James A. Bacon
Finally, there is evidence that Virginia public health authorities are wrestling with a critical issue I raised a week ago: Does Virginia have enough hospital beds to handle the COVID-19 epidemic. And, if not, what is being done about it?
We got a few answers yesterday when Physician-in-Chief Ralph Northam and other state officials held a press conference. They said they are working to increase the capacity of Virginia’s hospitals in preparation for an anticipated surge in the number of patients.
“We are working … to understand exactly how many beds we can push into service,” said state Secretary of Health and Human Services Daniel Carey at the news conference, according to the Richmond Times-Dispatch. But state officials would not release data about the state’s medical infrastructure such as the number of acute care beds, ICU beds, or ventilators, and offered no assessment as to whether the number is adequate.
Two weeks ago, Governor Northam assured Virginians that the state has “a plan” to deal with the coronavirus. At that time, I observed that he provided few specifics. As the crisis worsens — 67 confirmed cases in Virginia at yesterday’s count — it’s still not clear what that “plan” might have been.
Northam has acted forcefully to contain the virus, but there has been no discernible evidence until yesterday’s press conference that anyone was working on the potential shortage of hospital beds, as seen in China and Italy. It is not reassuring to see that public health officials are unable or unwilling to release basic data such as the number of hospital beds, ICU beds and ventilators. If they don’t have the numbers by this point, that’s disgraceful. If they won’t release the numbers, what are they hiding?
Two days ago, I published data culled from the Virginia Health Information (VHI) website suggesting that Virginia’s acute care hospitals have only 17,100 licensed beds, and only 14,600 are staffed. I could find no data on the number of ICU beds, required for the sickest patients, much less the number of ventilators.
According to the Virginia Hospital and Healthcare Association, Virginia has 18,547 licensed hospital beds and staff to serve only 16,914. Those numbers are somewhat higher than the VHI numbers. The VHHA did not have the numbers readily available when I asked for them last week.
The Virginia Mercury quoted Carey as saying that the governor’s team had estimates on the number of available hospital beds. Estimates? Seriously? Estimates?
If the state had a “plan” to deal with an epidemic, one would think that bed counts would be basic information maintained continuously on file. At least the VHI publishes the number of acute care beds. One would think that someone in the bowels of the Virginia Department of Health would maintain an up-to-date list of ICU beds and ventilators.
Whatever their state of ignorance, at least public health officials are dealing with the problem. Reports the RTD:
Carey said that most hospitals do not operate all of their beds on a regular basis, and that the state is working with hospitals to expand bed capacity, including by converting operating rooms into patient care rooms and by granting waivers so that hospitals can operate beds that are not licensed by state regulators.
He added that the state is looking into bringing in the National Guard for help if necessary.
Converting operating rooms into patient-care rooms — good idea.
Granting waivers so hospitals can operate beds not licensed by state regulators — good idea.
Meanwhile, hospital systems are “bracing for staffing and equipment shortages.” Among other measures, some have begun rescheduling elective surgeries to free up capacity for the anticipated influx of COVID-19 patients.
Also, said the Virginia Department of Health in a statement, “We are working hard to ensure Virginia’s hospitals and health systems to have enough ventilator equipment on-hand to accommodate the treatment needs of patients experiencing respiratory issues.”
The Mercury reports that the regional coalitions that comprise the Virginia Healthcare Emergency Management Program (VHEMP) have “hundreds of ventilators in reserve across the commonwealth that can be deployed to hospitals when needed.” Those could be supplemented by equipment from the strategic national stockpile, if needed. Again, no hard numbers.
