US hospitals scramble for additional beds as coronavirus cases double every three days

Hospitals in New York and other pandemic epicenters are at the tipping point and rushing to find beds for an on-coming flood of coronavirus patients. 

To meet the demand before resources run out, health officials are racing to make preparations as the worst of the outbreak has yet to hit.

In New York City, as a Manhattan convention center is being turned into a temporary hospital, area medical facilities already are becoming so jammed that patients needing critical medical attention are being sent by ambulance elsewhere to other facilities.

In New York City, as a Manhattan convention center is being turned into a temporary hospital, area medical facilities already are becoming so jammed that patients needing critical medical attention are being sent by ambulance elsewhere to other facilities

Hospitals like Mount Sinai Morningside (pictured) have resorted to converting specialized units, otherwise needed for cardiac and other specific care, to treat people with the virus

Hospitals like Mount Sinai Morningside (pictured) have resorted to converting specialized units, otherwise needed for cardiac and other specific care, to treat people with the virus

Floating US Navy hospitals are also on their way to New York City as well as Los Angeles. The USNS Mercy, a Navy hospital ship, is seen docked at Naval Base San Diego

Floating US Navy hospitals are also on their way to New York City as well as Los Angeles. The USNS Mercy, a Navy hospital ship, is seen docked at Naval Base San Diego

The city’s morgues also are filling up. 

Bellevue Hospital in Manhattan several refrigerated trailers to house the dead.

Elmhurst Hospital in Queens also had to set up a freezer truck outside to temporarily house dead bodies. Thirteen people died in the hospital in the last 24 hours, according to the city’s public hopsital network, which operates Elmhurst.

New York City's morgues also are filling up. Refrigerated trailers for keeping dead bodies are pictured set up outside Manhattan's Bellevue Hospital this week

New York City’s morgues also are filling up. Refrigerated trailers for keeping dead bodies are pictured set up outside Manhattan’s Bellevue Hospital this week

Elmhurst Hospital in Queens also set up a freezer truck to hold the dead. People are pictured  outside the facility waiting to get tested for the coronavirus

Hospitals like Mount Sinai Morningside have resorted to converting specialized units, otherwise needed for cardiac and other specific care, to treat people with the virus. 

Meanwhile, floating US Navy hospitals are also on their way to the city, as well as Los Angeles.  

Other cities like Chicago have begun contracting with idled hotels to provide beds for coronavirus patients.

Chicago also is reopening a 314-bed suburban hospital that closed in September as the state of Illinois, where the city is located, takes the additional step of converting three state parks into isolation sites for patients who can’t go home.

Chicago is reopening MetroNorth South, a 314-bed suburban hospital that closed in September to help treat coronavirus cases

Chicago is reopening MetroNorth South, a 314-bed suburban hospital that closed in September to help treat coronavirus cases

There are now 73,939 confirmed coronavirus cases across the US and more than 1,200 dead from the infection. 

There are now 73,939 confirmed coronavirus cases across the US and more than 1,200 dead from the infection

There are now 73,939 confirmed coronavirus cases across the US and more than 1,200 dead from the infection 

How the number of coronavirus cases has escalated in the US since the outbreak began

How the number of cases has escalated in New York City, the epicenter of the outbreak

How the number of cases has escalated in New York City, the epicenter of the outbreak 

New York City, the epicenter, has 21,393 known deaths resulting from infection.

As officials rush to get more beds for those afflicted, simple math is spurring hospital leaders to prepare. 

With total US cases doubling every three days, empty intensive care unit beds, needed by an estimated 5% of the sick, will rapidly fill.

US hospitals reported operating 74,000 ICU beds in 2018, with 64 per cent filled by patients on a typical day. 

But available ICU beds are not evenly distributed, according to an Associated Press analysis of federal data on hospitals that provided a cost report to Medicare in fiscal year 2018.

The AP found more than 7 million people age 60 and older — those most at risk of severe COVID-19 illness — live in counties without ICU beds. 

AP included ICU beds in coronary units, surgical units and burn units in the count.

