KC has enough hospital beds and ventilators to meet needs, but not if things turn bad
Should the worst happen and you’re struck down with a severe case of the novel coronavirus, consider yourself fortunate if you live in the Kansas City area. Chances are good that there will be space for you in the intensive care units at most area hospitals and there will be a ventilator available to help you breathe.
For now, that is.
Next week, you might not be so lucky.
We haven’t been hit hard. Hospitals in the region report that they currently have sufficient equipment, staff and ICU beds to accommodate the handful of serious cases they’re seeing right now.
And they have been making preparations to expand that capacity, should a surge in patients occur, by canceling elective surgeries and taking steps aimed at keeping their staffs healthy and flexible for reassignments to handle an influx of patients.
But if strategies to contain the virus (no large gatherings, working at home, etc.) fail and things get bad, all bets are off.
“If it got to be like it is in Europe, we would be in the same amount of trouble that they are,” said Steve Hoeger, director of safety and emergency management at Truman Medical Centers, as well as co-chairman of a disaster preparedness committee whose members include all the major hospitals in this region.
The Hospital Committee is part of the Mid-America Regional Council’s Regional Homeland Security Coordinating Committee. For years its members have have been planning responses to everything from terrorist attacks to mass shootings.
Just in case. Now comes the pandemic that those planners had long feared. With the Kansas City metro area having roughly the same number of hospital beds as the national average — 2.8 for every 1,000 population, which is less than a decade ago — there isn’t a lot of room for error.
A report this week from the Harvard Global Health Institute, in association with ProPublica, found that if Kansas City were hit by what researchers called a “moderate” outbreak in which 40 percent of adults get the disease over the next 12 months, local hospitals would be overwhelmed.
Such an influx of patients would require twice the number of available beds, according to the data.
During a Monday conference call, local hospital representatives compared notes and declared the emergency well in hand so far, Hoeger said.
But should the virus fell Kansas Citians in numbers anywhere near what we’re seeing in Italy, our local health care system would be similarly overloaded and physicians faced with tough choices of who to treat with limited resources and who would be left to die.
As in most major cities across the country, our hospitals already run at or near capacity most of the time.
“It’s usually a manageable situation,” Hoeger said.
On the plus side, the tough flu season is flagging, freeing up some capacity in the intensive care units, Hoeger said.
But there simply aren’t enough ICU beds or ventilators available in the eight-county metro area to treat large numbers of people who are very, very sick with Covid-19.
“You don’t admit someone who is mildly sick with this,” he said.
The vast majority of people infected by the Covid-19 virus don’t even need to see a doctor, let alone occupy one of a limited supply of hospital beds. They should go home, stay away from others and fully recover within two weeks or less.
“The people (hospitals) are admitting are really sick,” Hoeger said. “A lot of them are probably needing ventilators. And there is a limited supply of ventilators in the city and in the country.”
The Johns Hopkins Center for Health Security reported last month that as of 2010 (which the center said was the most recent public data) acute care hospitals in the United States owned only 62,000 full-feature mechanical ventilators and another 98,000 without full function that could be used in an emergency.
No one believes 160,000 ventilators in a nation of 330 million people is nearly enough under the circumstances.
“...the need for ventilation services during a severe pandemic could quickly overwhelm” the health care system, the paper went on to say, and noted caregivers might be able to get more from the federal Centers for Disease Control and Prevention.
But the CDC had only about 8,900 in its Strategic National Stockpile as of a decade ago, Johns Hopkins said, and offered no recent numbers.
President Donald Trump on Monday suggested that local officials attempt to buy more, but there aren’t many on suppliers’ shelves.
A Kansas official said Wednesday that there were 40 ventilators available — not in use — at Kansas hospitals in the Kansas City area as of March 4, and 168 statewide.
The Missouri Department of Health and Senior Services did not respond to The Star’s requests for how many ventilators were operational in that state. Likewise, the Kansas City health department also did not respond.
Hoeger wasn’t sure how many of the breathing machines are available for use in the Kansas City area, but said hospitals are polled weekly to measure the trend in ventilator usage locally to see if there are enough to meet the current need.
“Are we burning through those? Right now there is not a high demand,” he said. “Today we are doing just fine. But next week, next month, that could be a very different story.”
Hospitals are hoping local efforts to keep the virus at bay will prevent a potential catastrophe.
But just in case, hospitals across the area this week canceled surgeries that can be put off to free up staff, space and equipment.
Many are now forbidding visitors and calling off wellness clinics, in part to free up staff and to limit caregivers from being exposed to germs.
Doctors and nurses freed up from those non-essential duties can now fill in for sick colleagues or work in areas where they are most needed, should the virus increase patient load.
“All of the hospitals are working on their surge capacity,” Hoeger said, “and we’re all identifying different things that reduce the burden.”
At the University of Kansas Hospital, 12 evaluation rooms have been set up in an ambulance bay away from the entrance and general public areas for patients with serious respiratory illness.
Wearing protective clothing, health care workers assess patients brought in by ambulance to see how best to treat their illness.
“If a patient is experiencing emergent respiratory symptoms and has reason to believe they may have COVID-19, they should call 9-1-1,” the hospital said in a news release.
Others with less serious symptoms are advised to contact their regular doctor, but never show up to any emergency room or doctor’s office without calling ahead.
That way the staff can make arrangements to keep you from spreading whatever you have to others.
Like other caregivers, Hoeger said hospitals are also doing more screening of patients who may not show any signs of the illness but could be contagious.
In short, he said, the Kansas City area and country as a whole are taking many more precautions than those countries that have seen the worst of the outbreak so far.
“We are doing things a lot different than they did and we are learning from their mistakes,” he said.
This story was originally published March 18, 2020 at 5:00 AM.
