{"id":65221,"date":"2020-03-18T16:49:04","date_gmt":"2020-03-18T22:49:04","guid":{"rendered":"https:\/\/dh.durangoherald.com\/tj\/colorado-hospitals-already-seeing-shortages\/"},"modified":"2020-03-18T22:49:04","modified_gmt":"2020-03-18T22:49:04","slug":"colorado-hospitals-already-seeing-shortages","status":"publish","type":"post","link":"https:\/\/dh.durangoherald.com\/tj\/colorado-hospitals-already-seeing-shortages\/","title":{"rendered":"Colorado hospitals already seeing shortages"},"content":{"rendered":"\n

\"A
A negative pressure room inside St. Joseph Hospital on March 10.<\/span>Kevin J. Beaty\/Denverite<\/span><\/figcaption><\/figure>\n<\/p>

The chief medical officer at Denver Health says the hospital is seeing a spike in possible COVID-19 patients, creating a shortage of testing kits, supplies and personal protective equipment used to prevent the spread of sickness to hospital workers.<\/p>\n

\u201cWe need an alternative for testing. We need faster testing,\u201d said Dr. Connie Savor Price.<\/p>\n

The state\u2019s top safety-net hospital doesn\u2019t have enough tests or swabs to do them at the current pace, and test result turnaround times are too long, Price said. That is severely slowing doctors\u2019 ability to tell who has COVID-19 and who doesn\u2019t, so they can separate and treat the patients who have it.<\/p>\n

\u201cEverything\u201d hinges on testing as hospitals respond to the upswing in possible coronavirus patients, Price told Colorado Public Radio<\/a>. Price is also a professor of infectious diseases.<\/p>\n

\u201cWhile we wait for those results, we\u2019re treating those patients in isolation,\u201d Price said. \u201cAnd as a result, with every new patient who comes in, we are burning through our personal protective equipment to the point that we are on short supply, as is every other health care institution in Denver and likely in Colorado. And I think in the United States.\u201d<\/p>\n

Denver Health isn\u2019t sure how many possible COVID-19 cases it\u2019s dealing with because of the testing delays.<\/p>\n

\u201cOur ICU (intensive care unit) right now is full of patients awaiting test results,\u201d Price said.<\/p>\n

The number of patients in the unit under investigation for the virus doubled in the last 24 hours.<\/p>\n

\u201cWe are seeing more patients present with potential COVID infection, but we\u2019ve been unable to confirm whether they truly are infected or not,\u201d she said.<\/p>\n

The number of patients who have tested positive and are now in isolation at Denver Health jumped from five on Monday to 10 on Tuesday. It has not yet been two weeks since Colorado had its first identified case. The statewide tally stood at 183 on Tuesday night.<\/p>\n

Price also described a shortage of two key elements of the testing process: swabs and media, which is a liquid that a sample is placed in so that it can maintain its integrity while it awaits testing.<\/p>\n

Other doctors have confirmed these shortages as well. In an email shared with CPR News, Rocky Mountain Urgent Care was going to open a COVID-19 testing site, but the facility couldn\u2019t get testing medium and needed more protective gear.<\/p>\n

Price said she thinks all testing resources should now be diverted to hospitals since the state has already determined there\u2019s community spread elsewhere.<\/p>\n

\u201cUntil we get our supply chain fixed, until we get our testing capacity addressed, we should be focusing on our health care system right now,\u201d Price said, and particularly focusing on the sickest patients and those who\u2019ve tested positive.<\/p>\n

\u201cWe have to remember that most people with this infection will do fine. Eighty percent of the population who get infected will have mild illness and recover,\u201d Price said. \u201cIt is those who do not recover, that are very ill, we need to focus on, we need to be able to protect them.\u201d<\/p>\n

So, a lot of social distancing \u2013 staying at least 6 feet from others and avoiding large groups \u2013 needed to be focused on the elderly and long-term care facilities, dialysis centers and other parts of the system where people with illnesses are housed.<\/p>\n

Hospitals seeing a lot of patients, and the sickest patients, need to be a priority, Price said.<\/p>\n

\u201cRight now, that\u2019s where testing needs to be diverted,\u201d Price said.<\/p>\n

She said she\u2019s shared her request with state officials, \u201cand I\u2019m confident the right decision will be made.\u201d<\/p>\n

The governor\u2019s office had not responded to a request for comment.<\/p>\n

A spokesperson for the state department of public health said in a statement: \u201cOur testing practices evolve daily as the situation is evolving and so are our needs. We are taking into consideration the needs of hospitals while balancing the needs of communities throughout Colorado.\u201d<\/p>\n

The Colorado Hospital Association said in a statement it is also preparing for an influx of cases. The association said it, \u201cformally asked the state last Friday for more testing capacity. They have committed to doing so and are prioritizing tests coming from hospitals both for health care workers and for critically ill patients. Unfortunately, it also sounds like they may be backlogged and having a hard time catching up. From our standpoint, we are quickly moving toward surge response.\u201d<\/p>\n

Price said she discussed the problem with leaders of the state\u2019s other major hospital systems, which care for the vast majority of the state\u2019s population, and \u201cwe\u2019re all experiencing the same problems.\u201d<\/p>\n

The concerns come as the state recorded a second death due to COVID-19, a man in his 70s in Weld County.<\/p>\n

Not every metro hospital is seeing a surge, though most contacted by CPR News say they\u2019re only testing people who are sick enough to be admitted.<\/p>\n

