Not enough hospital beds in North Carolina for coronavirus patients, report says

North Carolina hospitals don’t have enough beds to care for the coronavirus patients that could stress the health care system as infection spreads, according to a Harvard University analysis.

Wake County would need twice as many hospital beds in six months as are available at an infection rate of 20%, according to the analysis by the Harvard Global Health Institute and the Harvard T.H. Chan School of Public Health.

ProPublica and The New York Times were the first to report the study.

Area hospital systems said they are preparing for a potential influx of coronavirus patients. Hospital officials interviewed this week said they were considering ways to expand spaces where they could care for ill patients with a highly contagious disease.

Dr. Joseph Rogers, chief medical officer at Duke Health Systems said in an interview this week with The News & Observer that potential coronavirus cases are “going to put an incredible strain on the health care delivery system” that’s already operating at nearly full capacity. He reinforced calls for personal actions such as social distancing to reduce the virus’ spread.

Alan Wolf, a spokesman for UNC Health Care, said in an email Wednesday that “the system is preparing for a range of scenarios to handle an anticipated increase in coronavirus patients. Certainly, there are levels of patient care needs that would strain the state’s entire health system. Our preparations include looking at ensuring we have enough space, staff and supplies.”

In a joint statement Wednesday afternoon, UNC Health, Duke Health, and WakeMed said they were going to start rescheduling some non-emergency surgeries, procedures and appointments. On its website, WakeMed said its physician practices are rescheduling all non-urgent appointments at least until March 27.

“This shift is part of the health systems’ preparation to conserve precious clinical resources and to protect patients and medical professionals.” a statement from the three health systems said. “The greatest concern among all three organizations is to ensure that we continue to provide needed care to our patients while also meeting the uncertain demands on our systems associated with COVID-19. Prudent use of resources today will allow us to prepare for the anticipated need.”

Pence asks for delay in elective procedures

The announcement follows a plea from Vice President Mike Pence, who at a news conference Wednesday asked patients and doctors to delay elective procedures.

“We are again today asking every American and our medical community leaders and hospitals to partner with us in delaying elective procedures across country in our health care system to ensure that medical supplies and medical capacity go where they’re needed most,” Pence said.

He also announced that the federal government is allowing doctors and other medical professionals to practice across state lines “to meet the needs of hospitals arising in adjoining areas.”

The Harvard study looked at hospital bed availability under three scenarios where 20%, 40%, or 60% of adults are infected, and how many hospital beds would be needed at six months, a year, and 18 months. It is based on hospital beds available in 2018.

The analysis assumes a hospitalization rate of 19% for people younger than 65 and a hospitalization rate of 28.5% for people 65 and older.

Under the moderate scenario where 40% of adults become sick over 12 months, about 137,000 coronavirus patients would need care in Raleigh hospitals, according to ProPublica.

Raleigh has six times fewer intensive care beds than would be needed. The report makes its estimates based on referral regions, so surrounding counties, including Johnston and Harnett are included in the Raleigh numbers.

At the 40% rate, about 91,900 patients catching COVID-19, which causes the coronavirus, over the year would need care in Durham. ProPublica reported. The 240 intensive care beds at area hospitals are 2.8 times less than what would be needed. Orange County is part of the Durham region.

Preparing for a surge in coronavirus patients

The virus spreads through droplets when an infected person coughs or sneezes, according to the Centers for Disease Control and Prevention. It’s possible that the virus can spread by people touching contaminated surfaces, but according to the CDC, that doesn’t seem to be the main way it spreads.

Under the moderate scenario, hospitals in the Greenville region would need more beds, ProPublica reported. The Greenville region has 120 intensive care beds, but would need 3.6 times as many to care for seriously ill patients, the report said.

Dr. Michael Waldrum, CEO at Vidant Health, said Wednesday that the health system is taking prospects for a surge in coronavirus patients seriously, with plans to increase space and conserve supplies. But “generalized data doesn’t always apply to local situations,” he said. Variables such as population density and who gets infected and when will make a difference in how many hospital beds are needed.

As of Thursday, Vidant Health had not yet seen a patient with COVID-19, Waldrum said.

“Health care is not built for massive surges in America,” he said. “That’s a reality. The question is, How big is the surge and how fast?”

Vidant Health operates Vidant Medical Center in Greenville and has hospitals and physicians practices throughout eastern North Carolina.

The rural nature of much of the region can mean that there are fewer opportunities for the virus to spread from person to person, Waldrum said, and it isn’t surprising that urban centers are seeing the greatest increases in coronavirus cases.

“Social isolation in rural environments is easier,” he said. “It’s a very different environment.”

The state is not keeping track of who is hospitalized and who has recovered, said Chris Mackey, a state Department of Health and Human Services spokeswoman.

This story was originally published March 18, 2020 at 3:54 PM with the headline "Not enough hospital beds in North Carolina for coronavirus patients, report says."