See how Florida hospitals could be overrun by coronavirus — and which are most vulnerable
As cases of COVID-19 increase across the state, Florida hospitals are bracing for a spike in patients that experts project will leave them scrambling for available beds.
In Florida alone, at least 688,000 people over the age of 18 are projected to need hospitalization from the disease, according to an analysis by the Harvard Global Health Institute and the Harvard T.H. Chan School of Public Health. The projection accounts for the large portion of Floridians over 65 — nearly 20 percent of the state’s adult population — who are more likely to be hospitalized than younger people as a result of the disease.
Whether Florida hospitals will be able to handle the influx of patients from COVID-19 largely depends on how fast the virus spreads (which experts say depends on the state’s ability to maintain social distancing) and whether hospitals across the state take actions to free up more beds. Some Florida hospitals have started to limit elective surgeries to make space. Another set up outdoor tents to be ready for a surge.
Although the outbreak is currently concentrated in Broward and Miami-Dade County, the greatest threat to hospital resources could be in different areas. These potential hot spots include the rolling hills of Ocala’s horse country; Silver Springs, home of the “world famous glass bottom boat”; Floral City, known for its moss-draped tree canopy and Heritage Days festival; and Tallahassee, home of the state government.
The calculations by Harvard show that if 20 percent of the population of Florida contracts COVID-19 within six months, hospitals across the state will be overrun with more patients than they have available beds. In some areas, the demand for beds would be more than triple the current capacity.
Even if the 20 percent spread occurs over 12 months, without adding beds or freeing up beds by limiting non-essential surgeries , the vast majority of Florida hospitals will still be over capacity, according to the Harvard model.
If the timeline of infection can be slowed to 18 months, most Florida hospitals will have sufficient beds to handle the increase in patients even without adding or freeing up beds. That’s precisely the rationale behind the concept of social distancing, which is intended to bring about a “flattening of the curve,” meaning the same percentage of the population gets the disease, but spread out over a longer period of time.
Scientists and health experts have recoiled at President Donald Trump’s idea of opening up the country by Easter, which could make the virus spread more quickly.
Even with effective social distancing however, hospitals around Ocala, Hudson, and Tallahassee could still be at or over current capacity if they don’t increase the number of available beds, the analysis indicates.
Epidemiologist Marc Lipsitch, from the Harvard School of Public Health, has predicted between 20 and 60 percent of the adult population will contract COVID-19 at some point, meaning the maps published above represent a conservative projection of the strain on Florida hospitals.
However, the model’s predictive power is limited in that it assumes that the virus will spread equally across 20 percent of the state’s population and that everyone has an equal chance of catching it. In practice, others studying the spread say some people are “super-spreaders” while others are relatively isolated. Densely packed cities may be more vulnerable to spread of the coronavirus, which leads to COVID-19.
Hospital preparations in hot spots
In Central Florida, hospitals are getting ready for a “surge” of COVID-19 patients as months go on, according to Ashley Jeffery, communication manager for the AdventHealth West Florida Division.
“As more cases of coronavirus are diagnosed, our AdventHealth division is preparing for a possible surge of incoming patients.
AdventHealth Ocala is a 425-bed facility, but that might not be enough. The area is projected to have the most potential strain on its hospitals of any area across the state and even with limited spread over a long period of time, the region’s hospitals are projected to be over capacity.
Over 40 percent of the adult population in the hospital referral region around Ocala is over 65, contributing to the burden on hospitals. To expand operating capacity, the hospital is building tents outside in case the situation turns dire.
“We are preparing areas outside of our hospitals, like tents, should we need them,” Jeffery said.
The extra capacity is just one part of the hospital’s preparedness plan. Medical staffers are also running drills in the tents to make sure the plan they have in place is the right one.
“You want to make sure it works before you need to use it,” Jeffery explained.” Right now we’re focused on being prepared. That’s why we do what we do and now is the best time to put that into action.”
Other areas in the northwestern part of the state are projected to be slightly better, but many will still be over or at capacity according to the best-case scenario presented by the Harvard researchers.
Tom Stone, CEO of Doctor’s Memorial Hospital in Perry, Florida, said his hospital has plenty of free bed space to deal with the rural area’s residents. He is more concerned about available space in the hospital’s intensive care unit, which he says has been all but shut down in recent years due to lack of nursing staff.
“We have space,” Stone told the Herald. “But again, it depends on the patient. Most of these people are going into ICUs and we have limited space of that.”
Doctor’s Memorial, 48 beds, is also in the same hospital referral region as Tallahassee, where hospitals are projected to be over capacity. Stone expects that if Tallahassee is overwhelmed, his small hospital 50 miles away may have to accept patients from out of town.
“How their plan works out will determine what we do down here and how we may have to help them relative to overflow,” Stone told the Herald.
Hospitals in Tallahassee are taking steps to open beds.
“Anticipating a rise in patient volume, we are focused on managing the patient population to reduce and delay elective and non-emergent surgeries and procedures to preserve bed capacity and personal protective equipment,” said Ryan Smith, vice president and chief clinical officer at Tallahassee Memorial HealthCare. In 2019 Tallahassee Memorial — one of two major hospitals in the state capital — opened a 34,000-square-foot ICU, equal to more than a dozen large houses.
“This move created a vacant surgery center and ICU beds,” Smith added. “We are currently assessing these vacated areas to determine which are best suited to bring back into service to support a surge in patient volume.”
Similar measures are being taken at Bayfront Health Brooksville, a 244-bed hospital in the referral region around Hudson, Florida, where hospitals are projected to need over 100 percent of their current availability even if the virus spreads over 18 months.
“Given the expected increase in COVID-19 cases in the community and overall patients in our care, we have suspended all scheduled, discretionary, non-life-saving surgeries to conserve our resources for the delivery of urgent medical needs,” said hospital spokesperson Jennifer Siem.
This story was originally published March 25, 2020 at 9:28 AM.
