Hospitals facing surge in COVID-19 cases as beds fill, health care workers get virus
LOUISVILLE, Ky. — After weeks of stabilizing, the COVID-19 unit at Louisville's Jewish Hospital is full and staying full with seriously ill patients hospitalized for days or even weeks.
"My census is higher now than it was back at the beginning of the pandemic, and that scares me a lot," Dr. Valerie Briones-Pryor, a University of Louisville Health physician, told members of the Louisville Metro Board of Health on Wednesday.
"I'll tell you, the 15 patients I've got on my ward that I'm taking care of right now — they're sick," she told the board.
A new surge of COVID-19 cases in Kentucky and nationwide prompted Louisville officials to warn Tuesday that the local health system could be overwhelmed if people don't take the steps to avoid the virus more seriously.
"If the numbers continue to go up like they are right now, we will have to do something else because our hospital system will be overrun," Louisville Mayor Greg Fischer said.
While Kentucky, with more than 11,000 hospital beds statewide, appears to have adequate capacity for such patients, health officials say the larger problem is ensuring enough health care workers, as some come down with COVID-19 or must quarantine because of exposure.
Latest numbers:Beshear announces 2,318 new coronavirus cases, 20 deaths
"At the moment, hospitals are able to keep up, but there are indications some facilities in the near future could run into situations where they wouldn't have enough staff," Dr. Steven Stack, Kentucky's public health commissioner, told The Courier Journal.
"All of us need all of them to be able to help us when we get sick," Stack said.
On Wednesday, the U.S. reported 103,087 cases of COVID-19, the highest single-day total on record for any country in the world, according to the Atlantic magazine's COVID Tracking Project. It reported rates of hospitalization are increasing nationwide, with 52,000 COVID-19 U.S. patients in the hospital this week.
Like many states, Kentucky has seen an escalation in cases of COVID-19 and growing numbers of people hospitalized, on Thursday reporting 2,318 new cases and 1,102 patients in the hospital, with 291 in intensive care. The state also reported 20 deaths Thursday.
Stack said the surge has doubled the number of Kentuckians hospitalized over the past five weeks. At the end of September, Kentucky had about 500 people in the hospital.
As of Tuesday, 8,250 of Kentucky's 11,713 hospital beds were in use, leaving 3,463 available. The ICU numbers are more worrisome: About 1,421 of 1,678 total ICU beds were in use this week, leaving just 257 available. The COVID-19 count in those ICU beds has continued to tick up recently, with 259, or 18%, of them in use for coronavirus patients.
"Unfortunately, it's widespread throughout all of Kentucky," Stack said.
Read this:UK leading COVID-19 vaccine trial with Norton, Baptist Lexington
Dr. Jason Smith, chief medical officer for U of L Health, which operates Jewish and four other hospitals, says for now the community has adequate capacity for COVID-19 patients, working in coordination with Norton Healthcare and Baptist Health.
The three major health care systems have about 3,600 hospital beds in Jefferson County.
But Smith said the potential exists for COVID-19 to overwhelm a health care system as it did in the early days of the pandemic in New York and, more recently, in El Paso, Texas.
"Never say never," Smith said. "Could that ever happen here? It's in the realm if possibility."
One advantage for the Louisville area is U of L's decision to take over Jewish and Mary & Elizabeth hospitals, both at risk of closing last year. That saved about 600 hospital beds and gives U of L more flexibility in admitting COVID-19 patients, he said.
"We'd be in dire straits," he said, calling U of L's decision to acquire the hospitals "game-changing" for care during the pandemic.
The state still has the ability to set up a 200-bed field hospital at the Kentucky Exposition Center in Louisville if needed. Gov. Andy Beshear said Thursday it would take seven to 10 days to do that. But for now, the state is encouraging hospitals to work together to coordinate COVID-19 beds and alert the state if it appears they are reaching capacity, he said.
Dr. Sarah Moyer, director of the Louisville health department, said she remains concerned about having enough hospital beds, as well as staffing them, should COVID-19 cases keep escalating.
"We are in a situation just like March," she told the health board Wednesday. "Staffing's going to be our weak link and having hospital capacity to treat our community as we go forward."
"The trend is not encouraging," said Dr. Ben Klausing, infectious disease specialist with Baptist Health Medical Group. "We're headed into our darkest days here in Louisville."
Related:When does the flu season start in Kentucky? Your questions answered
Coupled with the surge in cases, flu season will be getting into full swing soon and is a virus that still remains "highly infectious," Klausing said.
"We're not in an advantageous position," he said of the convergence of the two viruses.
In Indiana, with about 1,900 people hospitalized with COVID-19, public health officials have appealed to retired health care workers to volunteer to help overworked staff and ease shortages caused by workers forced to quarantine after exposure to the virus.
Most often, that exposure to COVID-19 comes outside the workplace as rates of the virus increase throughout the area, health officials said. About 80 of Kentucky's 120 counties are now in the "red zone," with more than 25 cases per 100,000 residents, according to the state's coronavirus tracking website.
A recent spike in cases in Barren County forced T.J. Samson Community Hospital to double its COVID-19 unit capacity from 14 to 28 beds. And the 196-bed facility has another 18-bed unit ready to open for COVID-19 patients, if needed, said Stacey Biggs, executive vice president for marketing at the county's only hospital.
The southern Kentucky county is among those listed in the red zone, with 56 cases of COVID-19 per 100,000 residents
Biggs said the hospital also has had to scramble to cover staffing as health care workers come down with COVID-19. So far, the hospital has been able to manage but Biggs said she's concerned the spread of the virus will worsen.
"It's worrisome that it could still get worse before it gets better," she said.
Officials:COVID-19 cases in Louisville could soon overwhelm health system
At St. Claire Health in Morehead, capacity is still adequate, with 89 patients filling 149 beds. But this week has seen a dramatic surge in the need for ICU beds. At one point, all but one of the 14 intensive care beds there were filled.
Some patients later were moved to other places in the hospital, but that capacity is under close review, sometimes hourly, said Don Lloyd, the hospital's chief executive and president.
Even with a more severely ill group of COVID-19 patients now turning up from the hospital's five-county service area, "we've been able to manage. (But) if those numbers double or quadruple, it might be a different story," Lloyd said.
Beshear, at his news conference Wednesday, asked Kentuckians to try to do more to limit spread of COVID-19 through steps such as wearing a mask in public, limiting contact with others and washing hands frequently. Otherwise, he said, the coronavirus will continue to spread with more people falling ill and some dying.
As of Thursday, the state has reported 115,277 cases of COVID-19 and 1,534 deaths linked to the virus.
"We can't just let this run throughout our entire population," Beshear said. "The amount of death we would see is not just unacceptable. It would be truly awful."
Deborah Yetter: dyetter@courier-journal.com; 502-582-4228; Twitter: @d_yetter. Grace Schneider: 502-582-4082; gschneider@courierjournal.com; Twitter: @gesinfk.