When will Miami’s coronavirus hospital surge hit? It could be late April or early May
The largest non-profit hospital system in South Florida is preparing for a potential surge of COVID-19 patients to flood emergency rooms in about 30 days.
Anticipating that, Baptist Health South Florida executives have ramped up training for nurses and other healthcare workers, moved forward with plans to add beds at their hospital in Kendall, and arranged for all pediatric patients needing hospitalization to be transferred to a competitor, Nicklaus Children’s Hospital.
With 11 hospitals from Marathon to Boca Raton and more than 2,600 beds across its system, Baptist Health is relying on its analytics team — and the hospital system’s own experience — to prepare for a rush of patients who will need intensive care and hospitalization, said Bo Boulenger, executive vice president and chief operating officer.
“We’re seeing the number of patients doubling every two to three days,” Boulenger said. “All the models seem to indicate that Miami-Dade County and South Florida is going to see a real surge in patients the first week in May.”
Miami hospitals are already seeing a significant volume of patients hospitalized with COVID-19, the disease caused by the novel coronavirus.
Baptist Health, which operates emergency rooms in Miami-Dade, Monroe and Palm Beach counties, said Wednesday it has 102 patients hospitalized across its system. Jackson Health System, Miami-Dade’s public hospital, said it had 82 COVID-19 inpatients on Wednesday.
At Jackson Health, administrators are stocking up on ventilators and expanding the number of available beds. That added capacity could come from the old rehabilitation hospital, which is sitting empty in case of a surge of patients suffering from COVID-19.
The Florida Department of Health said there were 148 COVID-19 patients hospitalized in Miami-Dade as of Wednesday afternoon.
The University of Miami Health System, or UHealth, is also eyeing the end of the month or early May for a potential surge. Dr. Tanira D. Ferreira, chief medical officer for the health system’s inpatient facilities, said the university has personnel looking at models projecting when the number of patients requiring hospitalization meets its peak in Miami.
“Nobody can say for sure, but most of the models seem to be consistent toward the end of April and the beginning of May,” Ferreira said.
Boulenger said Baptist Health’s planning department has analyzed several models for projecting the surge of COVID-19 patients, including one published by the Institute for Health Metrics and Evaluation (IHME), an independent research center at the University of Washington.
The IHME model projects that Florida hospitals will experience a peak in use due to COVID-19 on May 2 and that the state will have a shortage of 917 ICU beds and need more than 2,000 ventilators. Hospitals are still working to add beds and equipment, however, and it’s not clear if the IHME model accounts for those efforts.
Though the models are aligning on peak hospitalization, there’s still uncertainty about how accurate they might be. Caroline Buckee, associate professor of epidemiology at the Harvard T.H. Chan School of Public Health, said in a call with reporters on Wednesday that it would likely be several weeks until we understand how effective different social-distancing measures were on slowing the spread of the novel coronavirus.
Models take into account the “contact rate,” or the degree to which people in a given community interact with each other, Buckee said. But she said that it is difficult to adjust that rate to incorporate the possible effects of social distancing.
“It’s too early to say, and those types of precise forecasts around when the epidemic peak will occur are very difficult to make,” she said. “I think there’s a lot more uncertainty around the timing than people might realize.”
Preparing for the worst
South Florida hospital executives said they’re preparing for the rush of patients potentially to arrive sooner than the forecast date.
“I think we have a couple of weeks before we start to feel it,” Boulenger said.
Boulenger said Baptist Health is prioritizing three areas for its preparations: Identifying places where patients can be placed in beds, such as endoscopy centers and outpatient surgery clinics; ensuring there’s adequate staffing and back up, which means calling on retired and student nurses; and conserving needed medication and protective gear for healthcare workers.
By sending pediatric patients in need of hospitalization to Nicklaus Children’s, Baptist Health will open 22 emergency-room beds that can be converted into intensive-care beds, Boulenger said, and an additional eight to 10 beds in the ICU.
Matt Love, chief executive of Nicklaus Children’s, said the standalone pediatric hospital near Coral Gables currently has no patients hospitalized for COVID-19. Nicklaus agreed to the arrangement in part because the disease strikes harder in older adults than in children.
“There are very few pediatric cases across the country so it really is, this partnership really is bringing together two pillar organizations to increase the capacity on the Baptist side,” he said.
At UHealth, the emergency-management team is monitoring bed capacity, staffing, and equipment. Ferreira, the chief medical officer, said demographics also play a role: the health system is anticipating that older people and those with underlying health conditions are most likely to wind up in their care.
“It’s a very fluid situation,” Ferreira said. “We’re preparing for the worst and hoping for the best.”
This story was originally published April 1, 2020 at 6:09 PM.
