As the COVID-19 pandemic surges, hospitals have the ability to add the beds needed to handle the influx of patients.
The biggest challenge to effectively managing the patient surge comes from securing the clinical staff — doctors, nurses and others — to treat the growing number of patients with COVID-19 who require hospitalization.
“Physical space is not an issue,” said Dr. Justin Grill, chief medical officer at Mercy Health Muskegon. “The staffing is an issue.”
In response to the surge across West Michigan, Mercy Health Muskegon, Spectrum Health and Metro Health-University of Michigan Health today said they are again temporarily delaying elective surgical procedures that require an overnight or longer hospital stay. That frees up beds and staff for COVID-related care.
Hospitals will continue to perform medically necessary procedures such as heart surgeries.
“At this time, we are aiming to continue as many surgical procedures for which the patient can be discharged home that same day. We are postponing procedures that require an overnight admission, if they are not emergent. We will continue to evaluate surgical cases on a daily basis based on our hospital census,” Metro Health said in a statement today to MiBiz.
The 208-bed Metro Health Hospital in Wyoming today had 40 patients who were positive for COVID-19 and had an occupancy rate of 86 percent.
The hospitals’ moves to delay elective procedures come after COVID-19 cases and positive testing rates skyrocketed in October, threatening to overwhelm available capacity.
COVID-19 inpatients at Mercy Health Muskegon quadrupled in the last seven to 10 days, Grill said. Mercy Health Muskegon’s 267-bed hospital campus as of today had more than 120 COVID-19 inpatients.
As of mid-day today, Mercy Health Muskegon had another 10 to 15 patients in the ER who tested positive and were awaiting transfer to an inpatient bed.
“We have a significant burden of COVID right now, no question,” Grill said.
Spectrum Health today had 288 COVID-19 patients hospitalized across its system. The health system’s COVID-19 inpatient volume has tripled from 20 days ago and is three-and-a-half times that of the spring, President and CEO Tina Freese Decker said during a media briefing Wednesday.
COVID-19 cases are coming in across all age groups, and the mortality rate in the region has climbed in the last three weeks, Freese Decker said.
Spectrum Health and other health systems all are working on ways to expand capacity to handle the surge by converting space. Staffing the additional beds may prove harder.
Unlike the spring, the ongoing surge is across all regions of the state, limiting the ability of health systems to collaborate and share staff.
“We know our colleagues at other hospitals and health facilities are experiencing the same exponential trend that we are experiencing,” Freese Decker said. “That’s quite different from the last time when there were places we could go throughout the state or country for our staffing and for availability of services for people. … This means that we have very little opportunity to share clinical staff or transfer patients.”
Under present conditions, Spectrum Health’s hospitals will hit capacity “in a matter of days,” Freese Decker said.
“So, we must change this trajectory of community spread,” she said. “This is why we need our community’s help and support. We need to flatten this curve like we did last spring.”
On Wednesday, the state reported 6,008 new confirmed cases and 42 additional deaths. Michigan is at nearly 230,000 confirmed cases total and 7,766 deaths. Kent County now has the highest number of cases per million people — 32,851 — in the Lower Peninsula.
Emergency capacity approved earlier
Most West Michigan hospitals last spring sought and quickly secured emergency approval from the state to add more than 1,500 beds to handle a surge in COVID-19 patients.
Spectrum Health this week sought emergency approval to add another 16 beds at the Butterworth Hospital campus, citing “the alarming surge in the number of patients needing acute inpatient care for COVID-19,” according to a filing to the state.
Spectrum Health in the spring received state emergency approval to add nearly 390 beds across its hospitals.
Hospitals in Grand Rapids also are in “active discussions” with local and state officials about opening an alternative care site such as what opened in Detroit at the TCF Center.
The challenge with that option remains securing the needed medical staff, said Dr. Darryl Elmouchi, president of Spectrum Health West Michigan.
“Even if we had another site with hundreds of beds available, staffing will absolutely be an issue if we got to that point,” Elmouchi said.
To help ease the present rate of the coronavirus spread, Elmouchi and others urge people to wear a face mask, keep their distance from one another and avoid large crowds. He strongly advises that people spend the upcoming Thanksgiving holiday with only immediate family and to avoid larger gatherings with extended families and friends.
“I know that will be so hard for everyone, but given what we’re seeing here in West Michigan, we are very fearful that if big groups start getting together the spread will go on ever further,” he said.
Hospitals have also seen large increases in the rates at which people test positive for COVID-19, “and that tells us that over the coming weeks we will see a markedly increasing number of patients in our hospitals with COVID-19.”
In Muskegon, Mercy Health this week has a positivity testing rate of 19.6 percent, Grill said.
“As long as it’s that high, it’s basically spreading like wildfire,” he said.
Mercy Health Muskegon can add bed capacity by moving from private to semi-private rooms on one floor in a new patient tower that can handle 70 patients.
While the hospital and patients prefer private rooms: “In a pandemic you do what you need to do,” Grill said.
Mercy Health Muskegon, which recently consolidated inpatient care at the Sherman Boulevard hospital campus, is making other adjustments to maximize space. It is looking to use vacated space at the Hackley Hospital campus that would begin with 20 beds and “judiciously” increase to a 40-bed unit, Grill said.
The added capacity at Hackley could open as early as next week as a COVID-19 alternative care site, he said. Mercy Health Muskegon is working with other health systems in West Michigan and a regional collaboration to open beds at the Hackley campus, Grill said.
Mercy Health Muskegon is working on sourcing staffing for the Hackley unit.
“We are working diligently on that,” he said. “We are hoping in the very near future that we will have the staffing that will allow us to accommodate a COVID care site at Hackley Hospital as soon as next week.”
Another option in Muskegon is a temporary care site at Muskegon Community College’s Health and Wellness Center for 50 hospital beds for overflow and lower-acuity patients, Grill said.