In central Pennsylvania, tents have risen outside numerous hospitals, ready to screen and isolate people if and when the coronavirus surges.
Other work, including expanding the bed supply, is going on out of sight to prepare for a possible spike in people sick with the coronavirus, according to checks with central Pennsylvania hospitals.
It’s all in response to a big unknown: Can hospitals handle the worst-case scenario? Or even the best-case?
York-based WellSpan Health has set up screening tents outside six hospitals, including York, Good Samaritan in Lebanon County, Ephrata Community in Lancaster County and Chambersburg hospital.
All were staffed and ready as of Tuesday afternoon, said spokesman Ryan Coyle. He had no details on demand and usage. Geisinger Holy Spirit also had a screening tent.
UPMC Pinnacle, which operates six hospitals in the Harrisburg region, is readying special locations to take samples from people who need to be tested for coronavirus. Opening dates haven’t been set, spokeswoman Kelly McCall said in an email.
Penn State Health Milton S. Hershey Medical Center is planning drive-thru testing. It’s developing an in-house coronavirus test and using telemedicine to screen for coronavirus, also known as COVID-19. “We anticipate to have additional information to share on drive-thru testing within the coming days,” spokeswoman Barb Schindo said in an email.
Central Pennsylvania hospitals contacted this week had yet to see any influx of people sick with possible coronavirus or worried they might be. Some said they were fielding plenty of questions about coronavirus.
“The community is very interested in the guidelines and availability of testing,” McCall said.
At this stage, they are busy planning for a potential surge in people needing hospital care.
A potential shortage of hospital beds has suddenly become a subject of great worry around the country. It comes as emerging data and estimates regarding the toll of coronavirus suggest a huge mismatch between the supply of hospital beds and the number of people who might need them.
About 80 percent of the people who get coronavirus have only mild symptoms. Some may not even realize they’re sick.
However, Dr. Raghavendra Tirupathi, a central Pennsylvania infectious disease specialist, expects ten percent of people who get coronavirus will become severely ill and need hospital care. Many, if not most, will need breathing ventilators and intensive care, according to Tirupathi, the medical director of Keystone Infectious Diseases and chair of infection prevention at WellSpan Chambersburg Hospital.
As of Tuesday, Tirupathi was aware of no model that has attempted to forecast a worst-case scenario specific to Pennsylvania.
However, Dr. Tom Frieden, the former head of the U.S. Centers for Disease Control and Prevention, devised a national worst-case scenario in which half the population would get the coronavirus.
If that came true in Pennsylvania, with 10% of the stricken being severely ill, it would result in 640,000 people needing hospital care.
Pennsylvania has about 37,000 hospital beds, according to the Hospital and Health System Association of Pennsylvania. Hospitals have been cutting back on beds for years. They routinely operate at 70% or more of capacity, meaning a high proportion of beds are already full.
Frieden produced a better-case scenario, in which 10% of the population came down with the coronavirus. Even then, 128,000 people in Pennsylvania would need hospital care. In another scenario offered by Frieden, only 1% of the population would get the coronavirus. In Pennsylvania, that would put 12,800 people in need of hospitalization.
Frieden’s model makes clear the potential of hospitals being stretched far past their breaking point, as is happening in Italy.
It’s why Gov. Tom Wolf has shut down non-essential businesses and gatherings, urging people to stay home as much as possible. The goal is to slow the spread of coronavirus so the serious illnesses are spread out, rather than coming all at once, as a spike. Public health officials call it “flattening the curve,” and say it’s critical to keeping the health care system from being overwhelmed.
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As of Tuesday afternoon, Pennsylvania hospitals were seeing no surge of coronavirus patients, state Secretary of Health Rachel Levine said. However, she said “it would not surprise me if we start seeing rising numbers” beginning as early as next week.
Central Pennsylvania hospitals say they are looking at various ways to expand their bed supplies.
“We have a dedicated nursing unit at Lancaster General Hospital established to care for future COVID-19 patients requiring inpatient care. We have full capabilities in our intensive care unit, and we developed plans for what our surge-capacity options would be to use other areas of the hospital as necessary,” Lancaster General spokesman John Lines said in an email.
At UPMC Pinnacle, “We continue to evaluate and allocate our resources to ensure that we are able to provide needed care,” McCall said.
“When necessary, we have the ability to expand capacity by converting other areas, such as post-operative recovery areas, by canceling elective surgeries and turning post-anesthesia recovery units into intensive care units. We will keep the community informed should we need to expand our facility capacity and provide additional locations for care,” she said.
Schindo said, “Right now, Hershey Medical Center’s operations continue as normal. We are making arrangements and staging locations, should the need for additional patient care spaces arise.”
Still, Pennsylvania hospital officials, when pressed, have acknowledged the possibility of running out of beds. They say they’ll have to rely on coordination with other health care facilities and help from the state and federal governments.
The state, meanwhile, says it has been working with the hospital association and individual hospitals to prepare for surges.
“Every hospital is doing everything that is humanly possible to mobilize all of their resources,” Tirupathi said. He added, “You can never be fully prepared for this type of situation.”
Aside from beds, there’s worry over the supply of protective clothing for health care workers, including face masks.
Discussing supplies on Tuesday, Levine said the situation “will put strain on our hospitals and health systems.” But she added that hospitals have “stockpiles” and so does the state and the federal governments.
Still, President Donald Trump on Tuesday said his administration is asking construction contractors to donate supplies of face masks to the government for use by health care workers. Randy Padfield, the director of the Pennsylvania Emergency Management Agency, acknowledged a possible “strain” on face masks in Pennsylvania and said “that would be a very plausible idea.”