For the second day in a row, Texas has posted a record-breaking number of COVID-19 patients in hospitals. North Texas hospitals are also reporting a shrinking supply of intensive care beds needed for the most critical patients.
“Our situation is dire and at a tipping point,” said Dr. Joseph Chang, chief medical officer of Dallas County’s Parkland Health and Hospital System. “I don’t use those terms lightly.”
What’s more worrisome than a dearth of space, officials say, is staff shortages, especially of intensive care nurses.
Here are answers to some frequently asked questions about hospital capacity in North Texas.
How are hospital beds defined and counted?
The number of beds is defined by whether there is sufficient staff to care for a patient. Every day, the state publicly reports data that is tracked in part by the North Central Texas Trauma Regional Advisory Council, a quasi-government agency that helps coordinate hospital and other trauma services across multiple jurisdictions. Beds are categorized for adults and children.
“Beds that are sitting in closets or in empty rooms that lack clinical staff to support patients are not reported,” Rick Antonisse, the council’s executive director, said in an email.
Can North Texas run out of hospital beds?
It’s unlikely Dallas-area hospitals will run out of physical beds, experts say. North Texas has an abundance of resources that smaller regions, including El Paso, don’t. But having enough staff to care for patients is becoming more problematic.
“You can always create more beds and ventilators, but you can’t create more doctors and nurses with ICU experience,” Dallas County Judge Clay Jenkins said in a recent interview.
Parkland, which has about 2,000 medical staff members, and other hospitals rely on traveling nurses and on the state to send in more personnel, particularly specialists such as ICU nurses and respiratory therapists. The National Guard is another option. But Parkland’s Chang said the hospital probably would not seek its support, suggesting that the Guard is better equipped to help smaller hospitals.
If the hospital begins to run low on nurses and doctors, he said, officials will have to discuss “alternative levels of care,” which would probably mean fewer patient checks by nurses.
Why does the city of Dallas regularly report more hospital beds than the county or state?
The city and county of Dallas publish their own hospital census reports each day — often with different numbers. The county, which covers a larger geographic area, often shows fewer available ICU beds.
Officials are aware of the differences but have not isolated why they vary. One theory is that the two entities have different definitions of hospital beds. Another, the city officials suggest that their count is more accurate, with nearly 100% participation from hospitals in Dallas’ limits. Antonisse said the regional advisory council typically sees 80% to 95% participation. He said the health care facilities most likely to underreport are rehabilitation, surgical and psychiatric hospitals, which generally don’t have ICU beds.
Will there be a makeshift hospital at the Kay Bailey Hutchison Convention Center?
It’s extremely unlikely that Dallas or the county will seek to open a makeshift hospital. Officials say the model has proven ineffective.
What other steps may local or state governments take to help relieve some pressure from hospitals?
Local jurisdictions can submit requests to the state if they do not have the resources they need to treat COVID-19 patients. They can request anything from more nurses to mobile morgues.
More than 1,500 medical staffers have been sent to North Texas to help support hospitals, said Lara M. Anton, a spokeswoman for the Texas Department of State Health Services. And the state recently sent two infusion teams to the Dallas area to administer therapeutics at nursing homes.
How long do COVID-19 patients stay in the hospital?
There have been many medical advances in treating COVID patients. However, patients in Dallas County are staying, on average, almost as long as they did during the early days of the pandemic.
At Parkland, the average noncritical patient stays eight days, while the average intensive care patient stays about a month.
The average is similar across North Texas. Compared with March data, as of Dec. 1 the average hospital day decreased by only 12 hours, according to the Dallas-Fort Worth Hospital Council. However, with a rush of new patients, the average may go up.
I’m having a medical emergency, but it’s not COVID. Should I still go to the ER?
Yes. Health officials have emphasized that while hospitals are stretched thin, they will care for anyone with a health crisis, such as a heart attack or stroke.
CORRECTION, 9 p.m. Dec. 29, 2020: An earlier version of this article incorrectly reported that Dallas County does not report pediatric ICU hospital beds in its daily count, but it does.
