FARGO — Sanford Health’s projections for the delta-driven surge of the coronavirus suggest the building wave could place area hospitals under strains similar to those that overwhelmed medical centers in states like Louisiana and Florida.

Recently, Sanford’s Fargo hospitals have been operating at or near capacity, with a comparatively small COVID-19 inpatient population hovering between the upper teens and lower 20s over the past two weeks.

At the peak last Nov. 9-10, Sanford treated 116 hospital patients with COVID-19, a level five or six times higher than current admissions. As the next surge looms, hospitals are brimming with patients with other illnesses, including some who have delayed treatment.

“If we see a surge, we could very well look like Louisiana or Florida,” Dr. Doug Griffin, Sanford’s vice president and chief medical officer in Fargo, said Wednesday, Aug. 25. “It might mean some people might have to wait. It’s going to tax resources.”

Some hospitals in southern states including Louisiana and Florida, where the delta variant has produced huge spikes in COVID-19 cases requiring hospitalization, some hospitals ran out of capacity and had to transport patients.

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During the COVID-19 surge last fall, Sanford’s hospitals had ample available beds because people were avoiding hospitals and delaying care.

“It looks a bit different this time,” Griffin said. “We’re very, very busy.

“We could reach numbers of hospitalizations that would be very close to what we had last fall, which is very taxing.”

As of Tuesday, Aug. 24, the most recent figures available, Sanford, Essentia and the VA Medical Center in Fargo combined had 25 staffed beds available, including 14 intensive care unit beds.

COVID-19 infections continue to rise rapidly in North Dakota. On Wednesday, the state reported 364 new cases and 1,843 active cases — more than four times the 449 active cases reported on Aug. 1.

Sanford’s surge capacity last year was met with help from traveling nurses, who now are harder and more expensive to hire, Griffin said. Hospitals around North Dakota are paying between $175 to $200 per hour to firms that provide traveling nurses.

Elsewhere in the country, some hospitals have discussed turning away unvaccinated patients who have COVID-19 to make room for other patients requiring scarce hospital beds.

“I can’t envision that we would do that,” Griffin said. “We would not send them away.”

Hospitals treat people all the time with health conditions caused or exacerbated by poor decisions, but they counsel and treat those patients, he said.

Still, Griffin is concerned that Sanford might have to transport some patients. During the wave last fall, Sanford accepted transport patients from elsewhere in North Dakota and Minnesota.

Also, a COVID-driven surge in admissions could mean some patients will have to wait longer in the emergency department, and other patients will have to delay elective procedures.

“That is a risk for other patients,” Griffin said. “We don’t like that, but that’s kind of what could happen.”

Triage, where patients are screened and those with the most urgent needs are treated first, happens routinely in hospital emergency departments.

“That’s not a new concept,” Griffin said.

Hospital staffing remains a challenge, from housekeeping to food services to nursing and other direct care roles, he said.

Doctors, nurses and other caregivers are frustrated that more people haven’t gotten vaccinated, allowing the delta variant of the coronavirus to spread rapidly and placing a strain on hospitals.

“It is frustrating,” Griffin said. “We’re concerned as an organization. We did get a bit of a reprieve,” allowing a period of relative normalcy before the delta variant emerged. “I think the hard part about it is we kind of know what to expect. That does give a bit of apprehension to caregivers.”

Because safe and effective vaccines have been widely available for months and masking and other mitigation steps are known, “There’s a sense that a large amount of this could have been prevented,” he said.

Some caregivers have retired early, become traveling nurses or made other career switches. But mainly, Griffin said, caregivers are staying in their roles, despite the challenges of a prolonged pandemic. Sanford doesn’t expect a “mass exodus.”

“We’ve been doing all we can to retain our folks,” he said. “We’re concerned about morale.”