There’s now a waiting line in Nashville for the highest level of COVID care. And that line includes people from around the Southeast as the Delta variant is sending more unvaccinated people to the hospital.

Extracorporeal Membrane Oxygenation, or ECMO, machines are the last line of defense for many COVID patients. If a ventilator and oxygen aren’t enough, patients’ blood can be routed through a system that basically does the work of the lungs and heart by oxygenating their blood.

It takes a large team of doctors and nurses to monitor each patient on ECMO, so only major medical centers have them. And the three in Nashville — Vanderbilt, Ascension Saint Thomas and TriStar — are filled, says Dr. Aaron Milstone at Williamson Medical Center.

“That means the 48-year-old that I have under my care, who has been waiting for three days to get an ECMO circuit, cannot get ECMO,” says the pulmonary specialist, who’s working with dozens of COVID patients currently.

Late Thursday, Milstone got word a patient on ECMO died, so he tried to transfer his patient to the downtown hospital. But by the time she was cleared, another COVID patient at the medical center had taken the bed, he says. And a patient from Georgia was next in line.

“So when you talk about rationing care, we are already there,” Milstone says.

‘No beds’

Vanderbilt released a statement Friday declaring itself “completely full.” That includes its adult hospital and the emergency department. Transfer requests are largely being declined at the facility, which is often seen as the last hope for the region’s sickest patients.

Only the most urgent transfer requests are being granted.

“Those transfers are being placed in hospitals despite capacity and staffing challenges,” VUMC says in its statement Friday. “This is a significant stressor to our health care staff and providers. Patients we are treating for COVID are all ages, with some in their early- to mid-20s being very sick.”

The chief medical officer of Sumner Regional Medical Center in Gallatin took to social media Thursday night to say that hospitals throughout Middle Tennessee are at capacity, and that the Delta variant has “burned through us with a ferocity that’s hard to describe.”

“As an ER doc and a healthcare administrator, this past week has been one of the most exhausting and disheartening of my career,” Dr. Geoff Lifferth wrote.

To the west in Memphis, which experienced the state’s first confirmed Delta variant cases, Methodist Le Bonheur Healthcare has asked the federal government to help in recruiting doctors and nurses. And Dr. Shailesh Patel, chief medical officer of the system’s Olive Branch hospital, says increasing the region’s low vaccination rate is the only real solution.

Since June 1, 96% of the COVID deaths at Methodist Le Bonheur have been unvaccinated, he says.

“If we do not take action now, we’re going to be in a lot of trouble,” Patel says. “We’re not going to have the ability to care for people.”