60% of state’s ICU beds taken
Experts say hospitalization data is key in determining if supplies are running out
Data released this week by the White House paints a bleak portrait for Florida’s hospitals, which are already grappling with the biggest public health crisis in a century with the worst still yet to come.
While the number of cases and deaths in Florida — 10,268 and 170 respectively as of Friday evening — get the most attention, hospitalizations are another important data point. Experts say that number is key to determining if hospitals are running out of beds, intensive care units and essential equipment such as ventilators and N95 masks.
The number of people who have at one point been hospitalized with coronavirus in hospitals has grown significantly since March 18 when there were only 66 statewide. On Friday evening, there were more than 1,330 and climbing, nearly doubling since Monday, according to the Florida Department of Health.
About 60% of the state’s 6,000 ICU beds are already taken, according to Agency for Health Care Administration data on Friday evening. And it’s still about a month before experts say the state will hit its peak number of COVID-19 cases.
Dr. Charles Lockwood, dean of University of South Florida’s
Health Morsani College of Medicine, said hospitalizations are a good indicator of the severity of the virus because most people who have it can recuperate at home.
While the numbers of hospitalizations in Florida are startling, the situation isn’t as bad as New York so far, Lockwood said.
“New York had vast community spread before they even knew they did,” he said, referring to cases in which the source of a patient’s infection is unknown. “You have towering buildings with people living on top of each other, people taking the subway. In Florida you are much more spread out. It’s no accident that Miami-Dade and Broward are two hot spots. They are much more vertical.”
But things could get worse. According to data from the Institute for Health Metrics and
Evaluation at the University of Washington School of Medicine that predicted through August 4 between 40,000 and 178,000 deaths nationwide, Florida could have all of its ICU beds filled by April 16. When the virus is at its peak in the beginning of May, Florida will need a median of 2,600 ICU beds for coronavirus patients alone at its peak on May 1, meaning the state will have to come up with about 800 more. The model is current as of April 1 and is expected to update.
The worst case scenario projected by the forecast is Florida will need 7,800.
The news for overall hospital beds is a little better. There are more than 20,000 available beds for the nearly 17,000 predicted coronavirus patients at its peak.
The best-case scenario calls for Florida needing just 475 ICU beds and 3,700 overall.
The state also is expected to need 2,000 ventilators at its peak the first week of May. The state has requested 5,000.
The number of patients currently in hospitals is not publicly available and not all of those hospitalized with COVID-19, the disease caused by the virus, require intensive care.
While the situation sounds dire, predictive models can sometimes be off. Far fewer people died in 2009 of the swine flu, or H1N1, than originally expected. Raul Pino of the Florida Department of Health in Orange County said a model is only “as good as the data you enter into it.”
“A model constantly changes,” he said. “A model is basically a mathematical equation. It takes into consideration what is happening today, but as we apply more measures … that outcome may change.”
State officials and hospitals have said they are ready.
There are field hospitals in Miami and Broward to manage the influx of people needing care, and Gov. Ron DeSantis said he is talking with the Army Corps of Engineers about making more. He also last month ordered hospitals to stop elective surgeries to free up more beds.
Hospital capacity is something DeSantis said he monitors every day.
“The whole [notion of] ‘flatten the curve’ was the hospital system has to be able to cope with it,” DeSantis said Wednesday. “… I think some of the behavior changes have [also] helped free up beds. People started taking the hygiene and the social distancing a few weeks ago seriously. I think you’re going to see a big drop in the flu hospitalizations compared to last year.”
Central Florida’s two biggest health systems — Orlando Health and AdventHealth Orlando — said last month they can quickly add beds in about two dozen hospital campuses and freestanding emergency departments.
“We know Orlando’s two hospital systems are planning to treat between two and three times what their normal capacity would be, and they’re gearing up to do that. If we get four or five times that, then we’re going to be in New York’s shape, which is bad,” Orlando Mayor Buddy Dyer told the Orlando Sentinel on Wednesday.
Orlando Regional Medical Center and AdventHealth Orlando have already filled a lot of beds. The data does not differentiate between coronavirus patients and other patients.
The data as of Friday afternoon shows about three-quarters of the adult ICU beds at AdventHealth Orlando are already full while 57% of the ICU beds at ORMC are spoken for. In addition, nearly half of the 32 pediatric beds were occupied at AdventHealth Orlando, though the virus is not expected to hit children as hard as older people.
In Central Florida overall, the counties of Orange, Osceola, Lake, Seminole, Volusia, Brevard, Polk and Sumter have about 36% availability in ICU beds.
Local officials hope it never gets to the point where there aren’t enough beds.
“We are planning for what I would call a surgicallike strike to stop the spread of COVID-19 here in this community,” Orange County Mayor Jerry Demings said on Wednesday.
As of Friday morning, Orange County led the way in Central Florida coronavirus hospitalizations with 81 followed by Osceola’s 54, Seminole’s 32 and Lake’s 14 to date.
In the South Florida counties of Miami-Dade, Broward and Palm Beach that account for nearly 60% of the cases, hospitalizations are also higher. Miami-Dade leads the way with 205 hospitalizations while Broward has 164 and Palm Beach 115 to date.
Statewide, the hospitals with the biggest ICU units are busy. The largest, the University of Florida Shands Hospital in Gainesville, has 33% of its nearly 260 beds available.
Jackson Memorial Hospital in Miami-Dade, the hardest hit county, has just 12% of its 116 adult ICU beds available and three quarters of its 20 pediatric ICU beds available. Baptist Hospital of Miami has 11% of its 88 adult beds ready and all eight pediatric ICU beds open. Broward County’s Memorial Regional Hospital has 41% of 68 beds open. In addition, 23% of its 30 pediatric ICU beds are serving young patients.
Meanwhile, obtaining crucial supplies has remained a challenge.
Yolanda Martinez of Orange County Health Services said the county has requested 70,000 pieces of personal protective equipment, about a third of which are N95 masks, from the state and received 14% of those supplies as of Wednesday. N95 masks are designed to fit more closely to the face than ordinary masks and block particles more effectively.
“We do not have to stress the value of the N95 masks,” she said. “The people on the front lines know the value of this resource to protect their lives.”
Pino said medical students who graduated early and retired health-care professionals are chipping in to help. He also said, as the virus is “taking a hold” of the community, the next two weeks will be critical.
“It is in our control to stop the spread. It is in our control,” he said. “Social distancing, washing your hands and only going out when it is necessary.”