U.S. hospitals and health systems are facing a possible bed shortage due to the coronavirus outbreak, with White House officials warning that a dramatic uptick in confirmed cases could be coming as testing increases.
At least 9,415 cases of COVID-19, the respiratory illness caused by the coronavirus, have been confirmed in the U.S. with 150 deaths as of March 19, according to a tracker from Johns Hopkins University's Center for Systems Science and Engineering.
Among some of the countries worst-hit by the virus, the U.S. is second to last in hospital beds per 1,000 inhabitants at 2.8, according to the Organisation for Economic Co-operation and Development. China and Italy — the countries with the most COVID-19 cases as of March 19 — had 4.3 and 3.2 beds per 1,000 inhabitants, respectively.
South Korea, which has greatly slowed its outbreak in the past few weeks, had the highest amount of beds per 1,000 inhabitants with 12.3.
The American Hospital Association, or AHA, urged people to follow the Trump administration's recommendations to practice social distancing to limit the spread of the coronavirus.
"This will reduce the surge of acutely ill patients that hospitals will see and hopefully ensure we experience a manageable level of demand," AHA said in a statement.
Meanwhile, hospitals are making contingency plans and preparing for the possible surge in patient volumes, which could overload the U.S. health system.
Steward Health Care System LLC is dedicating Carney Hospital in Massachusetts to treat patients that have tested positive for COVID-19, according to a March 17 statement. The Dallas-based hospital company said the dedicated space will provide patients with the focused care they need and free up facilities to treat other patients. The company may use the same strategy in other areas of the country if needed.
Tenet Healthcare Corp. is developing separate triage areas where prospective COVID-19 patients can be seen by doctors and determine if a patient needs to be admitted, according to a statement.
The White House urged hospitals during a March 18 press conference to cut elective surgeries where possible to preserve personal protective equipment for healthcare workers.
Some hospitals, such as Northwell Health Inc. and Massachusetts General Hospital, have already done so, while the Steward Health Care System said cancellations were not necessary due to the newly dedicated facility and normal procedures and operations would go on as scheduled. The AHA has cautioned against a complete halt of elective procedures, saying in a March 18 statement that some may still be necessary.
The AHA requested $1 billion in funding for hospitals and health systems to make infrastructure changes in a March 16 letter to Congress, including constructing facilities to treat large numbers of patients with COVID-19.
That strategy was deployed in China during the height of the outbreak there, where a 1,000-bed hospital built over just 10 days opened in early February to treat the growing number of patients, according to multiple media reports.
Back in the U.S., state and federal governments are working to increase the capacity of health systems to handle increasing patient volumes. New York Gov. Andrew Cuomo on March 16 ordered the National Guard, private companies and building unions to convert existing buildings to medical facilities, with the goal of increasing the state's number of beds by 9,000.
President Donald Trump said March 17 that the federal government is prepared to work with New York on this project.
Hospitals will also be facing staffing shortages for positions like registered nurses, which could prevent hospitals from adhering to appropriate staff-to-bed ratios, according to Chris Plance, healthcare expert for international consulting firm PA Consulting.
"The staffing issue is significantly more complicated and harder for [hospitals] to solve," Plance said.
Staffing can be a struggle for hospitals even during a heavy influenza season, Plance said. To combat COVID-19, Plance said hospitals could increase levels of temporary staffing or alter staff ratio levels for the duration of the outbreak.