Do Georgia hospitals have enough beds to handle surge in number of coronavirus cases?
Parts of Georgia have coronavirus infection rates rivaling the hardest-hit regions across the world, and even as testing capacity increases, the state still lags far behind other regions of the country in the number of tests per person it’s performing.
Experts say the worst has yet to come, and Georgia’s hospitals are preparing.
Gov. Brian Kemp issued a statewide shelter-in-place order which took effect April 3, citing the need to reduce the strain on Georgia’s healthcare system. But a national analysis of available hospital beds, particularly ICU beds needed for the most critically ill patients, indicates Georgia needs to rapidly increase its stock. Data provided by state and local hospital systems suggests they are working to close that gap as the number of COVID-19 patients is expected to surge soon.
A Harvard Global Health Institute report examined bed capacity data for each of the 306 U.S. hospital markets. The data provides estimates on the number of beds available in each market, and how many beds each market would need to treat COVID-19 patients. Georgia is expected to reach peak hospital capacity on April 24, according to the Institute for Health Metrics and Evaluation at the University of Washington.
Using the most conservative projections from The Harvard Global Health Institute and the Harvard T.H. Chan School of Public Health, McClatchy analyzed their data to show:
Across Georgia, a 20% infection rate over a six month period would mean more than 1.54 million infected adults with 317,401 requiring hospitalization.
The state would need almost 1.4 times more hospital beds and 2.6 times more ICU beds, assuming hospitals are freeing up their available bed supply through measures such as delaying elective surgeries.
If those estimations are correct, Columbus hospitals would need to add three times their current supply of ICU beds — the highest rate in the state, behind only Savannah and southern parts of Georgia near the Florida border. Columbus would have enough hospital beds. Atlanta hospitals would need 1.7 times the number of beds and 2.8 times the number of ICU beds.
“We don’t know what the actual number is, but I think the 20% (infection rate over six months) is not unreasonable,” said Dr. Thomas Tsai, an assistant professor in the Department of Health Policy and Management at Harvard T.H. Chan School of Public Health. “The bottlenecks are going to be very local ... even within a city, it may be very local by hospital.”
“The devil’s in the details of how each healthcare system and hospital is planning for that. It’s best to hope for the best but prepare for the worst,” he added. “The storm might be coming just in a couple of weeks from now.”
Some of Georgia’s hospitals have already had issues with bed space.
Phoebe Putney Memorial Hospital in Albany’s Dougherty County has been overwhelmed. The main hospital’s three ICUs were filled to capacity. Thanks to help from the Georgia National Guard and staffing increases, five ICUs are now operational. Four of them are dedicated to COVID-19 patients, the hospital said in a news release.
Six months of medical supplies were used here in a week, and the state sent pallets of personal protective equipment to Albany, the Atlanta Journal-Constitution reports.
In Atlanta, Mayor Keisha Lance Bottoms told reporters March 25 that Atlanta’s ICU units were at capacity, and warned that area hospitals could soon fill up.
“We’re already down several beds at Grady Hospital, and people have to understand that when we overrun our hospitals, people will still come in with heart attacks, people will still have car accidents,” Bottoms told a local CBS affiliate.
Current state of coronavirus in Georgia
As of April 5, Georgia ranks 12th in the number of total coronavirus cases among U.S. states, with almost 6,500 confirmed cases and more than 200 deaths.
Still, the data published by the Georgia Department of Public Health doesn’t tell the full story. In a statewide coronavirus town hall, Kemp said information published by the state’s health department is two weeks behind.
“The data that we’re seeing today is two weeks old,” he said. “The data that we’re going to see two weeks from now is what really happened today, and that’s just the nature of this.”
The COVID Mapping Project, which tracks coronavirus data, lists Georgia in the bottom five of testing per capita. Only Mississippi, Alabama, Texas and Oklahoma were worse as of April 5.
Kemp and the state’s health officials are working to address Georgia’s lack of testing capacity. A group of Georgia universities, including the University of Georgia, Emory University, the Georgia Institute of Technology and others are expected to process 3,000 tests per day.
Current testing data suggests that Georgia may have been under-testing and under-diagnosing coronavirus cases, said Tsai, the Harvard professor.
“The testing is critical,” he said. “Georgia’s test positive rate is super high. ...That also may mean Georgia may have been under-testing the last several weeks. It’s both a factor of how many symptomatic cases there are but also how aggressive the testing strategy has been.”
If Georgia had tested sooner, it might have led to a more intensive public health response which ultimately would have resulted in fewer coronavirus cases in the state, Tsai said.