\u201cIt almost doesn\u2019t matter what virus you have, the treatment is basically the same. So right now, we do not feel like we have enough capacity to test the \u2026 people who aren\u2019t symptomatic enough to be in the hospital,\u201d said Dr. Jason Kelly, chief medical officer at Sky Ridge Medical Center in Lone Tree. \u201cOur basic philosophy is if you can\u2019t breathe, then come to the hospital and let us help you. If you\u2019re ok to stay at home, you should stay at home.\u201d<\/p>\n

To prepare for an influx, Kelly said he\u2019s trying to encourage staff to get some rest now. Sky Ridge has 30 ICU beds and some capacity to move some ventilators from the Neonatal Intensive Care Unit to the regular hospital if it becomes necessary.<\/p>\n

At Children\u2019s Hospital, Dr. Sean O\u2019Leary said they, too, are only testing kids sick enough to be admitted with respiratory symptoms.<\/p>\n

Even though children don\u2019t seem to be the biggest victims of COVID-19, O\u2019Leary said they are prepared to convert some of the hospital\u2019s pediatric capacity to young adults, if necessary, but \u201cnot 60 year-olds.\u201d<\/p>\n

\u201cWe\u2019re all in this together. The more we can practice social distancing, we really need to do our best with that,\u201d O\u2019Leary said. \u201cThe more we do that, the more slowly this virus can spread.\u201d<\/p>\n

Dr. Jason Persoff, a physician leading COVID-19 response efforts at another large Colorado hospital system, UCHealth, shared somewhat similar concerns.<\/p>\n

\u201cWe have seen a large surge in patient numbers who are being ruled out for COVID, but test centers locally and nationally are so backlogged, turnaround times are now approaching a week,\u201d Persoff said. He\u2019s the assistant director of emergency preparedness at the UCHealth University of Colorado Hospital at the Anschutz Medical Campus in Aurora.<\/p>\n

\u201cSo, that does place pressure on the system, since we need to use PPE (personal protective equipment) for inpatients who may have COVID,\u201d he said.<\/p>\n

Price said hospitals were working with each other and the state to collaborate, share and find solutions.<\/p>\n

Still another deep worry, Price said: ventilators. She said the facility had 90 of the medical devices used for artificial respiration. But with the steady growth of the number of COVID-19 cases expected statewide in the coming weeks and months, Denver Health could conceivably need all of them at once. Price cited reports out of Italy where there are protocols to ventilate two patients on the single ventilator.<\/p>\n

\u201cWe are ready to do that if we need to, but our critical care directors really hope we don\u2019t have to get to that point,\u201d she said.<\/p>\n

In terms of supplies, Persoff said UCHealth is implementing procedures to further conserve personal protective equipment for the long haul.<\/p>\n

Price also detailed a long list of changes Denver Health is implementing, including putting in an emergency command structure, screening at hospital entrances for symptoms and fever, putting travel restrictions on employees, using telemedicine and planning for a surge in the hospital\u2019s intensive care units.<\/p>\n

On Tuesday, Kaiser Permanente, the state\u2019s largest nonprofit health plan, also announced a sweeping list of changes.<\/p>\n

It\u2019ll expand telehealth and virtual care, consolidate medical offices, ramp up remote test sites, and take another major step: postpone elective and non-urgent surgeries and procedures. This is to make sure Kaiser has the capacity and equipment to care for a surge in more critically ill patients.<\/p>\n

Meanwhile, a report from ProPublica maps out scenarios for how overwhelmed the health system could become depending on how severe the coronavirus outbreak gets.<\/p>\n

The nonrofit journalism group examined the total number of hospital beds, as well as beds for intensive care, best equipped to deal with most serious cases. ProPublica based its analysis on data from the American Hospital Association and the American Hospital Directory.<\/p>\n

ProPublica also looked at the number of residents, including the 12% in the Denver region over 65. That group has significantly higher rates of both hospitalization and fatalities.<\/p>\n

In the moderate scenario, in which 40% of the adult population contracts the disease over 12 months, ProPublica found Denver would be among the regions that would need to expand capacity.<\/p>\n

The report estimated about 8% of the adult population would require hospital care.<\/p>\n

\u201cIn a moderate scenario where 40% of the population is infected over a 12-month period, hospitals in Denver would receive an estimated 195,000 coronavirus patients,\u201d the report states. \u201cThe influx of patients would require 6,510 beds over 12 months, which is 2.9 times the number of available beds in that time period.\u201d<\/p>\n

It found in Denver that intensive care units would be especially overwhelmed and require additional capacity.<\/p>\n

\u201cWithout coronavirus patients, there are only 330 available beds on average in intensive care units, which is 4.2 times less than what is needed to care for all severe cases,\u201d the report found.<\/p>\n

Those dire warnings explain the state\u2019s emphasis on closing public gathering spots like bars and restaurants and insisting on social distancing to prevent the spread. Experts say it is the most likely way to slow the contamination.<\/p>\n

Price commended local leaders for responding to the crisis with urgency.<\/p>\n

\u201cI think we\u2019re beyond containment. I think we now have to think about how we mitigate this in Colorado,\u201d she said. In limiting public gatherings, Governor Polis and Denver Mayor Michael Hancock have made \u201csome really impressive, important, very brave moves to make sure that we\u2019re safe.\u201d<\/p>\n","protected":false},"excerpt":{"rendered":"

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