The intensive care capacity of the Texas Medical Center could be exceeded as early as Thursday due to the increase in patients with COVID-19, the hospital system projects.
A TMC model also predicts the ICU’s surge capacity (additional temporary beds and equipment used in emergencies) It could be overcome as soon as July 6 if the high rate of new hospitalizations for COVID continues, the most aggressive model to date.
Eleven leaders of the system’s hospitals and medical schools said in a joint statement that COVID-related admissions were increasing at an “alarming rate”, increasing the capacity of ICU units. Texas Children’s Hospital this week began admitting adult patients to handle the increase.
“If this trend continues, the capacity of our hospital system will be overwhelmed, leading us to make difficult decisions to delay care that is not necessary for COVID to accommodate more COVID patients,” the group wrote. .
Leaders urged residents to stay home when possible, practice social distancing, and wear masks.
The TMC system reported that its intensive care units had a 98 percent capacity on Wednesday. 27 percent of that total were COVID patients, nearly double the 15 percent established by health experts.
There are two levels of ICU surge capacity in the TMC system, said Dr. James McDeavitt, executive vice president of Baylor College of Medicine. There are 373 “sustainable surge” beds, including general beds converted to intensive care by adding personnel and equipment such as ventilators. This level of care can be provided indefinitely.
If those beds fill up, the system has an “unsustainable overvoltage” capacity of 504 patients. This stage includes placing two beds in each room, converting non-residential areas to makeshift rooms, and lowering staffing levels to treat more patients. This level of care can only be maintained for several weeks.
McDeavitt said he is confident in the short term that the system can handle the spike in COVID patients.
“We are concerned, but today we do not have a crisis,” he said. “If this continues for another three weeks, and the slope of the virus remains what it has been, then we will come to a point where we will begin to dive into that unsustainable overvoltage capacity, and that is a place that no one wants. Come on.”
The key metrics for measuring the severity of the pandemic in the Houston area, including the rate of positive tests and the number of new cases and hospitalizations, continue in the wrong direction. Gov. Greg Abbott on Tuesday urged residents to remain in their homes, and the New York governor said on Wednesday that Texas travelers must remain in quarantine for two weeks after arriving at the Empire State Building.
The 25-county region surrounding Houston set a new COVID hospitalization record Wednesday with 2,251 patients. That number has tripled since Memorial Day, putting pressure on health care facilities.
The increase in cases, a fraction of which become hospitalizations, is due to residents contacting each other more since the Harris County home stay order expired in late April, Dr. said. Umair Shah, county health director. Governor Greg Abbott began reopening Texas on May 1 in a series of phases.
Texas reported more than 5,000 new cases on Tuesday and almost 6,000 on Wednesday. The number of infections across the state has been increasing steadily since Memorial Day. Harris County added 1,365 cases Wednesday, along with 14 deaths.
Local leaders, including Houston Mayor Sylvester Turner and Harris County Judge Lina Hidalgo, say the reopening of the state was premature and left the region susceptible to a more severe outbreak. Turner said Monday that Houston had wasted much of the success of the home stay period, which health experts had credited with keeping the number of new cases low.
On Wednesday, Turner announced a weekend crackdown on companies that violate capacity restrictions, and Hidalgo’s most recent mask order forces companies to require their clients to wear face masks. That strategy, he said, could include creating a “Board of Shame.”
“I want to warn people now that as we get closer to the weekend we are going to actively monitor whether or not people meet the occupancy requirement and whether or not they wear their masks, because we really want to break down on people who don’t stick to the rules, “Turner said.
The mayor also left the door open to pursue tighter enforcement and restrictions if conditions continue to deteriorate. Abbott has been ahead of many local measures and strategies during the reopening process, including mandatory mask orders for individuals. He surprised officials last week when he approved the issuance of an order in Bexar County that required companies to require their customers to wear masks.
Hidalgo again urged residents to distance themselves socially and wear masks to curb the spread of the virus, saying that only a collective change in behavior by residents can again control the outbreak.
“The truth is that, whatever the way you cut it, we are in a very serious situation,” said Hidalgo. “That hospitalization curve is not going to flatten itself.”
Greater Houston Partnership CEO Bob Harvey issued a similar note, urging companies to send employees to work from home, if possible.
Since the past week, the worsening pandemic has helped Harris County meet four of the five criteria to make it through the worst of four stages in its threat level system. These include an average of 7 days of more than 100 new cases of COVID, an increasing trend of 7 days in the daily hospital population, and more than three days of ICU use greater than 15 percent by patients with COVID.
The only criterion not met concerns the provision of personal protective equipment for health workers, which remains extensive.
Baylor’s McDeavitt said there are some encouraging signs. Patients appear to be less ill than spring patients, in part because they are often younger. Doctors have also had months to gain experience in treating the virus. Still, he implored residents to follow health guidelines and minimize contact with others.
“Suppose everyone you know is infected,” he said.
Dylan McGuinness contributed reporting.