Atlanta’s Fulton County accounts for the largest number of the state’s COVID-19 cases. Dougherty County isn’t far behind, and, despite having only a fraction of Fulton County’s residents, leads Georgia with 30 confirmed deaths related to COVID-19.
In Albany, located in the southwest corner of the state with roughly 90,000 residents, more people per capita have become infected with the novel coronavirus than perhaps anywhere else in the world, rivaling numbers found in Wuhan, China, parts of northwest Italy and New York City, the New York Times reported in late March.
More recent reports from the Georgia Department of Public Health paint a more dire picture. Using 2019 Census estimates and the state’s daily coronavirus update, the infection rate in Dougherty County is almost 7.8 per 1,000 people as of April 5.
The infection rate in southwest Georgia dwarfs others across the state, an analysis of COVID-19 data by Georgia Public Broadcasting shows.
“The important lesson for the areas of the country that may not be as hard hit now is to realize you don’t know where you are on that disease curve,” Tsai said, “It’s best to assume that the storm is coming.”
What is being done to increase hospital capacity?
Hospital capacity remains an issue across the country and here in Georgia.
The Associated Press reported Sunday that the Trump administration squandered an opportunity to build up the nation’s supply stockpile. Citing federal purchase contracts, AP reported the federal government largely waited until mid-March to place bulk orders for medical supplies like N95 respirator masks, mechanical ventilators and other supplies needed by health care workers.
When announcing his shelter-in-place order last week, Kemp said Georgia has a total of 3,520 medical-surgical beds, 450 ICU beds and 1,006 ventilators in its hospitals.
According to Kemp, Georgia is working to increase bed capacity. He’s suspended regulatory laws, allowing healthcare administrators to reconfigure hospital wings or start new construction to meet the state’s needs. Multiple hospital systems are also working on reopening previously shuttered facilities.
The Atlanta Journal-Constitution reported Saturday that state officials have committed $72 million for additional beds and staffing at hospitals around the state.
“We’ve turned over every rock and we continue to do that on shuttered facilities, looking at convention center sites for mobile hospitals and other things,” Kemp said during the shelter-in-place press conference.
In Columbus, private entities are working to address the shortages. Aflac Chairman and CEO Dan Amos and his wife Kathelen donated $1 million to Piedmont Columbus Regional to help the hospital treat COVID-19 patients.
The money will be used to renovate an unused floor of a hospital building and to create a unit of 29 beds and seven ICU beds for isolated patient care. Hospital officials said they hope to open the new floor in about a week.
Unlike Albany’s Phoebe Putney, Columbus’ hospitals have declined to share data on the exact number of people they’ve tested for COVID-19 since the first confirmed cases were announced in the state. State health officials are not tracking testing data by county, nor are they tracking the number of people in Georgia who’ve recovered from the coronavirus.
But Columbus hospitals have shared some details regarding their medical supplies and their plans to increase bed capacity.
In addition to the Amoses’ gift, Piedmont Healthcare, which owns other hospitals in the state, is working to increase bed capacity by canceling elective procedures. Piedmont has also recruited retired nurses and developed a “Piedmont Physician Reserve Corps,” a group of physicians who will volunteer at Piedmont hospitals across non-specialty areas.
Piedmont said it has also secured a new source of ventilators from an international manufacturer, but would not disclose its current supply. Piedmont is conducting COVID-19 tests on a daily basis but has not shared test results or total numbers.
Piedmont also would not say if any coronavirus-positive patients have been received from hospitals in Albany — though its Columbus contemporary, St. Francis-Emory Healthcare, has. Those transfers allow Albany to increase its bed capacity.
Last week, St. Francis would only confirm that it has received patients from Phoebe Putney Memorial Hospital and Phoebe Sumter, but not the number.
Like Piedmont, the hospital has temporarily halted elective procedures as a measure to increase capacity and would not disclose its current supply of ventilators.
In his press conference, Kemp praised Piedmont, along with a few other chains for their response to COVID-19.
“These systems have engaged the state to reopen several facilities and bring hospital beds online as we prepare for the potential patient surge,” Kemp said.
The goal now, Kemp said, is to keep people from overwhelming the state’s medical facilities by limiting the spread of COVID-19.
“Georgians should know that we’re going to continue to have a great state. We’re going to recover stronger than ever and this economy’s going to come back. We just got to fight through this thing here for a few more weeks and flatten that curve,” Kemp said.
Ledger-Enquirer reporter Allie Dean contributed to this report.
This story was originally published April 7, 2020 at 5:00 AM with the headline "Do Georgia hospitals have enough beds to handle surge in number of coronavirus cases?."