The Journal Gazette
Friday, March 27, 2020 1:00 am

US hospitals rush to find ICU beds

Associated Press

SEATTLE – With her due date fast approaching, Kelly McCarty packed a bag with nursing tops, a robe, slippers and granola bars. Last week's ultrasound, she said, showed “this baby is head down and ready to go.”

But the new coronavirus has thrown her a curveball, bouncing her and about 140 other expectant moms from their first-choice hospital to another 30 minutes away. The birth unit at the Edmonds, Washington, hospital is needed for COVID-19.

With capacity stretched thin, U.S. hospitals are rushing to find beds for a coming flood of patients, opening older closed hospitals, turning single rooms into doubles and re-purposing other medical buildings.

Louisiana is making deals with hotels to provide additional hospital beds and has converted three state parks into isolation sites for patients who can't go home. New Orleans was gearing up for a possible overflow at hospitals, with plans to treat as many as 3,000 patients at the city's convention center.

Illinois is reopening a 314-bed suburban Chicago hospital that closed in September. In Seattle, Harborview Medical Center is turning a homeless shelter into a 45-bed coronavirus recovery center.

In New York, the city's convention center is being turned into a temporary hospital. At Mount Sinai Morningside hospital, heart surgeons, cardiologists and cardiovascular nurses now care for coronavirus patients in a converted cardiac unit. Floating hospitals from the U.S. Navy are heading to Los Angeles and, eventually, New York. Military mobile hospitals are promised to Washington state. Arizona officials are seeing whether closed hospitals could be reopened.

Simple math is spurring the preparation. With total U.S. cases doubling every three days, empty intensive care unit beds, needed by an estimated 5% of the sick, will rapidly fill.

U.S. hospitals reported operating 74,000 ICU beds in 2018, with 64% filled by patients on a typical day. But available ICU beds are not evenly distributed, according to an Associated Press analysis of federal data on hospitals that provided a cost report to Medicare in fiscal year 2018.

The AP found more than 7 million people age 60 and older – those most at risk of severe COVID-19 illness – live in counties without ICU beds. AP included ICU beds in coronary units, surgical units and burn units in the count.

“Better to be over-prepared than react in the moment,” said Melissa Short, who directs women's health for Seattle's Swedish Medical Center, which is using data from China and Italy as it attempts to double its capacity to 2,000 beds.

If other countries have the same experience as China, 15% to 20% of COVID-19 patients will have severe illness. About 5% could become sick enough to require intensive care.

Equipment is a challenge. About 20% of U.S. hospitals said they didn't have enough breathing machines for patients, and 97% were reusing or otherwise conserving N95 masks, according to a survey conducted last week by hospital group purchasing organization Premier.

Who will staff the needed ICU beds is a question keeping U.S. hospital leaders awake at night.

In western Massachusetts, Nancy Shendell-Falik, a nurse turned hospital executive, is planning Baystate Health's response. The system's community hospitals and flagship hospital in Springfield are finding space for 500 additional beds, including 140 ICU beds.

She asks herself: Will cross-training staff and working in teams help the ICU nurses handle a surge of patients needing breathing machines? Will there be enough masks, gowns and face shields?

She also worries about exhaustion, burnout and nurses falling sick.

“Beds don't take care of patients. We need the staff to do so,” she said.

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