Hospitalizations due to COVID-19 are on the rise in Dallas-Fort Worth and, should it continue, the status quo will be insufficient to meet patient demand. Gov. Greg Abbott and Mayor Eric Johnson both have asked the federal government to send Disaster Medical Assistance Teams to help supplement hospitals that can’t handle the influx of COVID-19 patients.
Fewer than two weeks ago, Dallas hospitals signaled that they had the beds and the staff to handle coronavirus patients. With cases spiking in Houston, DFW Hospital Council President Steve Love was messaging COVID-19 patients to go to the hospital, as data was showing that locals were avoiding the hospital until it was too late. “We didn’t want people to look at Houston and panic,” he says.
But that was then. According to data from the Texas Health and Human Services, the number of available ICU beds in the region dropped from 525 to 296 between mid-June and July 8, a decrease of 44 percent. In the same period, the number of COVID-19 hospitalizations in the 19 county area that makes up the North Central Texas Trauma Regional Advisory Council has increased from 701 to 1809, an increase of 258 percent in three weeks. There were still around 2,500 available total beds in North Texas, but the pattern is not encouraging.
Love says that by late July, things will get worse, especially considering a bump in cases that could be the result of July Fourth. Because of that anticipated caseload increase, hospitals are looking at surge planning.
As hospitals move to surge capacity, they will open up additional pods or units to treat COIVD-19 patients. The first step is to open units within the hospital campus itself, such as converting ER rooms to ICU rooms or by opening up unused areas. The conversions will begin in the hospital, and the next phase would be to find space on the greater campus to accommodate sick patients. This could include repurposing nearby outpatient clinics.
Obviously, there are advantages to keeping expansion within the campus. It means nutrition, security, infection control, and other auxiliary service providers would not have to travel far to keep the patients safe. The next phase would be to look for offsite spaces such as buildings that formerly were hospitals or other clinics that could be opened up for the sole purpose of treating the surge patients. Love says bed capacity and PPE are not an immediate concern for most hospitals. The trickier issue is staffing, and yet North Texas seems to be well-positioned for that challenge.
“The beauty of it is, here in North Texas, we have large systems that are moving staff themselves within the system, and can do patient transfers where it makes sense and where it is practical,” Love says.
The state, too, is looking to sign contracts with nurse staffing agencies to be ready for a surge in patients. A DMAT team, which is usually reserved for hurricanes or other disasters, is also headed to Parkland Hospital to deal with the influx of patients at the request of the mayor and governor. These are 36-person teams made of physician’s assistants, nurse practitioners, nurses, administrators, paramedics, and respiratory therapists that drop into a location to give support to those on the front lines. The teams are coordinated by the NCTTRAC, which also maintains data on hospitalizations in its partner counties. Right now, two DMAT teams have been assigned to DFW.
When asked which areas or hospitals were feeling the pressure the most, Love responded, “I think they will all feel it within the next week to 10 days.”