Sun Sentinel Palm Beach Edition
State wants to know who is in ICU as hospitals fill
Guideline for tracking who gets beds changes
As more and more hospitals publicly report that their ICU beds are full, the state changed its guideline for tracking who is in its ICU beds — a change that will mask the true number of people in Florida’s intensive care units as the state struggles to keep pace with the coronavirus pandemic. Why?
Some hospitals in the state may be using their ICU beds for non-criticalcare coronavirus patients — people who need isolation but don’t need the most intensive level of care. And late Tuesday, at least a half-dozen South Florida hospitals had filled their ICU beds.
To ensure hospitals are not overwhelmed, Florida’s Agency for Health Care Administration Secretary Mary Mayhew has repeatedly said the state needs to keep a close eye — in real time — on how many ICU beds are available regardless of how sick the people are in those beds.
But now, instead of reporting the number of COVID-19 patients occupying ICU beds, the Department of Health wants hospitals to report only the number of COVID patients in those beds who are receiving ICU-level of care. The change could reduce the number of occupied ICU beds being reported to the state.
As of Tuesday, 1,887 patients with COVID-19 were being treated at South Florida hospitals, compared with 1,558 on June 1. About 75% of the adult ICU beds are full, and ventilator use
is going back up after a small decline.
“The Department of Health has heard hospitals are utilizing a portion of their ICU beds to specifically house and isolate patients with positive cases of COVID-19, including those that do not require intensive care. This change in wording was made to more accurately capture the number of COVID-19 patients receiving intensive care,” Florida Department of Health spokesman Alberto Moscoso said.
Gov. Ron DeSantis addressed the guideline change during a news briefing on Tuesday, saying even as cases go up in Florida, people don’t appear to be getting as sick, and he wants to verify that change. “What we are getting at is acuity. When people are going into the hospital, we want to know what percent need ICU care and to be put on a ventilator. Far fewer need ventilators than what we thought at the beginning. Having lived through this for months, a case today is not the same as a case on March 30th,” DeSantis said.
Gino Santorio, CEO of Broward Health, said the new guidelines for reporting will affect smaller hospitals, rather than the bigger health systems in South Florida that have isolated areas for general and intensive-care COVID patients.
“What is happening is a couple of hospitals in the state do not have dedicated ICUs,” Santorio said. “When patients required isolation, they sent them there whether they need intensive care or not.”
He said the state and individual hospitals still need to track how many ICU beds are filled, regardless of why, to know whether the spike in cases is followed by more hospitalizations. Hospitals like Broward Health are able to add ICU beds if needed by converting general beds, he said.
On Tuesday, a half-dozen South Florida hospitals had completely filled their ICU beds, according to information the hospitals report into the Emergency Surveillance System managed by the Agency for Health Care Administration. Those hospitals include Coral Gables Hospital and Homestead Hospital in Miami-Dade County; Broward Health North in Broward County; and St. Mary’s Medical Center, Lakeside Medical Center and Bethesda Medical Center West in Palm Beach County.
Some counties, like Miami-Dade, have required their hospitals to report their daily COVID-19 hospitalizations and discharges to the mayor. On Tuesday, Miami-Dade hospitals reported admitting 103 new patients and discharging 92.
At Tuesday’s news briefing in Orlando, doctors from Orlando Health said patients coming to the hospital with COVID-19 are not as sick as they were earlier in the pandemic and less likely to need ICU care.
“Not only do we have the capacity to take care of all our community, we haven’t tapped into our surge capability,” said Dr. George Ralls, a vice president of Orlando Health.
Still, the Department of Health’s change in reporting has some critics skeptical. Santa Rosa Beach attorney Daniel W. Uhlfelder has been keeping a close eye on re-openings, testing and hospitalizations. Uhlfelder has been appearing as the Grim Reaper to discourage continued reopening during the pandemic.
“I don’t believe in the coincidence of the timing,” Uhlfelder said. “Why in the middle of a global pandemic are those guidelines being modified the week when cases are skyrocketing? If we can’t have confidence in the numbers, how are we going to have confidence in the process?”