Fort Worth-area hospitals must add beds soon if COVID cases don’t slow, expert warns
The number of COVID-19 hospitalizations reached an all-time high Monday in Tarrant County, with at least 474 patients occupying hospital beds.
Tarrant County officials have stressed that hospital capacity is sufficient, with 1,791 beds and 425 ventilators still available Tuesday. And Tarrant County Judge Glen Whitley said that Tarrant County hospitals could add another 2,300 beds if necessary.
But if new cases of the coronavirus continue to grow at its current pace, Tarrant County hospitals could reach their base capacity in about three weeks, said Rajesh Nandy, an associate professor of biostatistics and epidemiology in the UNT Health Science Center’s School of Public Health. He has been studying Tarrant County’s data on hospitalizations, cases and mobility over the course of the pandemic.
Tarrant County reported a single-day high of 605 new cases on Tuesday. With Gov. Greg Abbott’s shutdown of bars and Tarrant County’s mask mandate, Nandy said he is hopeful the growth in cases will be slowed, but it is likely to take at least a week before changes will be seen.
As of Tuesday, about 75% of the county’s intensive care unit beds were occupied — the highest percentage since May 30 — Nandy said. And roughly 68% of the county’s total beds are in use. Both figures are not limited to COVID-19 patients.
Since Memorial Day, hospitalizations of patients with the novel coronavirus have been on the rise across Texas, and reached a new high of 6,533 patients Tuesday.
To ensure sufficient hospital capacity to treat a surge in COVID-19 patients, Abbott has suspended elective medical procedures in eight counties, including Dallas. But Tarrant County, the third most populous county in the state, has not been one of them.
A model from the UT Southwestern Medical Center analyzing data from June 19-26 predicts that if the current growth rates persist, hospitalizations in Dallas and Tarrant County could increase by 50% by July 9.
Even as officials in Houston warned of intensive care units hitting base capacity, Dallas-Fort Worth officials and representatives from hospital systems have stressed capacity is not in danger of being overwhelmed, leading Dallas hospitals to say that they don’t need to activate a pop-up facility at the Kay Bailey Hutchison Convention Center.
“In response to the recent increase in COVID-19 cases and hospitalizations, we want to reassure the public that this pandemic is not eclipsing our capabilities,” Stephen Love, the CEO and president of the Dallas-Fort Worth Hospital Council, said in a statement Monday.
Local hospitals’ capacity
Mujeeb Basit, an assistant professor in UT Southwestern Medical Center’s Department of Internal Medicine, said that it is difficult to assess at what point hospitals may be overwhelmed, because hospital beds and equipment like ventilators are not the only factors to consider.
Hospitals also have to ensure they have a sufficient amount of nurses and staff.
“The nursing capacity is particularly limiting. Because when you shift a regular ward, which is like six to eight patients per nurse, and you make that an ICU ward, now you’re talking like two patients per nurse,” Basit said.
And as more patients fill up hospitals, the risk of exposure for staff also increases, with more likely to get sick and pulled out of the workforce.
Tarrant County hospitals did not share specific plans on how they plan to ramp up capacity to add additional beds, whether that be expanding into unused spaces or establishing temporary facilities. And with numbers changing daily, it’s a dynamic situation that has to constantly be assessed, Basit said.
“We do have a number of safety valves that could be pushed,” Gary Floyd, the chair of the Texas Medical Associations’ Board of Trustees and past president of the Tarrant County Medical Society, said last week. “We’re not there yet at all though.”
Diana Brodeur, a spokeswoman for John Peter Smith Hospital, wrote in an email last week that the hospital has extensive surge plans in place. JPS has not yet needed to transfer patients to other hospitals to free up capacity or reopen the Arlington surgical center to house other patients.
“If, when and how plans are implemented depends on all sorts of factors we’ve already seen through the pandemic, including capacity, acuity, PPE stock, staffing, etc. It’s a regular, constant assessment and conversation at JPS to make sure we are addressing current need and ready for potential need in all of the critical areas,” Brodeur wrote.
Last week, the Texas Children’s Hospital in Houston took the unusual step of admitting adult patients in an effort to bolster hospital capacity amid a surge in COVID-19 patients, according to the Houston Chronicle.
Kim Brown, a spokeswoman for Cook Children’s in Fort Worth, wrote in an email Monday that the hospital has not had a similar request, but that it is willing to partner with adult health care systems if necessary.
And while Cook Children’s has seen more COVID-19 cases than in previous months — with six COVID-19 patients hospitalized Monday and a total of 211 positive cases in children — the hospital is “nowhere near reaching capacity in our COVID-19 ICU unit or other areas,” Brown wrote.
JPS saw a high of 86 patients being treated for COVID-19 Monday — although the number dropped to 78 Tuesday, according to the hospitals’ daily phone recording updating case numbers. The previous high was 83 patients on May 3, Brodeur said.
Robert Earley, the president and CEO of the JPS Health Network, told Tarrant County Commissioners last week when hospitalizations were at 59 patients, “that’s not where we want to see numbers go.”
But he noted that COVID-19 patients have come in with less severe cases, and that at the time they had hovered between nine and 11 ICU patients.
Other Tarrant County hospitals have been less forthcoming about specific numbers and capacity levels, but have stressed that resources are still sufficient.
“There’s no denying that COVID-19 is spreading through our community at an increasing rate. We have seen the number of COVID-19 patients and persons under investigation hospitalized in our Texas Health facilities triple in June, but we remain ready and able to care for our community,” Texas Health Resources CEO Barclay Berdan said in a statement Friday.
In a statement on Thursday, Baylor Scott and White Health said that while it has seen an increase in the number of COVID-19 cases recently, “it is important to note that the vast majority of our patients have been receiving and continue to receive care unrelated to COVID-19.”
Last week, the system reinstated a no-visitor policy, with limited exceptions. And COVID-19 patients are treated in separate areas of the hospital specifically designated for patients with infectious diseases, the system said.
Janet St. James, a spokeswoman for Medical City Healthcare, stressed that their hospitals have the bed capacity, staffing, personal protective equipment and supplies to meet healthcare needs.
Tarrant County hospital systems directed questions on specific capacity numbers to the Tarrant County Health Department, Texas Department of State Health Services or North Central Texas Trauma Regional Advisory Council — which aggregates data from DFW’s hospitals.
But Crystal Kellan, a spokeswoman for the the trauma regional advisory council, wrote in an email last week that it cannot provide data it collects to anyone other than the state and the entities providing it.
Meanwhile, on the Tarrant County Public Health dashboard, data on hospitalizations and available beds is only a snapshot of the hospitals that have reported in the last 24 hours — meaning some may not have reported their data.
“So the data may not show the full picture,” Richard Hill, a spokesman for the Tarrant County Public Health Department, wrote in an email earlier this month. “But even though the absolute numbers may not be complete, the trend shown on that data is reliable, as on average about 84 percent of the hospitals are actually reporting this information on a routine basis.”
COVID-19 Hospitalizations over Time
Coronavirus daily hospitalization counts in Texas and the larger Trauma Service Areas, beginning April 8, 2020. Data provided by Texas Health and Human Services.
This story was originally published June 30, 2020 at 6:39 PM.
