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Yet another life-threatening COVID-19 surge concern: The domino effect of full hospitals

Full beds at regional facilities results in Moffat County residents being turned away

The Memorial Hospital in Craig is struggling to find larger hospitals to which it can transfer patients with particularly severe or specialized needs, as the COVID-19 surge fills up those facilities.
Cuyler Meade / Craig Press

The impacts of the early waves of the deadly COVID-19 pandemic last year were felt by more than just those who contracted the virus. Folks sick with other ailments received sometimes compromised care as well, due to overwhelmed care facilities.

When Memorial Hospital in Craig receives a patient suffering from a heart attack, stroke or brain injury, among other life-threatening conditions, the reality of rural medicine means that the best care is sometimes going to be found in another facility.

Usually, that means a quick trip to Grand Junction, where St. Mary’s Hospital receives Memorial patients in need of specialized intervention, the likes of which the Craig hospital can’t reasonably be equipped to handle.



“Most issues needing a higher level or specialty care we can’t provide, St. Mary’s is our first place for things,” said MRH medical director Dr. Matt Grzegozewski. “Heart attacks, urology, gastroenterology issues, things like that — severe critical care that we don’t have an intensivist here to handle. We send them there. Stroke patients usually go to Denver.”

But as the current wave of COVID-19 washes over the region, St. Mary’s — and even some facilities in Denver — can’t keep up with the demand for treatment. And as a result, doctors caring for more than just COVID patients need to look elsewhere for help.



“We saw this earlier in the pandemic as well,” Grzegozewski said. “These tertiary referral centers are often swamped because rural towns like ours from all over the place with nowhere else to go — Rangely, Vernal, the whole Western Slope — that have sick COVID patients needing to get to the hospital for specialty intensive care, they’re sent there. St. Mary’s has only so many beds, and they get to complete capacity. We’ve had patients refused that have to go elsewhere.

“It’s been a difficult time, for sure.”

Grzegozewski said that’s seriously concerning as a physician.

“It’s concerning as a person and as a doctor,” he said. “It’s concerning because you know the type of care the patient needs and you don’t have the ability to provide it. It’s a very worrisome time. We have the ability, fortunately, to stabilize patients for a certain period, but often that definitive care, that specific treatment, that’s what we can’t do.”

The emergency department doctor said it’s not for lack of desire to provide the care locally — it’s just the truth about medical care in a rural area.

“The need for the specialty training these doctors and techs and nurses provide, it fortunately doesn’t happen that the vast majority of people need this all the time,” Grzegozewski said. “So, a neurosurgeon, if he were working in Craig — this is where he worked all the time — he would only see maybe a couple of cases a week. He doesn’t work in a town like Craig because there isn’t enough volume to justify, the machinery, the equipment he uses is extremely expensive, the techs he employs, they’re expensive. It takes a lot of years of training to get people up to speed on what they’re doing. And so in a rural community it’s just not a financially or technically feasible thing to do.”

Even now, with full hospitals all around them, Memorial has found alternatives in most cases — getting patients to Salt Lake City or to Denver when they’ve had to.

But that’s going outside the tested, proven system. And the system generally works, Grzegozewski said. Typically a transfer to a larger hospital gets a patient the care they need.

But this last year and a half have been anything but typical.

“Things we rely on, lifesaving things like bypass surgery or brain surgery, if your kid has childhood cancer and needs an oncologist, all those things are at those facilities,” he said. “But what’s happening is they’re swamped and they don’t have anywhere to put those cancer patients or heart attack patients, because they’re full of intubated COVID patients.

“A number of those are patients from rural communities like ours, which tend to be more unvaccinated than elsewhere. Those are the ones, as this pandemic proceeds, the rural counties are becoming particularly affected because of lower vaccination rate.”

To a physician like Grzegozewski, that’s agonizing.

“We had a gentleman in his 20s pass away this week,” he said. “It’s something we’re seeing with patients who have just made up their mind — they are not willing to listen to anything we say about vaccines.”


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