<figure>
                        <img src="https://media.eaglewebservices.com/public/2020/11/1605212780502.jpeg" alt="Steven Stites, chief medical officer of the University of Kansas Health System" />
                        <figcaption>Steven Stites, chief medical officer of the University of Kansas Health System</figcaption>
                    </figure><h2>'... the entire Midwest is on fire.'</h2><p><b>By CRISTINA JANNEY<br></b><i>Hays Post</i></p><p>Hospitals across the state are nearing capacity due to a surge of COVID-19 patients.</p><p>"We're at a crossroads, and we have a choice to make," Steven Stites,&nbsp;University of Kansas Health System chief medical officer, said during the health system's Thursday morning press conference. "Our choice will dictate how the next months or year goes for the health of the people you care about.</p><p>"When you get health care resources that are overwhelmed, it is not just the COVID patients who suffer. It's if you have a heart attack or stroke. Where are you going to go?"</p><p>Ellis County reported 102 new COVID cases on Wednesday. Its seven-day average positive rate has hit 40 percent.&nbsp;</p><p>As of Thursday, HaysMed was treating 22 COVID patients, 21 of whom have active infections. Four patients are on ventilators. Eight Ellis County patients are hospitalized.</p><p>COVID is the No. 1 reason for admission to the health system at this time, Stites said during a press conference on Friday.</p><h2>Surgeries delayed</h2><p>At this point, the health system has not delayed any elective surgeries at the facilities in Hays or Topeka, Stites said. As of Thursday, KU Med in Kansas City started postponing some surgeries based on bed capacity, he said.</p><p>Stites said he hoped the deferred surgeries could be completed within two weeks, but this will depend on the COVID situation.</p><h2>Rural hospitals struggle to transfer patients</h2><p>Kansas City and other major hospitals, where a higher level of care available,&nbsp; have been forced to refuse transfers from smaller, rural hospitals, Stites said.</p><p>KU Med in Kansas City turned down 140 transfers in October.</p><p>"What is different from this and New York, for example, early in the crisis, is that was one city or two or three cities that spiked and the rest of the country could help them," he said.</p><p>"In this case, the entire Midwest is on fire. We are struggling to get people placed."</p><p>Rural hospitals are spending five or six hours trying to place a patient, he said, adding that critical care is time sensitive.</p><p>It is not just COVID patients who can't get transferred, he said, it's also patients who have had heart attacks and strokes.&nbsp;&nbsp;</p><p>One hospital in southeast Kansas called 11 hospitals before it could get a transfer through. Garden City has tried to transfer patients to Colorado, but their hospitals are also full.</p><h2>Some hospitals unable to staff all beds</h2><p>The Kansas City hospital has been able to provide staff for all its beds, which he said not all facilities have been able to do.</p><p>The Kansas City facility is concerned about the number of staff members who are out because they have tested positive for COVID-19. Contact tracing has revealed these staff members have contracted COVID through community spread. No staff infections have been traced to contact with COVID patients within the hospital, Stites said.</p><p>Stites said there is no other solution to the bending the curve than following the guidelines for infection control, which include wearing a mask, avoiding mass gatherings, washing your hands and staying home if you are sick.</p><h2>Asymptomatic spread likely common</h2><p>Most of the patients who are being tested are symptomatic, said Dr. Dana Hawkinson,&nbsp;medical director of infection prevention and control at KU Med. However, the ratio of asymptomatic to symptomatic carriers may be as high as one-to-one.</p><p>Studies from Korea and Iceland have indicated 40 percent to 50 percent of people infected with COVID are asymptomatic. Dr. Joseph LeMaster, public health officer for&nbsp;Johnson County Department of Health and Environment, said these people may be unaware they are spreading the illness in the community.</p><p>LeMaster said the number of infections is increasing so rapidly contact tracers are not able to keep up with contacting people who are infected.</p><h2>Officials prefer masks, social distancing to lockdowns</h2><p>The doctors said COVID is being spread in many places where people gather, including school events, parties after sports, places of worship, weddings and places where there is shared food and alcohol, especially restaurants and bar.&nbsp;</p><p>"We have to assume when we are anywhere that everyone we are around has COVID right now, so you have to protect yourself, by not doing things and distancing and masking," said Dr. Allen Greiner, medical officer for the&nbsp;Kansas City Kansas Unified Government&nbsp;Public Health Department.&nbsp;</p><p>LeMaster and Greiner&nbsp;said they did not think local governments will resort to lockdowns like the one the state saw in March and April.</p><p>They said they did support mask mandates and social distancing.</p><h2>Fallacy of herd immunity</h2><p>The doctors also talked about false assumptions about herd immunity. About 12 percent of Johnson County's population has had COVID-19. However, 70 percent to 80 percent of the population would have to immunity to consider the population to have any sort of herd immunity.</p><p>Even with common cough and cold coronaviruses, doctors know you can be reinfected within the same year, Hawkinson said. Published reports have reported infection with COVID-19 as little as 60 days after the first infection.</p><p>He said physicians don't know what might happen when someone is reinfected. That person might have milder symptoms or they may have worse.</p><p>Herd immunity will likely not be possible until a vaccine or effective treatment is widely available, Hawkinson said. Any attempt to pursue natural herd immunity would be dangerous, he said.</p><h2>At a tipping point</h2><p>LeMaster said we are a tipping point.</p><p>"The next thing that happens after where we are now is the hospitals are overwhelmed and there are people who need to go into the ICUs who are in our hospitals who are dying of COVID in the emergency room," he said.</p><p>"... or a heart attack or stroke," Stites added.</p>

Kan. hospitals reaching capacity; rural hospitals struggle to find patients beds