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Our Lady of the Lake Regional Medical Center.

Despite welcome news that the omicron variant of the coronavirus is sending fewer infected people to the hospital during Louisiana’s fifth surge, the state’s healthcare system is facing familiar frustrations: drug shortages, overwhelmed emergency departments and record rates of illness among employees.

At the same time, the highly infectious yet less virulent variant is changing how hospitals cohort patients and is increasing the number of so-called “incidental” COVID cases — the number of people hospitalized for something else who also test positive for COVID.

In Baton Rouge, hospitals are taking different approaches to where COVID patients should be treated. 

Franciscan Missionaries of Our Lady Health System, which operates Our Lady of the Lake in Baton Rouge, no longer uses COVID wards, instead placing coronavirus patients in single-person rooms in the wing of the hospital most suited to their medical condition. 

“If the most appropriate care team for a COVID patient is on a neuro unit because the patient also has a neurologic disease, then we want the patient to get the care from the team that has the expertise for them,” said Dr. Catherine O’Neal, The Lake's chief medical officer and an infectious disease expert.

The Lake moved away from COVID wards during the summer prior to the delta surge. The wards returned as hospitals became inundated with sick patients, but the wards are not being used again for the current wave, O’Neal said.

The practice of isolating COVID patients from the rest of the hospital population began with the start of the pandemic when there was little understanding around how the virus spread and elective procedures were halted to keep hospitals empty.

As doctors began to better understand the virus's transmission and realized it could cause a host of medical issues beyond just respiratory problems, the decision was made to move away from COVID wards in the name of better patient care, O’Neal said. 

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“We don’t see a whole lot of in-hospital spread,” O’Neal said. “If you wear your PPE (personal protective equipment) and you keep that patient in a single-patient room and you have a high rate of vaccination amongst the people who are taking care of them, we just don’t see the harm that we feared at the beginning.” 

On the other hand, Baton Rouge General still keeps COVID-positive patients on a floor separate from the rest of the hospital's population, spokeswoman Katie Johnston said.

Dr. Joe Kanter, the state's chief health officer, classifies most COVID patients into three categories: Those who clearly are there because of a COVID infection; those who are incidental, who come in for another reason, such as a car accident, and just happen to test positive; and those who are more difficult to put into one bucket or the other.

“Most hospitals will tell you somewhere in the neighborhood of 30%, maybe 35% of patients that are truly incidental,” Kanter said. “There’s also this middle ground of patients that are harder to categorize.”

The middle ground includes, for example, patients with severe lung issues, for whom a COVID diagnosis is likely to worsen their condition.

Dr. Robert Hart, chief medical officer at Ochsner Health, said that at some hospitals, that has meant asymptomatic or mild cases might be grouped with non-COVID patients — a change from the previous practice of placing COVID patients in their own units.

That is partly due to a shortage in staff — Ochsner currently has 1,400 workers out due to COVID — and partly due to a change in how hospitals are learning to live with the virus, especially because the more transmissible omicron variant does not cause as much severe illness or death, Hart said.

“If you go back and follow the history of viruses, that is a progression that many of them take — they become more transmissible, less deadly,” Hart said. “This is just another step in that progression.”


Emily Emily Woodruff at ewoodruff@theadvocate.com.