Central Florida COVID-19 hospitalizations are rising
Hospitalizations from COVID-19 are spiking in Central Florida as the number of positive cases have reached record highs in recent days, less than a month after the state entered its second phase of reopening.
As of Monday, 115 patients with COVID-19 were being treated at Orange County hospitals, according to information shared by Orange County health department officials.
That’s 51 more cases than the week before and 85 more than the week of May 17.
Health systems told the county “their numbers were higher than ever before,” said Dr. Raul Pino, health officer at the Florida Department of Health in Orange County, in an email on Monday.
Seminole County is also seeing more hospitalized coronavirus patients. There are currently 46 patients with COVID-19 in the county’s hospitals.
“Three weeks ago we had an average of 3-4 per day,” said Alan Harris, chief administrator of Seminole County Office of Emergency Management in an email. “This is an increase for certain.”
Harris said three COVID-19 patients are currently in the ICU; in Orange, there are 20 patients in the ICU, a number that has stayed relatively flat over the past month.
In a shift from the beginning of the pandemic, when most of the hospitalized patients were in their 70s and 80s, patients now are in their 40s and 50s, Pino said.
As Florida on Monday passed 100,000 positive coronavirus cases, the number of COVID-19 hospitalizations are important because they indicate the spread and severity of disease and can signal whether local hospitals are at risk of getting overwhelmed.
Local hospitals say that they still have enough capacity, and they’ve learned how to better manage COVID-19 patients.
Unlike the early days, ventilators are not the first line of treatment for the majority of the patients. As a result, fewer patients are being admitted to the ICU.
Also, over time, treatments like convalescent plasma therapy and antiviral drug remdesivier have proven effective in fighting the disease, resulting in better outcomes for patients.
“We’ve learned a lot,” said Dr. Sean Benoit, chief medical officer at Central Florida Regional Hospital. “I think had these numbers occurred in the very beginning, it would have been more alarming. It still is alarming. We are paying attention to our numbers, our PPE and what we have.”
Benoit added that “the number of cases we’ve seen increasing certainly is real. It’s not just increased testing. It certainly increased hos
pitalization of COVID patients as well,” he said.
AdventHealth and Orlando Health, the two major health systems in Central Florida, are keeping a close eye on their numbers.
“We are watching trends carefully . ... While our inpatient COVID numbers are rising, the severity of the cases aren’t as significant as when we first began treating COVID-19 patients,” AdventHealth officials said in an email.
Orlando Health officials said that they’ve seen a steady increase in COVID-19 hospitalizations, mirroring the increasing number of cases in the community since mid-May.
“This second wave of patients has not demonstrated the level of severity and mortality that we saw with the first wave — 8% are being managed in an ICU, and only 5% are requiring a ventilator,” they said in an email. “Although patient characteristics such as age and comorbidities may play a role, the differences in first and second wave outcomes are likely attributable to more effective clinical care, including respiratory management and use of emerging therapies such as Remdesivir and convalescent plasma.”
It’s difficult to know how many patients are currently hospitalized with COVID-19 in specific hospitals for most counties, because the state does not report the data. The state also recently changed how the hospitals report ICU bed occupancy.
According to the governor’s office, the change was made to more accurately reflect the reasons a patient was moved to the ICU.
“For example, a pregnant woman who tests positive upon arrival to the hospital but is without symptoms could be moved to an ICU bed to isolate her from other maternity ward patients, not because she needed ICU levels of care,” said a spokeswoman for Gov. Ron DeSantis’ office on Monday in an email. “While she would still be taking up a bed — the key metric when it comes to ICU capacity — she could be moved elsewhere if needed for a patient who needs to go the ICU.”
Some counties, like Miami-Dade have mandated their hospitals to report their daily COVID-19 hospitalizations and discharges to the mayor.
In Monday’s press conference, Orange County Mayor Jerry Demings said the county will “endeavor” to make the hospitalization numbers public.
DeSantis has reiterated, as recently as a Saturday press conference, that more young people, many of whom have no symptoms, are testing positive and their illnesses don’t have “huge clinical consequences.”
“We’re seeing it spread in 20- and 30-year-olds faster than we would like to see, so we really want to send a message of doubling down on what we’ve been preaching since the start ... in terms of social distancing” and other public-health guidelines, DeSantis said.
The median age of COVID-19 cases in Orange County is 34, compared with the state’s average of 43. In Seminole County, the median age is 33. Osceola and Lake counties’ median age is 44.
State data shows that younger people are less likely to be hospitalized than older adults, but some still land in the hospital because of COVID-19 infection.
Florida’s stay-at-home order began on April 3 and expired on May 4 — except for several South Florida counties. The state entered the first phase of reopening by allowing limited opening of stores and restaurants and resumption of elective procedures at hospitals. The second phase took effect on June 5, allowing bars and movie theaters to open with 50% indoor capacity, and gyms at full capacity.
Pino also said that visits to hospital emergency rooms for COVID-19 or flu-like illnesses have been increasing noticeably in Orange County, going up from about 100 cases two weeks ago to about 300 cases last week.
Local hospitals have maintained their temperature screenings at the entrance, one-visitor policies, reliance on virtual visits, and in some cases they have strengthened some of their existing policies.
Last week, Orlando Health made it mandatory for all employees to wear masks after several staff members were exposed to COVID-19 in situations that could have been avoided had they been wearing a mask.
“Despite numerous, frequent communications reminding team members of our PPE policies throughout all our facilities, we learned of a recent lapse in mask wearing in a non-clinical area that resulted in several team members being placed in self-isolation,” an Orlando Health spokeswoman said in a statement. “As a result, we have strengthened the policy to mandate that team members wear masks at all times when they are in the presence of others.”
AdventHealth, Nemours Children’s Hospital and HCA hospitals, including Central Florida Regional Medical Center, have had the mandatory masking policy for staff in place already, they told the Orlando Sentinel.
“Wearing masks may be the No. 1 thing you can do, and when I go out into the community I see not as many people wearing masks as need to,” said Dr. Scott Brady, senior vice-president of ambulatory services at AdventHealth, in an emailed statement. “Masks help reduce the transmission of any kind of droplets and it’s the best thing you can do to keep yourself safe — it’s the most loving thing you can do for your community to keep them safe.”
The health systems have also implemented procedures, including patient testing, to identify and separate COVID-19 patients from others. They say that many patients have delayed their care because of fear of catching COVID-19 at the hospitals and are now showing up in the ER with more severe illness.
“My message to the community is to absolutely be careful. The cases are increasing. This is not a time to relax and not practice social distancing. You should still be wearing masks,” said Benoit of Central Florida Regional. “We also want them not to ignore their health. We want them to know that the hospitals have taken a lot of steps for their safety and security.”