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Health and Medicine

Patients, Doctors Frustrated As Covid Delays Elective Treatments In Oregon

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Erik Neumann/JPR
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Charlie Callagan developed multiple myeloma from exposure to Agent Orange but was unable to receive a planned bone marrow transplant because of overburdened hospitals during the pandemic.

It’s a bad time to get sick in Oregon. That’s the message from some doctors, as hospitals full of COVID-19 patients mean other medical conditions are going untreated.

Charlie Callagan sits outside on his deck in the smoky summer air in the small Rogue Valley town of Merlin in Southern Oregon. Though he looks perfectly healthy, 72-year-old Callagan has a condition called multiple myeloma — a blood cancer of the bone marrow.

“It affects the immune system; it affects the bones,” he said. “I had a PET scan that described my bones as looking ‘kind of swiss cheese-like.’”

Callagan is a retired National Parks ranger. Fifty years ago, he served in Vietnam. This spring doctors identified his cancer, which they assume came from exposure to Agent Orange, the defoliant used during the war.

In recent years Callagan has consulted maps showing hot spots where Agent Orange was sprayed in Vietnam.

“It turns out the airbase I was in was surrounded,” he said. “They sprayed all over.”

A few weeks ago, Callagan was driving to Oregon Health and Science University in Portland for a bone marrow transplant. On the way, he got a call from his doctor.

“They’re like, ‘We were told this morning that we have to cancel the surgeries we had planned,’” he said.

Callagan’s surgery was canceled because the hospital was full. That’s the story at many hospitals in Oregon where they’ve been flooded with COVID-19 patients.

Such delays can have consequences, says Dr. Mujahid Rizvi, who leads the oncology clinic handling Callagan’s care.

“With cancer treatment, sometimes there’s a window of opportunity where you can go in and potentially cure the patient,” Rizvi said. “If you wait too long, the cancer can spread. And that can affect prognosis and can make a potentially curable disease incurable.”

Such high stakes for delaying treatment at hospitals right now doesn’t end with cancer care.

“I’ve seen patients get ready to have their open-heart surgery that day," said Dr. Kent Dauterman, a cardiologist and co-director of the regional cardiac center in Medford. "I’ve seen patients have a brain tumor with visual changes, or someone with lung cancer and their procedures are canceled that day and they have to come back another day. You always hope they come back.”

In early September, Dauterman said the local hospital had 28 patients who were waiting for open-heart surgery, 24 who needed pacemakers, and 22 who were awaiting lung surgeries. He says during normal times, there wouldn’t be any wait.

“I don’t want to be dramatic, it’s just there’s plenty of other things killing Oregonians before this,” Dauterman said.

Right now, the vast majority of patients in Oregon hospitals with COVID are unvaccinated, about five times as many as those who got the vaccine, according to the Oregon Health Authority. COVID infections are starting to decline from the peak of the COVID Delta wave. But even in non-pandemic times, there’s not a lot of extra room in Oregon’s healthcare system.

“If you look at the number of hospital beds per capita, Oregon has 1.7 hospital beds per thousand population. That’s the lowest in the country,” said Becky Hultberg, CEO of the Oregon Association of Hospitals and Health Systems.

A new study focused on curtailing non-emergency procedures looked back at how Veterans Health Administration hospitals did during the first pandemic wave. It found that the VA health system was able to reduce elective treatments by 91%.

It showed that stopping elective procedures was an effective tool to free up ICU beds to care for COVID patients. But the study didn’t look at the consequences for those patients who had to wait.

“We clearly, even in hindsight, made the right decision of curtailing elective surgery,” said Dr. Brajesh Lal, a professor of surgery at the University of Maryland School of Medicine and the study’s lead author. “But we as a society have not really emphatically asked the question ‘at what price in the long term?’”

He says they won’t know that without more long-term research.

At his home in Southern Oregon, Charlie Callagan says he doesn’t consider his bone-marrow transplant as urgent as what some people are facing right now.

“There’s so many other people who are being affected,” he said. “People are dying waiting for a hospital bed. That just angers me. It’s hard to stay quiet now.”

He says it’s hard to be sympathetic for the COVID patients filling up hospitals when a simple vaccine could have prevented most of it.