Jackson Health CEO Issues Dire Warning Over Coronavirus Spike

MIAMI, FL — With Thursday's record-setting spike of more than 10,000 new coronavirus cases in Florida and thousands more cases over the previous three weeks, Jackson Health CEO Carlos A. Migoya issued a dire warning.

"If we continue to see more infection and more people needing to be hospitalized, in a period of three, four, five, six weeks, we'll get to a point that we will be way beyond the point that any hospital — or all hospitals — can do this," Migoya said.

As the leader of Florida's largest public health system, Migoya told reporters Jackson will limit inpatient surgeries and procedures to emergency and urgent cases starting Monday in an effort to make room for the growing number of coronavirus patients as well as other seriously ill people. See Florida Sees 10,000 New Coronavirus Cases, Largest One-Day Spike

"The reason we’re reducing those surgeries is to make sure that we have sufficient ICU beds that would normally be required from the surgery patients to be able to handle any COVID patient that we have coming in the door," he said.

On a typical day, Jackson can accommodate 1,350 patients.

"That number is a typical busy time for Jackson. It’s not a huge number for Jackson," Migoya said. "This means we may have 200 new patients come in today, but we are discharging 200 patients."

When the ratio changes, the health system comes under pressure with respect to staffing and bed availability.

"We have seen a growth in COVID patients in beds," Migoya shared Wednesday. "In the last 14 days, we went from 150 patients to approximately 300 patients. So obviously, that’s a scary number. Can we do more? Yes, we can do more, as we reduce some of these [other surgeries]. And that’s the challenge. What we cannot do, is that forever."

Miami-Dade is considered the epicenter of Florida's outbreak, with more than 1,000 deaths alone, along with nearby Broward and Palm Beach counties. Florida Gov. Ron DeSantis has said the median age of people testing positive for the disease over the past two weeks has consistently ranged between 33 to 37, which is reflected in Jackson patients.

Many are without symptoms.

"The highest level of shedding happens two to three days prior to symptoms. That’s why it’s important to (have) social distancing and masking," he said. "You’re shedding when you don’t know you even have it. That’s part of the danger that we have with this disease."

Dr. Lilian Abbo, Jackson's chief infection prevention and antimicrobial stewardship, said the medical community now understands the disease better after floundering during the early days in March and April.

"There was no consensus of what was working and what was not working," said Abbo, who is also a professor of infectious diseases at the University of Miami Miller School of Medicine. "We were blindly treating patients with our best educated guess, and every six hours the protocols and the guidelines were changing."

Since then, researchers have gained a better understanding of the disease through clinical trials and experience with patients.

"We stopped using the drugs that don’t work, for example some anti-HIV medication, some anti-malaria drugs," she said. "In terms of treatment, we are doing things differently. We are also trying to treat people quickly to avoid intubations. We don’t want people on a ventilator. We are trying to act quickly so we can prevent [the disease] from progressing."

She said younger coronavirus patients come to the health system in different ways.

"A lot of young women coming for labor and delivery may be positive and asymptomatic without knowing it," she said. "A second group is a younger group of people that are getting infected that require medical attention."

Those patients tend to have underlying conditions such as obesity with a body mass index greater than 30, diabetes, prediabetes and heart or lung disease.

She said doctors have had success treating some patients with convalescent plasma, some steroids and the drug remdesivir though the latter is in short supply.

"We don’t want to get to the point where we don’t have the drug," the doctor confided. "This would be extremely dangerous. This is one of the few drugs that has shown some efficacy. If we run out of this treatment, it would be fatal for people."