EDINBURG — Hospitals are having difficulty discharging COVID-19 patients due to a shortage in oxygen concentrators, preventing hospitals from freeing up beds for incoming patients.
Health officials at Doctors Hospital at Renaissance Health System said in Edinburg that while their hospital has plenty of oxygen, there’s a struggle to find oxygen concentrators which are a more convenient way for patients to receive oxygen at home.
“One of the things that we have experienced is oxygen concentrators that are in high demand and short supply,” said Maritza Padilla, assistant chief nursing officer at DHR Health.
“Patients would likely benefit from an oxygen concentrator in a home setting because this is something you plug in, it can continue running, giving you 5 liters of oxygen without you ever having to refill this,” Padilla said. “It’s a machine that is constant and helps the patients, it’s mobile so if they’re in the home, they can walk around the room with it without an issue.”
She added that they can be expensive and they can’t get them for the Rio Grande Valley fast enough through companies that provide durable medical equipment (DME companies).
If no other options are available, patients can receive oxygen through tanks or cylinders, which the hospital has available, but concentrators are more “optimal and convenient” for home use, according to Dr. Robert Martinez, the chief medical officer for DHR Health.
“Cylinders are the gold standard; if you need oxygen, that’s what you’re going to get,” Martinez said. “But like anything else, there’s a more convenient option that’s light, easier, you plug in and it’s just more convenient.
“I think that’s been a big misconception, the inside of the hospital is not short of oxygen. The home — that’s where our challenge has been.”
This has led to complications getting people home, said Dr. R. Armour Forse, the chief academic officer and bariatric surgeon with DHR Health.
“Us moving patients through so we can empty beds so the next patient can come in — that is one of our problems,” Forse said.
Martinez added that in order to be safely discharged, patients must only need a few liters of oxygen, typically 2 or 3, but that oxygen also has to be available to them.
“The oxygen has to be waiting for them,” Martinez said. “The family has to be trained on the oxygen, they have to go with them or be there when they get there, and it’s just another thing that they have to have to be able to go.”
During a trip to Weslaco on Tuesday, Gov. Greg Abbott told Hidalgo County Judge Richard F. Cortez that the county will be sent oxygen concentrators, additional beds and IV pumps as soon as Wednesday.
It’s unclear, though, how many will be sent or whether the additional supply would be enough to cover the need.
“There’s never been such a situation where so many oxygen patients are being dismissed at one time,” said Art Gonzalez, a respiratory therapist who owns Arts Medical Equipment, a DME company with locations in Pharr and Rio Grande City. “Usually oxygen is required for patients with emphysema but now with this COVID-19, seems like there’s a demand because of their lung condition.”
At this point, his company is even getting calls for oxygen for patients in San Antonio and Mexico.
People are also trying to purchase oxygen concentrators without the state-required prescription.
“They’re in so high a demand that even the companies that we’re ordering equipment from, they’re on back order,” Gonzalez said. “I have 40 concentrators on order and they haven’t been shipped out yet.”
Concentrators are also particularly expensive without insurance, running between $800 to $1,200 depending on the liter flow, according to Gonzalez.
A 1- to 5-liter concentrator will cost about $850 while a 10-liter concentrator is about $1,200 or more, depending on the vendor.
That high cost is another possible impediment to obtaining them for patients hospitalized with COVID-19, according to Veronica Silva, nursing director of DHR’s Special Infectious Disease Unit-2.
“Our case managers and social workers work diligently with the nursing team and the physicians to make sure that when we do discharge a patient home, it’s a safe discharge,” Silva said. “There are times that our patients don’t have the means to get oxygen, whether they don’t have insurance, whatever the case may be.”
In response, she said the hospital developed a type of charity through which they donate the needed oxygen to patients.
“Unfortunately, the disease — it hits the individual’s lungs and what is required is oxygen so a discharge with oxygen is a very common order, but not everyone has the means to purchase oxygen upon discharge,” Silva said. “We don’t want to delay, they want to go home, their family wants them home but we want to make sure it’s safe. … We have developed that so that we can have that afforded to them, to be able to discharge them home with oxygen.”
“I think it’s on a case by case (basis),” Silva added, “but we have done it and we will continue to do it for as long as our community needs.”
Editor’s note: This article has been updated to reflect the titles of health officials with DHR Health System.