North Texas has over 7.5 million people and, typically, about 5,000 hospital beds are free at a time.
Can our hospitals handle the coming surge in coronavirus patients?
In Dallas-Fort Worth, health officials are preparing for the worst -- while hoping people heed social distancing advice and that test kits coming soon will help health officials slow the spread of the virus.
D-FW has about 90 hospitals with a total of about 14,000 beds, and about two-thirds are usually full, according to data filed with the state in 2017. That inventory included 1,750 beds in intensive care units, said analyst Allan Baumgarten, who publishes the Texas Health Market Review.
That’s a lot of capacity, one expert said, and there are many ways to boost the total further. But if too many people require hospitalization, any health system can become overwhelmed.
In New York, Gov. Andrew Cuomo warned that the state is far short of having adequate space for COVID-19 patients, and he requested federal support to put up temporary facilities.
“You will have people on gurneys in hallways,” Cuomo said Monday.
Up to 21 million people nationwide could require hospitalization, he wrote in an open letter to President Donald Trump, adding: “This would crush the nation’s medical system.”
No such warnings have been coming from D-FW, at least so far.
“At the current time, we feel like we have the capacity” to deal with the virus, said Stephen Love, CEO of the Dallas-Fort Worth Hospital Council, whose members operate the region’s hospitals. “And if the surge should exceed where we’d like it to be, we have contingency planning to help accommodate that.”
He declined to detail the contingency plans. Would hospital executives funnel COVID-19 patients to a designated care center, as they’ve done in other states? Are there discussions to share ventilators, masks and other crucial supplies?
“I’ll assure you, as time progresses, we’ll be totally forthcoming with the public, no question about it,” said Love, who’s serving as spokesman for many of the largest hospital systems.
At a Wednesday press conference in Arlington, Texas Gov. Greg Abbott said he had spoken with hospital CEOs from around the state, including in D-FW, to discuss hospital capacity.
“We left there with some topline ideas that we are going to follow up on,” he said.
Abbott said he was “impressed” with the number of beds, and said the state was also tallying the number of standalone empty motels and hotels. They could be used to house infected people who need to be isolated but are not sick enough to be hospitalized.
“The conclusion was we have a plentiful supply to address the needs that we believe that we will be facing in Texas,” Abbott said.
A key variable is how quickly the disease spreads. Right now it’s not possible to calculate how many people might have to be hospitalized at the same time in our area, said Robert Haley, an epidemiologist with UT Southwestern Medical Center who spoke to The Dallas Morning News on behalf of the Dallas County Medical Society.
To know that, health officials would need to know how many people are infected now, and how fast the virus is spreading.
“We’re still running somewhat blind now because of the lack of testing so far,” Haley said. “No calculations are possible right now because there’s not enough information to make them.”
Testing capacity is ramping up, and social distancing will be key to keeping area hospitals running smoothly.
“Social distancing is standing between us and catastrophe,” Haley said. “People need to be glad to do it. It’s their patriotic duty.”
Researchers across the country are developing computer programs to help hospitals and local government leaders predict the impact of the virus on hospital capacity. The programs take into account the number of hospitalized patients and the rate of spread in a region, among other factors.
When people keep their distance from each other, the infection rate slows in a community. Infections will still continue but over a longer period of time, not all at once. That eases the burden on hospitals.
“The longer we string it out, the more likely it will be manageable,” Haley said.
Hospitals have begun preparations for a potential crush of new virus patients. UT Southwestern is funneling people to a tent outside its emergency department to check for fever and respiratory problems. Parkland Memorial Hospital has a mobile coronavirus testing lab in its parking lot.
UT Southwestern, Texas Health Resources and Baylor Scott & White Health are postponing elective surgery so they’ll have more resources to deal with urgent cases.
“That could increase bed capacity by up to 50%,” said Britt Berrett, a former president of Texas Health Presbyterian Hospital Dallas and former CEO of Medical City in Dallas.
If necessary, some intensive care patients could be moved to other beds, he said. Outpatient surgery centers and ambulatory facilities could also house virus patients in a crisis.
Last weekend, executives from Medical City hospitals had a nationwide call to discuss ways to use their facilities to respond to the epidemic, he said.
“There’s a lotta capacity here,” said Berrett, who teaches health care management at the University of Texas at Dallas.
At Parkland, there are contingency plans to double capacity in many rooms if necessary -- and if the hospital could get permission to do so, said Dr. Fred Cerise, CEO of Parkland Health & Hospital System.
“We are pursuing agreements on equipment, including beds, now in order to increase capacity should we need to,” Cerise said in an email.
He said Parkland would create more capacity by canceling elective surgeries and switching clinic visits to telemedicine. Virtual visits, which use smartphones and computers, have become a crucial way of responding to rising demand from the coronavirus.
This week, Medical City hospitals have been offering free virtual visits for patients worried about COVID-19.
Parkland is adequately staffed now, Cerise said, but he expects staffing shortages the longer this goes on, especially if schools remain closed.
“We are pursuing options for child care now in order to mitigate the impact of that on staff availability,” Cerise wrote.
A shortage of nurses and certain specialists, such as respiratory therapists, would be a greater threat than running out of beds, Berrett said. If he were still running a hospital, he’d be recruiting nurses who left the field and students who are nearing graduation.
“They can be helpful as extenders to supplement the staff,” he said.
If demand surges too fast, officials could ask for federal help to build facilities or shore up other shortcomings, said Love of the hospital council. Hospital executives have mapped out several steps if the number of confirmed cases spikes.
“Absolutely, we have contingencies,” Love said. “I’m not gonna get into those details. But trust me -- they’re coordinated with the public health departments, they’re coordinated with the emergency management.”
Staff writer Gromer Jeffers contributed to this report.
