ICU beds remain scarce in Texas as COVID hospitalizations decline
COVID-19 hospitalizations are declining across Texas and the Houston region, but ICUs remain stubbornly full, as the sickest patients require care for a longer period of time.
Last week, the number of available adult ICU beds in Texas sunk below 300 for the first time in the pandemic, with 270 beds available on Sept. 8 and 279 available on Sept. 9, according to the Texas Department of State Health Services. There were 326 beds available this Wednesday, including 65 in the nine-county region surrounding Houston, the data shows.
Texas Medical Center ICUs for weeks have been hovering around 90 percent full with Phase 2 surge plans — which add 373 ICU beds to the 1,330 available in Phase 1 — activated.
Overall, the situation in hospitals appears to be improving, said Dr. James McDeavitt, executive vice president and dean of clinical affairs at Baylor College of Medicine. He said Houstonarea ICU numbers likely peaked at the end of August, when COVID patients took up 49 percent of all critical care beds. As of Wednesday, that number dropped to 45 percent.
“That may not seem like much, but it’s a lot,” he said. “We’re still at high levels, but no longer peak levels … not the worst it’s ever been.”
He added that “some people are starting to see there’s a light at the end at least of this particular tunnel.”
Statewide hospitalizations have been steadily declining since Sept. 7, from 13,520 patients to 12,597 on Wednesday, according to DSHS. The weekly average of daily new hospitalizations in the Medical Center has been dropping from a peak of 390 in mid-August to 328 last week.
ICU data typically lags behind hospitalization data, McDeavitt said, due to the length of time patients in these units remain in treatment. He is cautiously optimistic that Texas Medical Center ICU usage will decline in the coming days.
Still, the high number of ICU patients forces doctors to delay much-needed procedures that take up bed space. At many hospitals, doctors have daily meetings in which they rank patients based on the level of care needed. Cosmetic surgeries are usually among the first to be delayed, but more urgent surgeries also have to be considered.
“What about the person out there who has a significant blockage in their heart arteries and they cannot come in to have their bypass?” said Dr. Syed Raza, vice president of medical operations at CHI St. Luke’s Health-The Woodlands Hospital. “It’s a discussion we have every day. We try to get the patients that have a possible cancer diagnosis — or who have cardiac lesions — in as much as we can. That takes a lot collaboration, a lot of energy and a lot of shifting of schedules, trying to figure out where we can get more nurses.”
In some cases, full ICUs can lead to life-threatening delays. In late August, U.S. Army veteran Daniel Wilkinson was admitted to Bellville Medical Center with gallstone pancreatitis, a treatable condition in which a gallstone blocks the pancreatic duct and causes inflammation. The Bellville hospital could not provide that level of treatment, and doctors could not find him an open ICU bed for about seven hours, said his mother, Michelle Puget.
His condition had dramatically deteriorated by the time doctors found him a bed at the Houston VA Medical Center, where he died on a Sunday afternoon surrounded by his family.
“I’m just hoping that somebody else doesn’t have to go through this,” Puget told the Houston Chronicle this week. “I’m not angry. I’m hurt. I’m heartbroken.”
Regional ICU figures remain at the same level since late August, according to state data.ICU capacity has remained steady at Harris Health System hospitals but is “beginning to come down,” said Dr. Esmaeil Porsa, president and CEO of Harris Health System.
He said he could not immediately provide specific data but said the system is still exceeding baseline capacity. While an infusion of nurses from the state and Harris County considerably helped earlier staffing issues, fatigue is the biggest issue among his ICU staff, he said.
“It’s really that more than anything else,” he said. “ICU nurses are worn out.”
He also noted a 30 percent decrease in the number of patients compared with last month.
Despite the improved outlook, “this is not the time to relax,” he said.
“The message hasn’t changed,” he said. “Please, please, for God’s sake, get yourself vaccinated.”