One local hospital says it is already using “surge areas” to manage an overflow of COVID-19 patients as cases and hospitalizations continue to rise above levels previously seen during the ongoing pandemic.
Jeff St. Clair, president and CEO of Springhill Medical Center, told Lagniappe this week the COVID-19 population at the facility in Mobile is the highest it’s ever been, with close to 50 in-house patients as of July 13 — nearly half of whom are on ventilators. He said the percentage of positive tests is trending up as well.
The silver lining at the moment is that the hospital had prepared for an increased number of COVID-19 patients and the cases being treated at the facility are less severe than some seen in the spring.
“Our acute care COVID isolation beds are full, our critical care COVID isolation beds are full, and we are holding some COVID patients in designated surge areas to manage the overflow,” St. Clair said in an email. “Our other critical care beds are full with patients who do not have COVID, but need the highest level of care for other reasons. Even though we have more inpatients than we did during the March/April peak, we are seeing a much lower percentage of those needing critical care.”
Like others in the medical community, St. Clair attributed the decrease in critical and fatal cases of COVID-19 at Springhill to younger people being hospitalized for the disease and the expansion of available therapeutic treatments doctors have learned to use since the pandemic began in March.
“The biggest increase has been in the age group of 21 to 49. That’s the ‘back to work, back to party’ crowd, but it’s also an age group that does not get nearly as sick as those who are older or have comorbid conditions,” St. Clair said. “I believe that the doctors who have been treating have had matters well in hand since the start, but perhaps they have picked up on some nuances over the last four months.”
The exact number of hospitalizations is hard to determine because neither local nor state health officials release information about the capacity of local hospitals even though it’s reported daily through the Alabama Incident Management System (AIMS). So far, Springhill Medical Center is the only local facility that has disclosed any of that information publicly on its own.
A statement from the University Health System did acknowledge hospitalizations at its facilities have gone up as well, but didn’t divulge any specifics. The system credited precautionary measures taken during the early stages of the outbreak — like changing visitor policies, temperature screenings and mask requirements — for allowing its facilities to better manage resources and hospital capacity.
The way cumulative hospitalizations and deaths are being tallied in Alabama also recently changed.
According to the Alabama Department of Public Health (ADPH), the numbers provided so far have been based on case investigations entered into Alabama’s disease surveillance system, but it will now be taken from the AIMS system directly. This will mean the number of hospitalizations reported daily will now include the total number of admissions, discharges and deaths of confirmed COVID-19 patients.
On the county level, that will mean non-county residents being treated in local hospitals or who die in local hospitals will be counted with Mobile County’s cumulative numbers for hospitalizations and deaths going forward — likely leading to an increase in both.
Laura Cepeda, medical director at the Mobile County Health Department (MCHD), said the change will allow public health officials to more quickly and accurately capture what impact COVID-19 is having on local hospitals. It should be noted the change only went into effect in statewide data on Monday and is still being applied to local figures, which Cepeda said should be updated soon.
While some local hospitals haven’t responded to requests about the number of COVID-19 patients in their care currently, data collected by MCHD suggests an influx of hospitalizations and new cases across Alabama isn’t sparing any of the facilities in the region.
According to MCHD, county hospitals averaged 129 COVID-19-positive patients per day last week — a 75 percent increase from the week before. The average number of patients in ICU beds also grew by 11 percent to around 34. Area hospitals’ total ICU bed availability averaged 10.5 percent, which was down slightly from the prior week’s average of 12 percent, according to data shared by MCHD.
Don Williams of the Alabama Hospital Association (AlaHA) said Mobile’s recent increase in cases and hospitalizations isn’t unique. Statewide, Alabama set its own record with more than 1,800 new cases reported last week — a spike Williams said can’t be attributed to increased testing alone.
“You guys in Mobile are in the middle of a growing problem. Obviously, you had the big problem a few months ago largely driven by nursing homes, but now we’re watching your numbers go up and up,” Williams said. “Your capacity is good as far as beds, but overall ICU beds are becoming more stressed in the Mobile area. That’s also true statewide, but this isn’t our lowest point yet. We have something like 250 ICU beds available in Alabama today, but we actually got down to around 206 beds last week.”
While Mobile’s cases have been going up at “staggering” rates, Jefferson and Montgomery counties have recorded more cases in recent weeks. Jefferson also leads Mobile and Montgomery counties in the number of cumulative cases and deaths despite being an early adopter of government shutdowns, restrictions on certain kinds of businesses and public face mask requirements.
Williams said one of his major concerns going forward is how the state and local communities respond over the next few weeks. Because despite the big jump in cases over the past week, Williams doesn’t think Alabama has seen the impacts of the Fourth of July reflected in the number of new cases and hospitalizations.
He told Lagniappe public health officials expect to see that over the next week or so.
“We expect a continued rise in the caseloads, but the issue for us is whether we get a handle on it that allows us to limit community transmission into the second half of July,” Williams said. “If we don’t, we’re going to be looking at an average of 1,500 people in our hospitals going into August at a time when our children are returning to school. That’s not a situation anyone wants to be in.”
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