<figure>
 <img src="https://media.eaglewebservices.com/public/2021/1/1610389428307.png" alt="After missing a dialysis appointment, Keely Connolly needed emergency care at a Hutchinson, Kansas, hospital. But all beds were filled, so she was transferred to Salina — 65 miles away from her home and young daughter. Courtesy photo" />
 <figcaption>After missing a dialysis appointment, Keely Connolly needed emergency care at a Hutchinson, Kansas, hospital. But all beds were filled, so she was transferred to Salina — 65 miles away from her home and young daughter. Courtesy photo</figcaption>
 </figure>Kaiser Health NewsKeely Connolly thought she would be safe once the ambulance arrived at Hutchinson Regional Medical Center in Kansas.She
 was having difficulty breathing because she’d had to miss a kidney 
dialysis treatment a few days earlier for lack of child care. Her 
potassium was dangerously high, putting her at risk of a heart attack. 
But she trusted she would be fine once she was admitted and dialysis was
 begun.She panicked when a nurse told her that no beds were 
available and that she would have to be transferred — possibly more than
 450 miles away to Denver. She had heard a rumor about a dialysis 
patient who died waiting for a bed at a hospital in Wichita, about an 
hour down the road.“‘I don’t want to die in the ER,’” Connolly, 
32, recalled thinking. “I just wanted them to fix me, but then the woman
 came in and said, ‘There are no beds.’ I got really scared and I didn’t
 know if they had time to get me anywhere else.”When a bed was 
finally located 65 miles away in Salina, Connolly, who has kidney 
failure, was relieved but worried: How long would she be gone? Who would
 care for her young daughter? How would she get home? What would it all 
cost?Connolly was caught in a situation experts have warned about
 since the beginning of the coronavirus pandemic: Covid-19 patients are 
overwhelming hospitals, squeezing space and staff needed to treat 
emergencies like Connolly’s.While it has happened in pockets 
throughout the country since the spring, the pressure on hospitals is 
widespread now — reaching into both urban and rural communities at an 
alarming pace, even as local officials and citizens continue to <a href="https://khn.org/news/article/pandemic-backlash-jeopardizes-public-health-powers-leaders/" target="_blank">slam public health departments and pandemic guidelines</a>. Traveling nurses are hard to come by as their services are in high demand nationwide and <a href="https://khn.org/news/highly-paid-traveling-nurses-fill-staffing-shortages-during-covid-pandemic/" target="_blank">their pay has escalated beyond the reach of some smaller hospitals</a>.“This
 is the first time since I have been here that we’ve had a scenario 
where multiple hospitals, for longer periods of time, are experiencing 
some kind of shortages,” said <a href="https://www.kha-net.org/AboutKHA/KHAStaffListing/KHAStaff/" target="_blank">Cindy Samuelson</a>, a senior vice president of the Kansas Hospital Association.And
 it got worse after Connolly’s emergency in mid-November. The 14-day 
rolling average positive test rate in Reno County, where Hutchinson is 
the county seat, reached 46% on Dec. 22, though it has since come down 
to 24% as of Jan. 4, said D.J. Gering, data analyst for the <a href="https://www.renogov.org/741/COVID-19" target="_blank">Reno County Health Department</a>. The results did not include inmates from the Hutchinson Correctional Center, the local state prison.By
 Oct. 1, four covid deaths had been recorded in the county of about 
62,000. By Jan. 4, the death toll since the pandemic began had jumped to
 105. For comparison, Gering said, Reno County had 19 deaths attributed 
to pneumonia and influenza combined in all of 2019.Hospitalizations
 at the 190-licensed-bed Hutchinson Regional Medical Center increased 
800% from mid-October to mid-December then started to temper at the end 
of the month, said <a href="http://www.hutchregional.com/about-us/hrhs-administration" target="_blank">Chuck Welch</a>, vice president of Hutchinson Regional Medical System.“I
 hate to be overly optimistic until we are well past the possible 
holiday surge from Christmas and New Year’s,” he said in an email.Operating
 between 90% and 95% capacity, the hospital is providing care to 
patients with a multitude of needs and still has room to expand. The 
