By Liora Engel-Smith
A COVID-19 fueled hospital surge may be in the cards for several of North Carolina’s most populated regions by late summer or early fall, according to a recent report.
Daily COVID-19 hospitalizations across the state have nearly doubled since April, reaching a seven-day average of roughly 800 over the recent week. At the same time, hospitals across the state have resumed elective procedures, filling some of the available beds. If cases and hospitalizations continue to grow at the same rate as they have in June, Greenville, the Triangle and Charlotte regions may be completely filled by late summer or early fall, the UNC report says.
Of the three regions, hospitals in the Greenville area may run out of beds as early as the end of July, while Triangle and Charlotte hospitals would reach that point the following month, the analysis shows.
“We’re nowhere near out of the woods yet,” said Mark Holmes, director of UNC’s Cecil G. Sheps Center, who co-authored the analysis with researchers from Duke and NoviSci. “This is an example of why we need to be vigilant and mindful [of COVID-19].”
These projections depend on the course of coronavirus in North Carolina in the coming weeks, Holmes added. If infections and hospitalizations rise faster, the surge will arrive earlier. If the numbers dip, the surge can be delayed or averted. In recent weeks, however, the number of infections in the state has increased in the wake of late May’s loosening of stay-at-home restrictions. It’s likely the uptick in numbers hasn’t yet reflected recent protests and other mass gatherings, which could further increase hospitalizations in the state, at least in the short term.
Some of the regions that may run out of beds sooner, including Mecklenburg, Durham and Wake counties, are already seeing a sharp rise in cases. Mecklenburg County’s cases, for example, more than doubled from May 28 to June 17, surpassing 7,500 cases as of Wednesday. That sharp rise in cases has prompted state officials to focus testing and contact tracing efforts on areas such as Mecklenburg and the Triangle, where cases are mounting, Gov. Roy Cooper said on Monday.
Ramping up, ramping down
As the pandemic spread across the state in March and April, some projections warned that a spike in hospitalizations could exceed the state’s capacity as early as in mid-April, but state health officials believe stay-at-home restrictions averted that early surge, giving hospital systems and the state two more months to prepare. Minimizing North Carolina’s initial wave of COVID-19 infections prevented a hospital bed shortage like the one New York City experienced in March and April.
“These two months were a blessing,” said Joseph Rogers, chief medical officer for Duke University Health System, which has hospitals in Durham and Raleigh. “I mean, if we had what happened in New York, it would have been a catastrophe as it would have in almost every city in America.”
The state, too, has taken steps to increase hospital capacity, including the reopening of the shuttered Sandhills Regional Medical Center, a rural facility that could deal with potential patient overflow. The state has also planned to use dormitories and hotel rooms for patients who need medical care but aren’t sick enough to be in the hospital.
Hospitals have made a range of contingency plans that allow for spaces such as conference rooms, cafeterias and even offices to be converted to additional space.
Hospitals across the state had also suspended elective procedures, a step they can take again in case of a surge, said Cody Hand, senior vice president of advocacy and policy at the North Carolina Healthcare Association. Larger hospitals can also expand their bed capacity and convert regular hospital beds to ICU beds as needed. Large hospitals can also transfer non-critical patients to smaller facilities to make room in ICU units, he added.
UNC’s analysis showed that such capacity expansions could delay reaching bed capacity by a few weeks to a month, depending on the region.
Hospital systems in the regions that could reach a surge first have also signaled they are ready.
Vidant Health, a system with a flagship hospital in Greenville, signaled that staff is ready to accommodate a possible surge despite recent financial difficulties.
“As a system of care with nine hospitals across eastern North Carolina including an academic medical center, Vidant is prepared, able to respond and, importantly, adapt to this fluid and evolving crisis,” spokesman Brian Wudkwych said in an email Wednesday. “We have the bed capacity, staffing, supplies and equipment we need at this time, and we continue to plan by accessing the collective expertise and resources from across our system.”
Rogers, of Duke, said that the hospital’s internal data has shown a steady increase in the number of people with COVID-19 in Raleigh and Durham and they predict that this trend will continue. To plan for a likely surge, Duke has looked at housing COVID patients in operating rooms and in a portion of the new patient tower that’s currently under construction. One of the floors at the tower, he said, will open this weekend and could accommodate a patient surge.
The other way to blunt the growth in hospitalizations, he added, is to continue to educate people on the importance of social distancing, wearing facemasks and frequent handwashing.
“All those things blunted the curve early on,” he said. “Unfortunately it’s very hard to sustain these public health measures and I understand that people are getting fatigued.”
But the report, he said, highlights the importance of “rebending that curve” to avert a patient surge.
This story has been updated to reflect that the brief was a collaboration between Duke University, UNC and NoviSci researchers.