‘Better to be over-prepared than react in the moment,’ said Melissa Short, who directs women’s health for Seattle’s Swedish Medical Center, which is using data from China and Italy as it attempts to double its capacity to 2,000 beds.

In South Korea, some died at home waiting for a hospital bed. In northern Italy, an explosion of cases swamped the hospital system. Video and photos from two Spanish hospitals showed patients, many hooked to oxygen tanks, crowding corridors and emergency rooms.

About 10 days ago, Dr. Tanya Sorensen got a call from the doctor leading the response to the virus at Washington state’s Swedish Medical Center. The doctor asked how could the system consolidate its birth services to keep healthy delivering moms away from the sick?

About 10 days ago, Dr. Tanya Sorensen got a call from the doctor leading the response to the virus at Washington state's Swedish Medical Center. The doctor asked how could the system consolidate its birth services to keep healthy delivering moms away from the sick?

About 10 days ago, Dr. Tanya Sorensen got a call from the doctor leading the response to the virus at Washington state’s Swedish Medical Center. The doctor asked how could the system consolidate its birth services to keep healthy delivering moms away from the sick?

‘It took me aback,’ said Sorensen, a medical director for the hospital system’s women’s services. ‘It brought home the fact that we are going to be facing a huge surge of cases of COVID very soon.’

Swedish’s Edmonds facility announced Saturday it is closing its 7th floor birth center temporarily, gaining 35 beds for the expected influx. Pregnant women who would have used the facility instead will go elsewhere, including an affiliated hospital in Everett.

‘They need more beds. If they can open up a whole floor, I understand,’ said Kelly McCarty, a pregnant public school teacher who was being rerouted to the hospital.  

Pregnant women who would have used Seattle's Swedish Medical Center's Edmonds facility will go elsewhere to make room for coronavirus patients. 'They need more beds. If they can open up a whole floor, I understand,' said Kelly McCarty, a pregnant public school teacher

Pregnant women who would have used Seattle’s Swedish Medical Center’s Edmonds facility will go elsewhere to make room for coronavirus patients. ‘They need more beds. If they can open up a whole floor, I understand,’ said Kelly McCarty, a pregnant public school teacher

For most people, the coronavirus causes mild or moderate symptoms, such as fever and cough that clear up in two to three weeks. For some, especially older adults and people with existing health problems, it can cause more severe illness, including pneumonia, and death.

If other countries have the same experience as China, 15 per cent to 20 per cent of COVID-19 patients will have severe illness. About 5% could become sick enough to require intensive care.

Equipment for taking care of cases at such levels is a challenge. 

About 20% of US hospitals said they didn’t have enough breathing machines for patients and 97% were reusing or otherwise conserving N95 masks, according to a survey conducted last week by hospital group purchasing organization Premier.

Who will staff the needed ICU beds is keeping hospital leaders around the country awake at night.

In western Massachusetts, Nancy Shendell-Falik, a nurse turned hospital executive, is planning Baystate Health’s response.  The system’s community hospitals and flagship hospital in Springfield are finding space for 500 additional beds, including 140 ICU beds.

She asks herself: Will cross-training staff and working in teams help the ICU nurses handle a surge of patients needing breathing machines? Will there be enough masks, gowns and face shields? She also worries about exhaustion, burnout and nurses falling sick.

‘Beds don’t take care of patients. We need the staff to do so,’ she said.

During 9/11, she worked as a chief nurse at a hospital eight miles from the twin towers. She also worked at a Boston hospital that took in casualties of the 2013 marathon bombing.

‘Those things changed our world forever, but they were very time-limited activities. What’s scary about this,’ she said, is ‘we don’t know the duration.’

This weekend, McCarty and her husband plan to drive to the Everett hospital, a trial run for when she goes into labor. When her contractions start, they’ll call her dad to come stay with their 4-year-old daughter. McCarty is taking it in stride, knowing the depth of the need.

‘If it was my first child, I think it would be a little harder,’ McCarty said of adjusting her birth plan for COVID-19. 

‘I know what it’s like and I’ve been through it before. Where I deliver isn’t necessarily that big of a deal. I’m happy to oblige.’

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