problem, Welch said, has been staffing.<a href="https://khn.org/news/highly-paid-traveling-nurses-fill-staffing-shortages-during-covid-pandemic/" target="_blank">Competing for traveling nurses and specialists</a>
 against larger hospitals to backfill positions open from sick or 
quarantining staffers has been challenging. When the hospital has been 
faced with increasing numbers of covid patients seeking emergency care, 
handling “normal” emergencies like Connolly’s has been much more 
difficult, Welch said.While staffers work to transfer patients as
 close to home as possible, with so many hospitals in Kansas beyond 
capacity, it has become more common than before to transfer as far away 
as Colorado and Nebraska. Such transfers require medical flights, which 
are typically not covered by insurance and can cost patients upward of 
$50,000, Welch said.“It is collateral damage,” he said. “It is 
something that has sort of been lost out of the narrative of these folks
 where everybody is relieved when we find them a bed. Everybody forgets 
about the downstream impact of the cost of those transports.”Connolly
 recovered after three days in the Salina hospital. But the question 
still looms about the costs for her emergency care. Connolly had left 
her job as a corrections officer at the prison in September because 
coronavirus cases began to spike inside. Without her employer-sponsored 
health insurance, Connolly now relies on Medicaid and Medicare Part A, 
which means she is responsible for more out-of-pocket costs for things 
like pharmaceuticals and ambulance services.Connolly worries so 
much about her finances that she’s been too scared to look at her recent
 ambulance bills. Being a single parent, living with kidney failure and 
undergoing dialysis during a pandemic are her primary concerns.As with many underlying conditions, covid-19 appears to pose an extra
 risk for people with kidney failure and patients undergoing dialysis, 
said Dr. <a href="https://www.asn-online.org/about/bio.aspx?ID=42512" target="_blank">Alan Kliger</a>, a nephrologist at Yale University and co-chair of the American Society of Nephrology’s COVID-19 Response Team.Data
 from New York and Europe early in the pandemic showed that about 1 in 5
 dialysis patients who acquired covid died, he said. However, the 
complication and mortality rates have fallen in recent months, according
 to unpublished survey data from members of the nephrology society, 
Kliger said.“It’s still a high risk,” he said.For 
Connolly, the pandemic has also complicated her three-times-a-week 
3½-hour dialysis schedule. For example, when her daughter’s kindergarten
 class was told to quarantine for 14 days after an in-class exposure to 
the virus, she had to scramble to find babysitters so she could attend 
dialysis.“I don’t want too many people to watch her because of 
covid,” Connolly said of her daughter, adding that she is lucky the 
girl’s father is supportive. But he can’t always step in, which means if
 Connolly can’t find a sitter, she may have to skip or reschedule 
dialysis.Connolly wants to get another job. But living in a 
county where so many refuse to wear masks and some elected leaders 
accuse the health department of providing false information about covid 
testing rates and statistics makes her afraid to be in public more than 
necessary.“I want to work,” she said. “I had a good job. I served
 my community. The reality of knowing how bad it is at the hospital — I 
have seen it firsthand. And now I am out and seeing people without masks
 and I am thinking, ‘If I get this and I have to go back, I may not 
leave the hospital next time.’”The reality, said Kliger, Welch 
and others, is that while the virus runs rampant, hospitals will 
struggle to keep up, which potentially endangers medical staffers and 
anyone needing hospital care — and the virus will continue to spread as 
long as people refuse to wear masks and disregard scientifically sound 
guidelines.Connolly said she would love to see more empathy for 
people who have underlying health concerns like her from those resisting
 safety measures such as masks.“Even if they think that it 
doesn’t work, what if it does? What if it could? I don’t really 
understand how wearing a mask is going to take so much out of your day, 
compared to someone who is immunocompromised and gets sick,” said 
Connolly. “Or you lose your grandma, or your parent. That’s going to 
affect your life a lot longer than wearing a mask for a little while.”

When hospitals can't handle non-COVID patients