Will Coronavirus Push IL Hospitals To Capacity Tipping Point?

CHICAGO — Will the new coronavirus push Illinois hospitals over a capacity tipping point?

Public health and hospital officials have been slow to answer questions about if or when spread of COVID-19, the illness caused by the new coronavirus, might create an untenable situation at local emergency rooms and intensive care units.

"This is not a normal situation. Every day, hospitals are assessing their bed situation, supply situation and staff situation to meet the current need in real time," said Illinois Hospital Association spokesman Danny Chun.

"We're seeing all kinds of projections on how many people will get the virus. How many will need hospitalization. How many people might die. And the ranges are huge, so you can't predict those shortages at this point and time when you don't know how widespread the viruses are."

When asked for information about capacity at hospitals run by Advocate Health Systems, a spokeswoman replied via email, "I have no info on patient levels. I'll send you an invite to a media briefing with one of our docs later today but can't offer more."

The Illinois Department of Public Health told Patch that the agency is "tracking hospital resources on a daily basis and is monitoring the data very closely."

IDPH officials sent Patch "a summary of today's statistics" that include the following: As of Tuesday, there were 814 empty intensive care unit beds, 597 empty isolation beds and 1,467 ventilators statewide.

On Wednesday, there were 825 empty "adult" intensive care unit beds, 615 empty isolation beds and 1,450 ventilators available statewide, according to the IDPH.

State health officials have not yet responded to follow-up questions about the data, including whether hospitals in specific parts of the state are nearing capacity.

On Monday, ProPublica published a report that included a national database based on new study by the Harvard Global Health Institute. It illustrates for the first time which regions around the country are home to hospitals that could be particularly stressed by the spread of COVID-19.

In most scenarios, "vast communities in America are not prepared to take care of the COVID-19 patients showing up," said Dr. Ashish Jha, director of the Harvard Global Health Institute, who led a team of researchers who developed the analysis.

The ProPublica report includes a series of maps laying out nine different scenarios of how quickly the spread of the new coronavirus could lead to hospital regions across the United States reaching or exceeding capacity, based on Harvard Global Health Institute's hospital bed capacity and COVID-19 estimates.

From ProPublica: As of 2018, Chicago had 7,760 total hospital beds, of which about 59 percent were occupied, potentially leaving only 3,160 beds open for additional patients. The bed count includes 910 beds in intensive care units, according to data from the American Hospital Association and the American Hospital Directory.

Intensive care units are best equipped to handle the most acute coronavirus cases.

The Chicago region has a population of about 2.6 million residents; 12 percent are over the age of 65. The experience in other countries has shown that elderly patients have significantly higher hospitalization and fatality rates from the new coronavirus.

In the moderate scenario, in which 40 percent of the adult population contracts the disease over 12 months, Chicago would be among the regions that would need to expand capacity.

It is estimated that about 8 percent of the adult population would require hospital care. In a moderate scenario where 40 percent of the population is infected over a 12-month period, hospitals in Chicago would receive an estimated 167,000 coronavirus patients.

The influx of patients would require 5,570 beds over 12 months, which is 176 percent of available beds in that time period. The Harvard researchers' scenarios assume that each coronavirus patient will require 12 days of hospital care on average, based on data from China.

In the Chicago region, intensive care units would be especially overwhelmed and require additional capacity. Without coronavirus patients, there are only 310 available beds on average in intensive care units, which is 3.7 times less than what is needed to care for all severe cases.

In the Chicago area, hospitals and doctors have started to take precautions to preserve hospital capacity, supplies and staffing to prepare for treating additional patients infected with the coronavirus.

For instance: Advocate Health Systems hospitals announced a "no-visitor" policy with few exceptions; limited outpatient appointments and certain elective procedures and surgeries; launched a COVID-19 hotline; and closed all dining rooms.

Advocate Good Shepherd and Lutheran General hospitals have set up a "temporary drive-up testing center" for patients authorized by the local health department to undergo a COVID-19 screening.

Dr. Robert Citronberg, Director of Infectious Diseases at Advocate, said there's a "legitimate, at this point theoretical, concern" about the coronavirus pushing hospitals past their capacity.

"We’re doing everything humanly possible to prevent that from happening. Starting with efforts to encourage social distancing which is the single most important thing we can do. Also encouraging people who don’t need to be in the hospital to stay out of the hospital. ... In the worst case scenario that certainly could happen. Still, hopefully with all our interventions that we will prevent that situation from every happening."

Citronberg said he wasn't able to "give any specifics" about capacity levels at Advocate hospitals saying, "We are not at capacity at this point. We certainly have a lot of room left." He said cancelling elected surgeries frees up "a ton of space and resources" that can be repurposed to take care of people who need to be treated at the hospitals.

Dr. Katherine Tynus of Northwestern Medical Center said she has been conducting telephone visits, postponing follow-up exams and steering patients away from hospital emergency rooms.

"I'm telling my patients to postpone any testing procedures or follow-ups. Don't get a mammogram. Reschedule your colonoscopy. Just wait," Tynus said. "At the doctor's office, we've got people coming in who are sick and worried, and the last thing we want to do is expose other patients who are sick and frail in the waiting room."

Tynus said that because of a lack of COVID-19 tests, she's often not able to confirm whether patients have been infected.

"People have come into the office because they're feeling a little sick. They might have the flu. They might have strep throat. But I can't tell them if they do or don't have [COVID-19]. If they have strep or the flu, we're pretty sure they don't have it. There's a study out of China that says they don't co-exist. Otherwise, we can't tell people they're OK."