Published March 19th, 2020 at 8:58 AM
A new national study is warning that hospitals in the Kansas City region and around the country could not have enough beds to care for all the COVID-19 patients who are seriously sickened by the virus.
As for the Kansas City area, the new analysis says that in the worst-case scenario — with an infection rate of 60% of adults ramping up in just six months — the need would be three times current capacity.
In a more conservative scenario, based upon infection rates from previous pandemics, hospitals in the Kansas City region would have capacity. That model assumes a 20% infection rate of adults that is spread out from 12 months to 18 months.
The data was compiled by ProPublica, a nonprofit newsroom, in conjunction with the Harvard Global Health Institute. Researchers used data from the American Hospital Association among other sources.
“Additional capacity has to be part of everybody’s strategy,” Dr. Ashish Jha, director of the Harvard Global Health Institute, told reporters in a video conference Wednesday. “Almost no one is going to get through this without additional beds.”
Kansas City area health officials said the system does have extra capacity, and there is hope that all the mitigation strategies — such as closing schools and restaurants — can keep the spread of the virus to a minimum.
Health officials are stressing that, rather than banking on assistance from an already stressed health care system, ordinary people have to take all the preventative measures that have been suggested.
“The most important thing to do now,” said Dave Dillon, spokesman for the Missouri Hospital Association, “is to inform the public that they are part of the public health team.”
As of Wednesday, the U.S. Centers for Disease Control and Prevention (CDC) reported 7,038 cases around the country with 97 deaths. As of Wednesday, Kansas had reported 21 confirmed cases, and Missouri had reported 13.
There had been one death in each state, as of Wednesday afternoon.
COVID-19 is the abbreviation for a novel respiratory coronavirus that was first detected in China and which has now been detected in more than 150 locations internationally. Current information suggests that most COVID-19 illness is mild, according to the CDC, but also indicates that serious illness occurs in 16% of cases.
People with severe chronic medical conditions, such as heart disease or diabetes, seem to be at the highest risk of developing severe symptoms. Symptoms can include cough, fever, and difficulty breathing.
The model developed by ProPublica and Harvard assumes that about one-fifth of all adults infected will have to be hospitalized.
The analysis counts 6,740 hospital beds in a Kansas City region of approximately 2.6 million residents. About 800 of those beds are in intensive care units, which are best equipped to handle serious ill COVID-19 patients.
Health providers in the Kansas City region work on emergency preparedness through the Mid-America Regional Council’s Health Care Coalition. Steve Hoeger is co-chair of the Hospital Preparedness Committee.
Health officials have been talking regionally about emergency strategy for years, Hoeger said, but it was the anthrax-infected letters that started appearing shortly after the 9/11 terrorist attacks when federal, state and local leaders really started focusing on what a coordinated response might look like in the face of something like a bioterrorism attack.
As far as the coronavirus pandemic is concerned, Hoeger said, the message to the general public is the same as it is to be prepared for any potential medical emergency, such as the aftermath of a flood or tornado.
He said people need to stock up on prescriptions, Kleenex, and other essentials before they get sick. And, Hoeger said, it is imperative for people to only go to the hospital if they are seriously ill, and even if they test positive for the coronavirus, it makes no sense to rush to the hospital because there’s no pill or shot that is going to relieve mild symptoms.
“Be prepared today as an individual and reduce the burden on the hospitals and the health care system overall,” he said, “and save those for the people who really need it.”
As part of emergency planning, Hoeger said, the regional hospital system shoots for a goal of having a surge capacity of about 20% additional beds. This would mean, for instance, using beds in pre- and post-operating areas. It could also mean using beds in a GI lab, for instance.
With the coronavirus outbreak, he said, there are “a lot of people with restless nights and long days making sure we are prepared.”
Health officials say that one of the biggest ways they are maximizing available capacity is by eliminating elective surgeries and other procedures that can wait. But availability of beds also depends upon an adequate amount of supplies.
Those supplies include sanitizing wipes along with masks, gloves and all other types of basic needs, said Charlie Shields, CEO of Truman Medical Centers in Kansas City, Missouri. There is general agreement among hospital officials, he said, that “there needs to be more in the pipeline.”
Staffing is another limiting factor on the number of patients hospitals can serve. Personnel can become particularly stretched if some workers get sick with the coronavirus.
And people within the healthcare system remain uncertain just how many people are infected as health authorities are ramping up efforts to make enough test kits available throughout the nation, as researchers rush to discover a vaccine.
“I expect a big spike in the next week and then in 10 days a start to slow down,” said Jha, the Harvard researcher. He said there was “no question in my mind” that all the measures taken lately to prevent the spread of the disease will help.
When it comes to hospital care, geography matters.
And even though safety-net hospitals like Truman operate slightly in the black, the situation can be even more dire for rural hospitals.
And that is why the recommendations for hospitals to curtail elective procedures can be problematic for rural hospitals, Dillon said. Those procedures are covered by insurance and provide a significant boost to the bottom line.
Dillon said a blanket recommendation to eliminate all elective procedures ”doesn’t necessarily make sense if it, in fact, it jeopardizes the viability of the hospital at the same time.”
Shields was equally skeptical of one assumption used in the model by Harvard and ProPublica. The researchers said it could be possible for hospitals to open up half of their beds by strictly managing patients and ensuring only the neediest were in the facility.
That might be feasible at a suburban hospital with a relatively routine set of patients, Shields said, “but that is not the case for hospitals that do what we do.”
The low-income patients seen at TMC and other safety nets tend to present with more complex cases.
Mike Sherry is senior reporter for Kansas City PBS. He can be reached at firstname.lastname@example.org or 816.398.4205