If you live in one of the rural communities tucked into the forested hillsides along the Oregon-California border and need serious medical care, you'll probably wind up at Asante Rogue Regional Medical Center. It serves about nine counties on either side of the border.
It is one of three hospitals Asante owns in the region. All three ICUs are 100% full of covid patients, according to staff members.
"We've had two deaths today. So, it's a very grim, difficult time," Dr. Michael Blumhardt, medical director of the hospital’s intensive care unit, said on a recent Tuesday in August. “The delta virus is passing through the region like a buzzsaw."
Unlike earlier covid waves, he said, patients are in their 20s, 30s, 40s and 50s.
"We're seeing clusters of families being admitted. We had a father and an adult daughter admitted to the intensive care unit and he passed away. Right before, I had to put the daughter on life support," he said.
Overall, vaccination rates in many states look pretty good. Oregon and California both have vaccination rates above the national average. But zoom in on any state, and you'll see a checkerboard effect with huge differences among counties. In Oregon, around big-city Portland, two-thirds of all residents are fully vaccinated. But rural counties aren't even close to that. Jackson County, on the California border, has the largest number of unvaccinated individuals in Oregon. That's pushing hospitals to their limits.
Blumhardt blames the current surge on the delta variant, but also a widespread rejection of the vaccine.
"This is far more severe for this region than the prior covid waves," he said.
Inside the Asante ICU, Chelsea Orr, a registered nurse, closely monitors patients, "just trying to keep people alive," she said. "We're taking care of a lot of ventilated patients here that are super sick."
What feels different about this stage of the pandemic, she said, is the incredible loss of life: “We're working harder than we've ever worked before and still losing."
Down the hallway, Justin McCoy waited outside another patient’s isolation room. "I've been an ICU nurse for 10 years. I've never seen anything like this," McCoy said. "It's really terrible seeing these patients who can't breathe. That is a very difficult thing to watch. It's really terrifying for them, and it's really difficult for us to see day in and day out."
Blumhardt said the vast majority of their covid patients are unvaccinated.
"We admit nine unvaccinated to every one vaccinated individual. So clearly the vaccine is protecting against hospital admission," he said.
Jackson County has been seeing record numbers of new covid infections. Within weeks, many of those people may need hospital care — and a new forecast from Oregon Health & Science University predicts that by Labor Day the state will face a shortfall of 400 to 500 staffed hospital beds.
Blumhardt said smaller hospitals in Oregon are trying to transfer their sickest patients to Asante, but so far they've had to decline around 200 people because of lack of space.
Even though Asante has already postponed some surgeries, staffers are simply worn out, said emergency room physician Dr. Courtney Wilson.
"I think people are frustrated," Wilson said. "It feels discouraging that we have had a vaccine available for a really long time in this community and we have a really low vaccination rate here."
Oregon Democratic Gov. Kate Brown recently sent National Guard troops to overwhelmed counties, to help with nonmedical tasks, including about 150 soldiers to southern Oregon. Medical leaders at Asante and another local hospital system, Providence, have asked for the state to set up a 300-bed field hospital.
"I don't know how we're going to get everybody taken care of. That's the bottom line. We're all hands on deck at every level of the organization," Blumhardt said.
Residents of Jackson County are starting to respond to the crisis. The rate of new vaccinations here has grown to about twice that of the Portland area. But thousands of people still need to be vaccinated to catch up.
This story is part of a partnership that includes Jefferson Public Radio, NPR and KHN.
This article was reprinted from khn.org with permission from the Henry J. Kaiser Family Foundation. Kaiser Health News, an editorially independent news service, is a program of the Kaiser Family Foundation, a nonpartisan health care policy research organization unaffiliated with Kaiser Permanente.