reach the site. Even hospitals in the area have struggled with water shortages that could complicate dialysis treatments.

“This is a large-scale system failure, and it is overwhelming,” Ms. McClure said. “I’m worried people are going to die.”

Federal officials were pledging assistance on Thursday. Liz Sherwood-Randall, the homeland security adviser for President Biden, told reporters that the Federal Emergency Management Agency was supplying 60 generators to critical sites like hospitals and water facilities, and sending 729,000 liters of water and 50,000 cotton blankets to the state.

Still, some doctors in Texas cautioned that the situation could grow worse, noting the possibility of rising risks connected to Covid-19 as the state tries to recover from the storm. About 7,600 coronavirus patients were hospitalized statewide as of Wednesday, according to the Covid Tracking Project, down from about 14,000 at the peak in mid-January.

Though Texas avoided the worst of the pandemic last spring, the state has struggled often since then. Case numbers spiked last summer and again in the fall and early winter. The Eagle Pass, Lubbock and Laredo areas are among the country’s five metropolitan areas with the highest rates of known cases over the course of the pandemic.

About 10.6 percent of Texans had received at least one dose of a coronavirus vaccine as of Thursday and about 4.3 percent were fully vaccinated, placing the state below the national average in both metrics but not among the lowest performers.

In Laredo, on the border with Mexico, Dr. Ricardo Cigarroa, a cardiologist who has shifted to treating coronavirus patients during the pandemic, said vaccine distribution was delayed by about a week because of problems associated with the power grid failure.

The storm had brought added risks, too. Many people were finding comfort, he said, by huddling with one another to warm up. “But Covid loves that,” Dr. Cigarroa said.

David Montgomery reported from Austin, and Simon Romero from Albuquerque. Reporting was contributed by Mitch Smith from Chicago, James Dobbins from San Antonio, and Marina Trahan Martinez and Richard Webner from Austin. Sheelagh McNeill contributed research.

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