Yesterday, the city of Dallas’ ICU bed occupancy crested 70 percent for the first time since the pandemic arrived. That number is an unofficial eyebrow raise for the people in charge. If sustained or exceeded, that level would require a plan to quickly expand capacity in the event of a rush of admissions. But top doctors, public health officials, elected leaders, and hospital representatives agree that Dallas is not there yet.
Yesterday, 25 hospitals within the city of Dallas reported to Mayor Eric Johnson that 588 of their 828 ICU beds were now occupied, 71 percent. That was the highest since the pandemic began. But since April 21, total ICU bed occupancy in the city has hovered between 60 percent and 68 percent, a sign that Dallas’ beds were rotating patients out at a sustainable pace. (Keep in mind: that’s all ICU beds, not just those for COVID patients.)
Steve Love, president of the Dallas-Fort Worth Hospital Council, said the rise “relates to surgeries and treatment that had been postponed previously and not related to COVID-19 patients.” Here is his full statement:
“Our hospital COVID-19 patient population for the North Texas region has remained fairly constant over the past week. As businesses open up and restrictions removed or reduced, we will carefully monitor any increased admissions in COVID-19 patients to ensure we have capacity. The hospitals also have surge capacity over and above the current bed capacity and each hospital and hospital system has worked diligently to have a surge plan ready if needed. We obviously hope we do not have to activate our surge plans.”
That surge plan includes turning operating rooms into de facto ICU beds, something Parkland Hospital did early on. A Parkland spokeswoman said total ICU capacity there is 116, with 98 reserved for COVID patients. Another 30 could be added from the neurosurgical ICU. County Judge Clay Jenkins said Parkland had added ICU beds earlier, when elective surgeries were on hold. (For scale: Parkland is currently treating 18 COVID-19 patients in the ICU.)
“It’s been a slight increase, but it hasn’t been a rapid increase,” Jenkins said. “But we’re clearly not seeing a decline in ICU admissions or hospital COVID beds. We’re actually seeing a slight increase. So that’s concerning, and the CDC would say you don’t want to open in the face of an increase, but that’s decided by the governor.”
Taken regionally, the data are more telling.
The North Central Texas Trauma Regional Advisory Council represents the 19 counties that make up what’s known as Trauma Service Area E. We don’t know how many total COVID patients are hospitalized in the city of Dallas alone, but we do know that about 621 confirmed cases are in a bed and 578 suspected cases are as well. That’s a decline of 5 percent and an increase of 6 percent week-over-week, respectively. There are a total of 17,117 beds over those counties, 11,024 of which are occupied. That’s a total of 64.4 percent. In the ICUs, there are 2,141 beds occupied by 1,389 patients. An occupancy rate of 64.9 percent.
Love is comfortable so long as those levels remain static. The goal is to avoid a situation like in El Paso, which saw a single day jump of 40 percent in patients requiring hospitalization for COVID-19. According to local news reports there, total hospitalizations in the county had increased 75 percent since the end of April, data that spurred Gov. Greg Abbott to exclude the city from his most recent reopening order.
Should it come to that, the hospitals would enact their surge plans and the makeshift hospital at the Kay Bailey Hutchison Convention Center could be stood up. It could be accepting patients within five to seven days. Mayor Eric Johnson said the governor assured him that the state and feds would provide those resources if necessary. But we’re not there yet.
On Thursday, Johnson reported that ICU bed occupancy in the city of Dallas was back down to 68 percent, an overnight decrease of about 28 beds. Dr. Mark Casanova, the head of the Dallas County Medical Society, said the ICU’s ascent was concerning and something to watch, but not yet a cause for action by hospital executives.
“If we’re at 75 percent capacity come Monday and 80 percent next Friday, well, then that’s starting to raise some pretty significant alarm bells,” Casanova said. “But we have the cushion right now.”
Both Jenkins and Casanova agree that the numbers should be personally actionable, though. Just because bars are open doesn’t mean you should visit them. Wear a mask. Stay 6 feet from others. Continue to avoid gatherings. Personal responsibility, he said, will steady the numbers. And on Thursday, the county had another day of declining, sub-200 new cases: 183.
“It’s up to all of us, to not focus on what is legal but what is safe,” Jenkins said. “People have to ask themselves, Do we really need to go to the bar and have some beers and make some bad decisions or do we want to wait on that?”