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Arizona Hospitals Prepare For Coming Surge Of COVID-19 Patients
On Tuesday, Max Sussman of Scottsdale pulled up to the Phoenix Convention Center to make a donation at a medical supply drive. He didn’t exit his car, but let people working the drive take two bags out of his backseat, all while maintaining social distance.
Sussman donated gauze, masks and gloves. It was most of his own personal stockpile.
“I think that those materials are best left with medical professionals who need it right now,” he said.
Even though the spread of COVID-19 in Arizona isn’t at the level of states like New York or Washington, a large influx of patients is expected in the coming weeks. Hospitals and government officials are moving to get supplies and increase capacity ahead of the potential surge. They are also making adjustments to typical protocols in order to stretch what they currently have.
Emergency room doctor Frank LoVecchio, who works at Valleywise Health and other area hospital companies, said it’s not uncommon in normal times for, say, an intensive care unit doctor to use just one mask the entire shift. But in an interview Monday night, he said he’s being asked to use his mask more than he should.
“I went the whole shift yesterday using one,” he said. “But the day before I used two, because [there] was lots of secretions around on a person that was being put on a respirator and I thought the possibility that I [would get] exposed was high.”
All the hospitals LoVecchio works at are close to capacity already. They have plans for non-conventional methods to treat many more patients at once, he said.
“There’s other novel things that people sometimes could do,” he said. “They could take a respirator and ... for lack of a better word, do these different attachments and maybe you could use it for two patients, which normally you wouldn’t do. But there are some respirators that you [could] put two patients [on] if needed.”
Some supplies have been coming in, and officials say more is on the way. Arizona received thousands of masks, gloves, and gowns on Saturday from the Strategic National Stockpile. More are on order. The state health department also has a request to the federal government for 5,000 ventilators. And Gov. Doug Ducey on Tuesday announced the state will get a donation of a quarter-million masks, arriving next week.
The state’s largest health care provider, Banner Health, in a release Tuesday, said it has enough equipment but put out a call for donations of masks in particular.
Steward Health Care, another large hospital company, declined an interview request. Dignity Health did not have anyone available for an interview, but offered to answer questions via email. Those answers were pending at the time of publication.
In addition to supplies, hospitals are looking for more beds.
“We are currently checking in with the daily bed capacity EMResource that is an online resource that hospitals report in to daily to really track to see if the surge is in fact happening, And what we can say is, today it is not,” said Ann-Marie Alameddin, president and CEO of the Arizona Hospital and Health Care Association. “But hospitals are preparing for that.”
There are various measures a hospital can take to get more or different kinds of beds. An ICU bed could perhaps go in a Medical-Surgical unit, but that might require relaxing nurse-to-patient ratio rules, Alameddin said. The nurse-to-patient ratio on an ICU unit is 1 to 2.
State health department director Dr. Cara Christ listed options for increasing capacity at a press conference Monday.
“We will continue working with hospitals to identify ways to increase their internal capacity,” she said. “Including the use of triage tents outside of emergency departments, utilizing hospital rooms, recovery areas, and other unused portions of hospitals to provide additional beds, and working with hospitals on any waiver requests they may need in order to increase their internal capacity.”
She said the state is looking at using ambulatory surgical centers and respiratory training sites for ICU care. Christ also mentioned using sites like the Arizona Veterans Memorial Coliseum for recovery care for people who can leave the hospital but are not ready to return home.
The “potential surge” of coronavirus patients is “above and beyond our current capacity of beds,” Christ said. There are 16,905 licensed hospital beds in Arizona and 1,532 ICU licensed beds.
Christ regularly urges people to call their doctor if they feel symptoms and not go to the emergency room unless it’s truly an emergency.
LoVecchio thinks increased testing for COVID-19 from commercial companies will help not only to track the spread, but also make people more disciplined about staying away from others. A positive test result, he said, is more effective pressure than a doctor simply recommending someone go into quarantine.
“I don’t want to be an alarmist, but all indications are that we haven’t reached our peak,” he said. “All indications are that we’re going to have a rough couple of weeks here.”
Alameddin said things may seem beyond our control right now, but we have the power to slow the spread of COVID-19 and lessen the future stress on hospitals.
“We have a tremendous amount of control to keep ourselves healthy, to keep our families healthy,” she said. “And that’s by staying at home and not having contact with other people or keeping a safe distance.”
It’s our obligation, she said, to protect our own health and that of our health care workforce.