South Florida Sun-Sentinel Palm Beach (Sunday)
Can hospitals handle state’s soaring cases?
As hospitals fill up with ever-growing numbers of COVID-19 patients, officials are readying plans designed to avoid the nightmarish crowding that marked New York hospitals at the height of that city’s epidemic.
At Jackson Memorial Hospital in Miami, where more than 90% of intensive care beds were full Friday, plans are ready to add 120 additional ICU beds. At Baptist Health, which operates 10 South Florida hospitals from the Keys to Palm Beach County, administrators have begun hiring nurses to staff the expansion they’re readying as they run out of beds. At Memorial Hospital West in Pembroke Pines, an auditorium has been converted for patient use.
The Florida Division of Emergency Management has stepped in to back up the hospitals if they can’t keep up, working on bringing in another 1,000 nurses from inside and outside Florida, leasing space for 450 beds at the the Miami Beach Convention Center and searching for space elsewhere to handle any overflow.
But as hospitals get ready to add beds, questions remain about whether they can provide
enough nurses to staff them.
“You can’t safely take care of more than one or two patients when they’re in an ICU,” said Martha Baker, president of the union that represents nurses and doctors at Jackson. “You get a bad burn or a bad car accident, you could have two nurses on one patient. If you can’t meet the needs of an ICU patient, they die. It’s easy to open up another bed. It’s another thing to open up a bed and have a nurse to go with it.”
The state government on Friday for the first time posted the current totals for COVID-19 hospitalizations. They show 6,974 people hospitalized statewide, and on Saturday the number went up to 7,186. The most by far were in Miami-Dade County, with 1,595, followed by Broward with 1,005, followed by Palm Beach with 595
Hospitalizations have been rising sharply, reflecting a surge that began last month and produced record daily counts for new cases. But Florida officials say hospitals are prepared and won’t face conditions remotely like those at hospitals such as Elmhurst Hospital in New York, where desperately ill patients waited on plastic chairs for beds to open up, others lay on stretches in hallways and some died unattended.
“Hospitals have capacity,” Gov. Ron DeSantis said at a news conference Friday in Orlando. “You’ve got a lot of beds available. No major system has gone to a surge level.”
Early in the epidemic, tents were set up for testing and emergency room triage. Although there had been talk of using tents for field hospitals, a statement Friday from the Florida Division of Emergency Management noted “at this time, mobile field hospitals consisting of tents may not be the best resource to deploy during hurricane season.”
The state has leased space at the Miami Beach Convention Center to set up a hospital with 450 beds, of which 50 are intensive care beds, said Jason Mahon, spokesman for the Division of Emergency Management. The state also has a 15-bed mobile ICU that can be deployed, he said.
In Palm Beach County, where the ICU use stood at 77% Saturday, Bill Johnson, Palm Beach County’s emergency management director, said he’s in close contact with hospitals about their COVID-19 situations.
“We monitor their status, we have regular calls with them,” he said. “We have contingency strategies that we work out.”
Baptist Health, which operates hospitals in Miami-Dade County, Palm Beach County and the Florida Keys, has several hospitals at 90% ICU capacity or worse. Administrators have hired 100 additional nurses and are putting another 96 through training as the system’s hospitals prepare to take in more patients.
“As a system of 10 hospitals, we can manage our volume by moving patients throughout the system,” spokesman David Zarco said. “We also have surge plans in place to convert or shift beds, which gives most of our hospitals 20-30 percent surge capacity per hospital. Using those beds, which are not counted in our daily reporting, is dependent on sufficient staffing.”
At Memorial Healthcare Sy st e m, wh i c h s e r ve s southern Broward County, hospitals are seeing double the normal number of patients.
“Our ICU capacity is beyond 100 percent,” said Leah Carpenter, chief executive of Memorial Hospital West. “Lucky for us we have construction experts who are able to convert non-traditional spaces into patient spaces.”
Workers converted an auditorium and a space in the hospital’s central tower to areas to care for patients.
“So while the numbers continue to climb exponentially, we are making every effort to never ever turn a patient away,” she said.
At Broward Health, which operates four taxpayer-supported hospitals, ICU occupancy rates Friday ran from 100% at Broward Health North to 64% at Broward Health Imperial Point.
The system has a surge plan in place but has not had to activate it, spokeswoman Jennifer Smith said. She refused to provide details. Asked how many ICU beds Broward Health could add, she declined to give a number, saying, “We can continue to add staff beds pending the need.”
At Jackson Memorial Hospital, where intensive care occupancy stood at more than 90% Friday, 120 ICU beds can be added in areas that had been used for surgical recovery, CAT scans and other procedures, said Roy Hawkins, Jr., the hospital’s chief executive officer.
The huge Miami hospital, which suspended elective procedures, can supply each ICU bed with oxygen units, monitoring equipment and other necessary supplies, he said.
“Obviously we wouldn’t have to open 120 beds overnight,” he said. “There’s a phased approach to it, and I’m confident we have what we need. We have enough to staff up, should we be in surge over the next week or so.”
Although the state has agreed to send an additional 100 nurses to Jackson, the head of the nurse’s union there questions whether that will be enough for a staff that’s already struggling with the COVID-19 caseload.
There are 4,200 nurses already at Jackson Health System, the majority at the flagship hospital, so 100 more won’t represent a large increase, said Baker, the nursing union president.
“Normally an ICU nurse has one or two patients, we’ve been giving some ICU nurses three patients,” she said. “That’s not ideal. But when those patients are there and they need a nurse and you don’t have one, what’s your option, right? It’s wartime.”