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Coronavirus in Ohio: Hospitals say they've trained to 'surge' patient load in pandemics

Cincinnati Enquirer logo Cincinnati Enquirer 3/13/2020 Anne Saker, Cincinnati Enquirer
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As Ohio accelerates its defense against the spread of the novel coronavirus, hospital officials across the state worked Thursday to reassure residents that their facilities can handle a major increase in patients who get sick from the infection.

The executives also said doctors, nurses and other caregivers are prepared to manage a surge in patient counts from the highly contagious virus and the upper-respiratory disease it causes, COVID-19.

The stress the virus could place on hospitals could be severe. Dr. Amy Acton, director of the Ohio Department of Health, said as much as 40% of Ohio’s population could eventually contract the virus now being passed by "community spread." That's the reason health officials are trying to slow its advance now, even though 80% of those who come down with the virus will have nothing more serious than cold-like symptoms.

a group of people in a room: The CEOs of Cincinnati Children's Hospital Medical Center, Christ Hospital, Bon Secours Mercy Health, UC Health and Tri-Health attend the discussion on the coronavirus pandemic. © Sam Greene/The Enquirer The CEOs of Cincinnati Children's Hospital Medical Center, Christ Hospital, Bon Secours Mercy Health, UC Health and Tri-Health attend the discussion on the coronavirus pandemic.

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The hospital systems spoke about readiness as civic authorities ramped up public health measures to slow the rate of infection and reduce the potential burden on the health care system, which could be considerable under the best of circumstances.

A USA TODAY analysis of American Hospital Association bed data estimated that if the U.S. rates of severe and critical illness are the same as in China and Italy, there will be six patients for every hospital bed in the country. The same analysis finds that in Ohio, there could be more than 14 patients for every hospital bed. In Kentucky, there could be more than 12 patients per bed.

[ This story is being provided for free to our readers during the new coronavirus outbreak. Consider supporting local journalism by subscribing to the Enquirer at cincinnati.com/subscribe. ]

On Thursday, Ohio Gov. Mike DeWine canceled all gatherings of more than 100 people and ordered all schools closed for at least three weeks. On Tuesday, the World Health Organization declared the novel coronavirus a pandemic, or on a global scale.

In Cincinnati, the chief executives of five of the region’s six major health-care systems said their hospitals have trained and prepared for a global health pandemic. The officials said the hospitals can increase their patient counts from 20% to 50% if needed.

Other measures to accommodate the infection include canceling elective surgeries, although the executives said that step was not necessary now.

“As the infection evolves, and we’re learning more and more, the situation is by definition very fluid,” said Dr. Richard Lofgren, CEO of UC Health, the nonprofit that operates the University of Cincinnati Medical Center and West Chester Hospital in Butler County. “We need to make sure that we have abundant caution, but we don’t need to panic. We really do understand how we’re going to move forward.”

In Akron, Joe Milicia, a spokesman for Cleveland Clinic Akron General Hospital, said the Northeast Ohio system “has the capacity to add up to 1,000 beds if needed.”

The hospital leaders said preparedness is more than a bed count. Mark Clement, CEO of TriHealth, said the team of public health agencies and hospitals now must work to persuade people to keep the infection from spreading by hand washing, staying at least an arm’s length from other people and canceling mass gatherings such as sporting events.

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The goal, Clement said, is to “flatten the curve,” or to apply pressure on the rise in infections so that patients won’t overwhelm hospitals. Clement and Lofgren said by early next week, TriHealth and UC Health aim to erect stations inside hospitals, separate from emergency departments, where people with symptoms can be evaluated. Signs of a novel coronavirus infection are a fever, a dry cough and shortness of breath.

Testing remains at a premium. Ohio can test about 1,000 people right now before more test units become available next week. Dr. Dustin Calhoun, director of emergency management at UC Health, said patients who visit the “pop-up” assessment stations will be examined for other possible disorders, such as influenza. If a test must be done, a doctor can write the order on the spot.

If the disease COVID-19 becomes epidemic in Southwest Ohio, the local hospitals have a joint team that can quickly erect a mobile hospital under a massive tent, said Christa Hyson, spokeswoman for the Health Collaborative, the trade group for the health care industry in Cincinnati.

Hyson also said the hospitals manage a regional cache of N95 masks and other protective gear for medical personnel, although Hyson declined to say for safety reasons how many units are now stored in that cache, or its location.

Yet concerns linger about the amount of equipment available to protect health workers caring for sick and contagious patients. Deborah Arms, president of the Ohio Nurses Association, which represents 11,000 nurses across the state, said she has heard some hospitals have rationed the safety equipment, and some equipment has been stolen.

Arms said the union is recommending that nurses use the N95 mask more than once if they can and to get more than one task accomplished while gowned and gloved to minimize exposure. “Those are some of the strategies that we’re employing, in the event that there is not enough to go around,” she said.

Dr. Nick Kreatsoulas, chief clinical officer at Mount Carmel Health System in Columbus, said it's too soon to begin canceling elective surgeries, mainly because not enough people have been tested for the virus to know how many have been infected. "We're trying to stay ahead of the game here,” he said.

Ohio State University's Wexner Medical Center has been preparing for the virus for weeks, said Dr. Andrew Thomas, Senior Associate Vice President for Health Sciences and Chief Clinical Officer.

If there is a wave of hospital admissions, the center can scale back or outright cancel elective surgeries for a day or two at a time. The hospital could reassign entire floors to with patients with the virus, he said. But efforts to limit contacts among people now might be the best medicine in handling the disease.

"If we can make some really tough choices on things over the next month then we might be in a much better spot by April 9 than we otherwise could be," Thomas said. 

Contributing to this story: Max Filby, Mike Wagner, Megan Henry and Danae King of The Columbus Dispatch and Betty Lin-Fisher of the Akron Beacon-Journal.

This article originally appeared on Cincinnati Enquirer: Coronavirus in Ohio: Hospitals say they've trained to 'surge' patient load in pandemics

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