While UnityPoint — Marshalltown has not reached full capacity for patients, it has gotten very close in recent weeks.

Dr. Lance Van Gundy with the hospital said UnityPoint — Marshalltown can handle 25 to 26 non-intensive care unit (ICU) patients. However, the Marshalltown facility no longer has an ICU.

“Many of the larger hospitals to which we refer have been at capacity from a day-to-day basis,” he said. “If there was ever a time for a casual reader to take notice — folks, this it! It should not take the death of a family member to get you to take this disease seriously, but some days it feels like this is the case.”

The rising COVID-19 numbers — Marshall County has a positivity rate of 20 percent during the last two weeks — is something UnityPoint is doing its best to manage. However, the hospital only has nine ventilators that can be used and a handful of medical providers who know how to manage ventilators. The medication necessary to sedate patients for ventilator use can run out and respiratory therapists could easily experience burn-out.

Ventilated patients are intubated for seven to 10 days, and Van Gundy said recent data shows an average of 12 days for intubation.

“That means 12 days of 24-hour-a-day care, drips of sedating medication, IV nutrition, fluids, prevention of bed sores,” he said. “This takes a coordinated army of rotating staff and care providers — all for that one person.”

People who are intubated have a higher death rate from COVID, so Van Gundy said it is used as a last resort. Intubation also places medical personnel at high risk of contamination.

Van Gundy said in his more than 25 years of practicing medicine, he has never seen anything like this pandemic.

“Please trust though, this disease is severe, real and is stressing the limits of the health care system,” he said.

In addition to the COVID-19 pandemic, there are other illnesses medical facilities are dealing with. Marshall County Public Health Nurse Pat Thompson previously mentioned an increase in the number of shingles cases. While Van Gundy has not seen the increase, shingles is caused by mental and physical stress.

“Certainly, the pandemic and the national conversation around our election have raised the stress levels,” he said. “Also, other viruses — including influenza and COVID — can stress the immune system and allow the shingles virus to awaken in individuals who previously had chicken pox.”

With the rise of shingles, COVID and influenza season right around the corner, Van Gundy is concerned.

“We are already at peak capacity to manage hospitalized patients and some days struggle to find appropriate care for those most in need of ICU level care,” he said. “Everyone needs to do their part to limit the spread of disease by following the rules that, frankly any third grader can recite – wash your hands, wear a mask, practice social distancing.”

The stress of the pandemic has caused a host of other increasing problems UnityPoint – Marshalltown is dealing with. Domestic violence is on the rise. Van Gundy said there is evidence that, in an effort to stay at home and stay safe some patients do not seek emergency care for heart attack and stroke symptoms in as timely a fashion as they used to and that affects progression and survival.

Drug abuse and alcoholism are on the rise, all reflections of the social stress the world is under. Finally, he said the test for sexually transmitted diseases of chlamydia and gonorrhea are limited because medical providers are using so many of the testing supplies – the special q-tip swabs and reagents used for COVID-19.

“But to my knowledge we have no active local outbreaks,” Van Gundy said.

He urges everyone to be better than the average third grader — to wear a mask, wash hands and socially distance.

“This disease is, for the love of God, not a political animal,” Van Gundy said. “Wearing a mask is not an infringement on your rights. It’s an expression of honest intelligence and a willingness to realize, ‘Hey, I could have this virus and not know it. I think I am going to wear a mask so that I don’t give it to someone else or bring it home and contaminate my family.'”

He said wearing a mask shows compassion and empathy for other people, and that kind of concern is the only way the pandemic will be controlled and prevent it from escalating.

“I love and respect the people I encounter every day. So, I wear a mask,” Van Gundy said. “When you choose not to, that reveals something about your character, not your politics.”

Van Gundy said people should also get their flu shots. He said the system is already stressed with COVID, and the last thing the hospital needs is a wave of seasonal flu bringing in patients with identical symptoms.

Another tip Van Gundy provided is to be mindful of stress and the stress of everyone around. He said people need to own it, reach out and do something to make someone else smile every day.

The last piece of advice Van Gundy had was to unplug from social media in all forms. Track total screen time and keep it less than two hours each day, then turn it off at least once a day and at least 30 minutes before sleep. “Finally, please watch ‘The Social Dilemma’ on Netflix to understand how damaging social media is, how it has damaged most of us in this country and separated us,” Van Gundy said. “We are stronger together, not divided and as humans we are social creatures. We are all under stress this year like never before. Recognizing ways to identify this and then understanding, listening and helping each other will go a long way to the return of health and happiness.”

He asked everyone to participate.

“Do your part and flatten the curve and we will get to the other side of this virus,” Van Gundy said.

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Contact Lana Bradstream

at 641-753-6611 or

bradstream@timesrepublican.com.