North Country hospitals lack ICU beds and ventilators as COVID-19 epidemic hits
When Governor Cuomo appeared Tuesday night on MSNBC, he said the one thing keeping him up at night is the tsunami of sick people expected to land soon on the doorstep of New York’s hospitals.
Those numbers are big and a little confusing, so let’s talk just about the North Country and the capacity for the regional hospitals here which will bear the brunt of this epidemic.
North Country ICU beds measured in dozens, hundreds might be needed
"Our ICU is a 14-bed ICU," said Dr. Wouter Rietsema at CVPH Hospital in Plattsburgh.
"We have ten ICU beds with 3 overflow ICU beds," said Karen Abare, director of infection prevention and control at Samaritan Health in Watertown.
That’s two of the North Country’s biggest urban hospitals, Plattsburgh and Watertown, each serving tens of thousands of people across a sprawling rural area. Together thay have a total of 27 ICU beds, many already being used by people sick with other ailments.
It’s important to remember that before this crisis many of our regional hospitals were struggling financially, merging and downsizing. Governor Cuomo says New York’s system simply wasn’t designed for this kind of challenge.
"They don’t build extra ICU beds, just in case," Cuomo said. "An intensive care bed is very expensive."
Building capacity fast. Will it be enough?
Which means hospitals are now scrambling to expand capacity. Adirondack Health in Saranac Lake, which has just eight ICU beds, has opened a COVID-19 clinic and is now acquiring a large tent for handling overflow patients.
"We are working to source additional beds and received formal approval from NYS DOH today for a covid19 testing and triage clinic in Saranac Lake in previously vacant hospital space," said Adirondack Health spokesman Matthew Scollin, in a text sent to NCPR. "We are working on sourcing a 40 by 80 foot tent for additional testing and triage space."
Samaritan Health in Watertown is also preparing to expand capacity and convert standard beds so that more people with respiratory ailments can be treated. "We do typically try to surge an additional 20 to 30 percent and we do have plans to activate to do so," Abare said.
Dr. Rietsema in Plattsburgh says similar planning is underway there: "We have a surge plan that incorporates other parts of the hospital that can function if we need to as an overflow for our ICU utilizing space in our operative areas."
Worst case scenario - and the role of the federal government
But if coronavirus spreads the way public health experts now predict, those increases – measured in dozens of beds - won’t build enough capacity for the hundreds of people who could be severely ill at one time within the next sixty days.
"The worst case scenario can be pretty bad," said Dr. Rietsema. "If you read what’s going on and what has been going on in Italy, you read some pretty scary things. People are making triage decisions about who gets critical care and who doesn’t based on an assessment of how likely they are to survive. That’s a scenario we don’t want to be in. That’s a scenario we are preparing for."
Governor Cuomo met yesterday with hospital executives from across the state and he says everything is being done to allow hospitals to ramp up fast. That effort is complicated by the lack of ventilators.
He called on the federal government to mobilize the military and the Army Corps of Engineers to mobilize to help hospitals cope.
"Get us backup beds, so when the hospital is overwhelmed we can have some of the people who are in hospital beds go to a backup medical facility," Cuomo said. "If you don’t do it you know what is going to happen."
People who can’t get into hospitals in the coming weeks will be far more vulnerable to complications from COVID-19.
All of these warnings add up to one thing. Slowing the spread of Coronavirus is crucial. Social distancing, avoiding crowds, hand-washing are steps that could mean far fewer people going untreated as the epidemic crests.
