Over a telebriefing session with members of the media, Erica Henry, Emergency Operations Supervisor at the Department of Health (DOH) discussed Personal Protective Equipment (PPE) logistics support for COVID-19 – finding supplies, obtaining them and getting them to the right place – as well as hospital surge capacity.
Right now, according to Henry, hospitals are implementing their emergency operations plans. These plans include strategies such as limiting visitations, screening patients, rapidly discharging patients to appropriate levels of care, and extending clinic hours.
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Henry confirmed that Washington State has about 12,000 hospital beds in total.
I know you’re all writing down 12,000 hospital beds, but I want you to hear this: that’s not an important number. It’s not what we need to be talking about. And I’ll tell you why. Not all hospital beds are created equal – they don’t serve all patients, and the patients in those beds can require very different levels of care, which means different staffing needs and different resource needs.”
Henry also indicated that geographic surge must not be overlooked.
We might have the ability to physically add more beds to a rural, more isolated community. But it doesn’t help that community if they can’t then get the staff or the resources to support care in those beds. This is one reason why quantifying things by numbers isn’t an effective way to try to understand the complexity of health care.”
As far as data goes, the state has emergency department surveillance systems that pull data on emergency department visits. The data is used to measure how many patients are displaying a “corona-like” illness and how many of those visits convert to an admission into the hospital.
Through this same surveillance system, hospitals can report during each shift how many of each type of licensed bed they have in total, and how many of those beds are occupied. All in all, said Henry, these data points provide a general surface glance at the status of the health care system.
Throughout her remarks, Henry cautioned that data does not tell the whole story.
For the whole story, we need our other tools, and that’s discussion and relationships. We do this in partnership with health care coalitions and local public health jurisdictions. Together we work to understand where those critical stress points are within our hospitals and we troubleshoot ways to relieve those.”
Outside of the data realm, another mitigation strategy pointed out by Henry was the reduction of barriers to bringing in emergency workers, like medical students or retired medical workers. Systemic adjustments such as this could help ameliorate staffing shortages that may occur as the outbreak enters a phase of potentially rapid and widespread infection.
Addressing resource shortages, Henry stated frankly that there are resources shortages that cannot be filled faster the medical supply chain can replenish.
While DOH is looking at bringing in additional ventilators that can treat both non-COVID patients and those with COVID-19, Henry said it was challenging to quantify these types of resources.
Different ventilators do different things. That’s why we can’t answer the question of how many ventilators we have. It doesn’t tell what you want to understand. They do different things. The type of respiratory therapy a patient needs determines which equipment is best for them.”
Along with an increased demand for ventilators comes an increased demand for certain kinds of specialized pharmaceuticals and staff to operate additional ventilators.
A combination of data and discussion, Henry emphasized, is necessary to deliver the health care demands imposed on the system.