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Tampa Bay hospitals brace for a possible surge in patients

Area hospitals have less capacity to handle a continued surge in coronavirus cases than they did in April. But they say they are prepared.

The Tampa Bay area is back on the brink of a possible surge in hospitalizations related to the coronavirus, and data shows the local health care system’s ability to respond has eroded since the spring.

Between early April and now, about 38 percent more people have been admitted to hospitals in Hillsborough, Pinellas, Pasco and Hernando counties, according to state data analyzed by the Tampa Bay Times.

Elective surgeries have resumed and doctors say patients who have put off routine care are starting to show up again — all while the state sees record-breaking increases in COVID-19 infections that don’t appear to be slowing down.

Statewide, about 22 percent — or about half the beds open at the start of April — are available now, the Times found. Tampa Bay has seen a steady decrease in hospital space, too, dropping from more than 40 percent of beds available to about a quarter.

The landscape is similar in South Florida but worse in Central Florida, where capacity has dropped to about 16 percent, data shows. Other counties are worse off: Hardee had no beds available Tuesday evening, while Flagler and Orange each had about 11 percent left.

Top doctors in Tampa Bay say they aren’t in crisis mode yet, but surge plans are in place. Hospital executives say they stand prepared to expand bed space quickly if needed, and that they will work with competitors to accommodate patients if necessary.

What happens next is up to residents and their choices about social distancing and face coverings, Dr. Ulyee Choe, director of the Pinellas health department, told commissioners at a June 23 meeting.

“What would occur if this trend line continues is increased death, increased hospitalization and then ultimately, overwhelming the health care system,” he warned. “What that would lead into is complications and death for both COVID patients as well as those without COVID.”

Dr. Charles Lockwood [ DIRK SHADD | Times ]

Dr. Charles Lockwood, dean of the University of South Florida College of Medicine, said while there is less bed space currently, hospitals overall are better equipped to treat the coronavirus now than they were a couple months ago.

Doctors know more about the disease, plus protective equipment is less scarce, extra ventilators have been ordered, and treatment options have expanded. There are more medications, and doctors have started using a new strategy — prone positioning, or flipping patients onto their stomachs — to help people breathe more easily.

It often helps hospitals avoid putting patients on ventilators in the ICU, Lockwood said. “We’re just a lot better able to care for these patients.”

Hospitals have options as they begin to reach capacity or overflow, said Jennifer Tolbert, a health policy expert with Kaiser Family Foundation, a nonprofit focused on national health issues that has been tracking the pandemic’s effects in the United States.

They might look for unused beds in places like children’s hospitals and rehabilitation facilities, or even open a makeshift hospital in a local convention center. They could convert their own conference rooms and waiting areas into more space for patients.

“As long as you have the equipment, you can set up beds,” Tolbert said. “The key issues to think about are staffing and equipment. Finding space is easier.”

Another move that might happen if Florida’s infections keep creeping up is a return to a ban on elective surgeries, Tolbert added. Gov. Ron DeSantis stopped those procedures statewide March 20, as Florida prepared for a surge the first time, and they resumed May 4.

Tampa Bay hospitals, which put off thousands of procedures in that time, are playing catch up now, and that’s a key reason they are so full, Lockwood said. Non-coronavirus patients now make up a larger part of those in ICU beds than six weeks ago, but it is not clear how many. The state to this point has not released that data but has said it will begin doing so this week.

Most of those admitted in recent weeks that do have the virus have been young compared to earlier on in the pandemic, Lockwood added. The average age among coronavirus cases in Hillsborough was 48 six weeks ago, for example. Now it’s 37.

Meanwhile, the county’s rate of death from the virus is close to 1 percent — one of the lowest in the country, Lockwood said.

Dr. Larry Feinman [ Courtesy of HCA Healthcare ]

Though young people are less likely to stay in hospitals long or need intensive care or a ventilator, they can easily spread infection to other, more vulnerable people once they leave, said Dr. Larry Feinman, chief medical officer for HCA hospitals.

That’s when the strain on Tampa Bay’s health care system could get worse.

“I do think we all need to be concerned at this point,” said Dr. Nishant Anand, chief medical officer for BayCare Health System, which operates 15 hospitals in and around Tampa Bay. “If we see more people getting infected, especially an older age demographic, we will see more hospitalizations, and that has impacts for everyone in the community.”

Dr. Nishant Anand [ Courtesy of BayCare Health System ]

Anand pointed out that BayCare can shift patients between its locations as needed, as can HCA and AdventHealth hospitals, according to those companies. Each BayCare location has “extensive modeling on how to adapt” facilities if needed, said spokeswoman Vjollca Hysenlika. She declined to share specifics about just how much BayCare can expand.

Recently, BayCare’s Morton Plant Hospital in Clearwater has been among the hospitals with the least remaining capacity in Tampa Bay, data shows. For the last few days of June, the facility had about 46 of its 450 beds open, a little more than 10 percent. As of Tuesday afternoon, that number was down to 8 percent, with only 36 free beds. In Morton Plant’s ICU, only three of the 59 beds for adults were available.

AdventHealth, which operates six hospitals in the region, has “sufficient” space and equipment for a surge in admissions, according to a statement provided by the company. Spokeswoman Richelle Hoenes declined to share details on how much the hospital system can grow its capacity but said she has “not heard any top leaders talk about worrying about a surge.”

At AdventHealth Tampa, the typical reported bed capacity in early April was about 545, which has grown to about 560 in recent days, although some updates have shown nearly 600 beds. The percent of those beds available has dropped from just below 50 percent to less than 20 percent.

HCA’s 15 hospitals in and around Tampa Bay are prepared to expand ICU beds by 200 percent, said Feinman, the chief medical officer. Each facility has weeks worth of protective equipment, and there’s more on standby in a central warehouse.

Northside Hospital in St. Petersburg has served as a good example of how HCA’s facilities can expand to handle a surge in patients. Since April, the number of people admitted at once tripled, going from about 75 in early April to about 240 in late June. And data shows the hospital responded by dramatically upping its reported capacity, from about 160 beds to about 430.

On Tuesday afternoon, Northside’s available capacity was about 42 percent. Its adult ICU capacity was about 14 percent.

At Tampa General Hospital, about 28 percent of its more than 1,200 beds were available for the last few days of June, although capacity on Tuesday afternoon dropped to just 13 percent.

The area’s largest hospital has increased its number of rooms for COVID-19 patients, and there is room for more, according to spokesman Curtis Krueger. He did not share specifics, but said it’s not unusual for Tampa General, one of the area’s two trauma centers, to have a high number of critical patients, and noted that most in ICU beds currently are not infected with the virus.

Tampa General announced in April a $2.65 million donation by businessman and philanthropist Eddie DeBartolo Jr. and his wife, Candy, which will be used to treat COVID-19 patients. The money will fund construction and equipment for a long-term unit dedicated to diagnosing and treating patients infected with the virus, though the timeline for opening has not been announced.

Dr. Peter Chang [ Courtesy of Tampa General Hospital ]

Dr. Peter Chang, vice president of care transitions at Tampa General, said it’s hard to predict what comes next for Tampa Bay. He’s expecting the worst and hoping for the best, and telling everyone he can to wear a mask and limit movement.

“Over the last couple of months, the luxury of what we have had is time to prepare,” Chang said. “We’re really kind of bracing and trying to do everything we can to prepare for what may come. But we don’t really have a good estimation for what that is.”

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