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 available beds. 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 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, Macon would need 2.3 times its current number of ICU beds, and even then would have barely enough 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.
The current state of coronavirus in Georgia
As of April 6, Georgia ranks 12th in the number of total coronavirus cases among U.S. states, with more than 7,000 confirmed cases and 229 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, The 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.
Macon-area hospitals have largely refused to provide details on the number of individuals they’ve tested or treated for COVID-19, but some have shared details regarding their medical supplies and bed capacities.
Hospitals across Middle Georgia are postponing elective surgeries and monitoring their ICU capacity as COVID-19 cases continue to rise.
Coliseum Medical Centers has a supply of 72 ventilators and 40 ICU beds.
“We are planning for a possible surge of COVID-19 patients and could add more (beds,) but we are not seeing it yet,” hospital representatives said in late March.
Navicent Healthcare refused to answer questions about their current ventilator supply or the number of patients who have tested positive for COVID-19. The system has more than 100 ICU beds available. The hospital said it makes “case-by-case” decisions on which surgeries get postponed. Representatives for the hospital system said it’d had the supplies, bed capacity and staffing needed.
Houston Healthcare has 26 total ventilators and 21 ICU beds. Fairview Park Hospital in Dublin has 23 total ventilators and 16 ICU beds.
Information from Macon-area hospitals was gathered as part of an information request from the Center for Collaborative Journalism and partners WMAZ, Georgia Public Broadcasting and the Macon Telegraph.