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Not enough beds: These maps forecast Quad-Cities' hospital preparedness
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Not enough beds: These maps forecast Quad-Cities' hospital preparedness

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A new Harvard analysis shows how the Quad-Cities health care system could become overwhelmed if efforts fail to slow down the spread of the new coronavirus.

The analysis, which uses predictive modeling and data on hospital bed capacity, shows what’s at stake when health experts implore Quad-Citians to take social distancing seriously.

If locals “flatten the curve” — slowing the transmission of COVID-19 infections over time — the local health care system has a fighting chance to help treat a possible surge of patients.

However, if the virus spreads widely and rapidly, the local health care system could become swamped, setting up worst-case scenarios with shortages of medical professionals, equipment or supplies.

In a worst-case scenario, the area would need to increase bed capacity by more than 400%. 

Experts emphasize the models aren't forgone conclusions and don't account for efforts already undertaken to increase medical capacities and to slow the spread of the coronavirus, which poses a complex public health emergency evolving every day.

In a joint statement, Genesis Health System and UnityPoint Health noted proactive steps both health care systems are taking in response to the pandemic, including postponing elective procedures and encouraging virtual provider visits. They also emphasized the public’s “vitally important role in helping us not overtax the system,” encouraging Quad-Citians to work remotely and practice social distancing.

Models illustrate possible futures

In the analysis, researchers at the Harvard Global Health Institute modeled hospital capacity over time — six months, one year or 18 months — under three possible infection scenarios: if 20%, 40% or 60% of the population is infected.

According to data from the American Hospital Association and the American Hospital Directory, the Quad-Cities area has about 1,610 hospital beds and 140 beds in intensive care units. At any given time, however, some beds are already occupied and unavailable for new patients.

In the model's "moderate" scenario — in which 40% of adults are infected over one year — an influx of an estimated 32,100 coronavirus patients locally would require 153% beds available in the local area.

For the purposes of the study, the local area includes most of the Greater Quad Cities, from Geneseo and Aledo to Maquoketa and Clinton.

According to the model, availability of intensive care unit (ICU) beds could be particularly dire even under the moderate scenario. The Harvard analysis suggests that there’d be a need for 356% of currently available ICU beds — a nearly fourfold increase.

However, the burden on the health care system diminishes if fewer people are infected over a longer period of time — in other words, if the spread of the disease is slowed down and contained. For example, if 20% of adults are infected over 18 months — the best-case scenario modeled by the researchers — just 50% of the available hospital beds would be needed and 115% of the available ICU beds.

Conversely, the worst-case scenario — in which 60% of the adult population gets infected over six months — would severely squeeze the health care system, the data suggest. Under the worst-case scenario, 460% of available beds would be needed across the region, and 1067% of available ICU beds.

But if even 20% of adults are infected in six months, the area health care system would need 153% of its available beds and 356% of its ICU beds, according to the analysis.

In the joint statement, Genesis and UnityPoint noted that “data is based on modeling that may not take into consideration the fluidity of the COVID-19 crisis and does not take into consideration surge planning already in place” in both hospital systems.

The statement elaborated: “Together we have responded to this crisis proactively by postponing elective procedures. By postponing elective surgeries, we will be able to increase bed capacity and resource availability should we face a surge of hospital patients.”

The statement added that planning ongoing in both systems includes "how to expand the number of intensive care and acute care beds if necessary, ideas to conserve human and material resources, acquisition of additional resources, ideas to temporarily reassign clinical staff to care for a possible surge of patients and supporting our staffs so they are able to provide care safely with the confidence their family needs are being met at home.”

ProPublica maps

Maps show different scenarios modeled by the Harvard Global Health Institute. Experts emphasize the models are not perfectly predictive or exact but are useful in giving an impression of how a complex system might respond to a complex and evolving public health challenge.

Metro areas from across the country were analyzed by the Harvard team. Overall, the Quad-Cities health care system appears better poised to handle a possible influx of COVID-19 patients than other areas nationally.

Still, a serious outbreak could overwhelm even the relatively better-equipped health care systems.

"There are so many hospital beds, so many ICU beds and so many ventilators," explained Louis Katz, medical director of the Scott County Health Department. "If demand exceeds supply, then docs and families are put in the position of deciding who gets the last bed or ventilator — not a position any of us want to be in — ask the docs in Italy."

Local demographics also heighten the urgency of social distancing. Around one in six residents of the region is 65 years or older, the population most threatened by the new coronavirus.

“If the curve of positive infections spikes up dramatically, hospitals may be affected,” Scott County Health Department Director Edward Rivers said Thursday. “If everybody does their part, it is our hope it will flatten that curve and allow them to continue them to operate within their resources.”

An analysis released Thursday by the Centers for Disease Control studied COVID-19 cases in the U.S. through March 16. Of the 2,449 cases whose ages were known, between 21% and 31% were hospitalized, with 5%-12% requiring ICU admission.

Although COVID-19 is downplayed by some young people, the CDC report found that as many as 21% of hospitalizations were in the age group 20-44.

As of Thursday afternoon, two cases of COVID-19 were confirmed in Scott County, though neither patient lives in Scott or Rock Island counties, according to health officials. One of the state's new cases is in Muscatine County.

Still, health authorities are assuming the virus has already arrived in the Quad Cities and are asking residents to take precautions accordingly.

“It’s in our community — we know this,” Rivers said about COVID-19. “Social distancing remains our strongest tool to help minimize the spread of this disease in this community.”

As Genesis and UnityPoint said in their statement: “It is a trying time for all of us, but be assured that the two local health systems are thinking about how best to care for patients now, and if the outbreak escalates over an extended period.”

Graham Ambrose is the Iowa politics reporter for the Quad-City Times. 


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