Coronavirus
Missouri and Kansas hospitals may be overrun by COVID-19 — especially in these areas
Color-coded maps that chart the COVID-19 pandemic as it might pass through Kansas and Missouri paint a sobering picture.
The maps are based on an analysis from the Harvard Global Health Institute that projects a total of at least 287,000 people in Missouri and Kansas combined will be hospitalized as a result of the virus.
Whether area hospitals will be able to handle the influx of patients from COVID-19 largely depends on two things: how fast the virus spreads, determined by the states’ ability to maintain social distancing, and how successful hospitals are in taking actions to make more beds available.
The maps answer this question:
What might happen in the Kansas City area — and Columbia, Lawrence, Wichita and beyond — if only one in five of the states’ residents came down with COVID-19, assuming nothing were done to contain the disease or plan for such a sobering scenario?
The first set of maps — one for each state — depict hospitals’ current capacity to handle a surge in patients if 20 percent of the state’s population contracts the virus within six months.
Based on the Harvard calculations, nearly every community in Kansas and Missouri would find their hospitals beyond capacity to treat the sickest patients in that scenario.
Hospitals in and around Kansas City would have only half the number of beds available that they would need to care for the sickest COVID-19 patients along with everyone else suffering all sorts of other maladies.
Hospitals in northwest Kansas would have only a third of the beds needed. Under these circumstances, demand for beds in Springfield, Missouri, and its surrounding counties would be almost two and one-half times more than the supply.
In these areas where demand far outstrips supply, patients likely would not receive all the care they’d need to fight off the disease.
Of course, steps are being taken. We’re staying at home, washing our hands raw and maintaining a safe distance from strangers, friends and loved ones. At least we’re supposed to.
But even if social distancing is moderately effective, and the spread of the virus happened over 12 months instead of six, most hospitals in Missouri would be near or over current bed capacity, as would the regions in Kansas where patients tend to go to hospitals in Kansas City or Denver.
Only if social distancing is effective in slowing the spread to a timeline of 18 months will most hospitals in both states be able to handle the surge in patients at current capacity. But hospitals in Colorado Springs are still projected to be over capacity, which could affect some patients in far western Kansas.
But these are only projections. They are not a portent of what certainly will be. Things could turn out much better.
Or they could be worse.
Marc Lipsitch, professor of epidemiology at Harvard University, said 20 to 60 percent of the world’s population could end up catching the new coronavirus — meaning the maps represent a conservative estimate of how many patients there are likely to be. The maps also do not account for the possibility that the virus will spread differently in rural or urban areas.
Harvard Global Health Institute’s analysis factors in the age of a community’s population and how long patients would likely stay in the hospital.
In China, where the outbreak began, the median hospital stay was 12 days. Some 58 percent of the most severe cases were patients more than 50 years old, according to a Feb. 28 article in The New England Journal of Medicine.
When hospitals were overrun in Italy, doctors were forced to make stark choices, deciding who to help and who they’d have to let die.
Precautions are being taken. But we still don’t know how much good any of that will do, if one in five of us come down with COVID-19. And what if the rate is higher?
What we do know is this: cases are mounting and we are far from knowing what the peak will be, even if we do have a pretty good idea when that spike will come.
“Things are changing rapidly,” Dr. Steve Stites, chief of medicine at the University of Kansas Hospital, said Wednesday at the hospital’s now-daily press briefing. “We’re starting to feel the surge.”
A specialist in pulmonary and critical care medicine, Stites estimates that the number of COVID-19 cases should begin to spike in two or three weeks. It could be up to six weeks, he said, before we know whether efforts to contain the spread of the virus have been successful.
Likening the coronavirus outbreak to a football game, Stites said the Kansas City area is in the early first quarter, whereas New York, where the virus is spreading fast, is in the second.
In both cases, “there’s a lot of game left,” Stites said at Tuesday’s briefing.
Kansas, Missouri hospitals prepare
The good news is that Kansas City was ahead of many other areas, even hard-hit Seattle, in trying to slow the spread. Local officials hope that social distancing, business shutdowns and canceling of public events will limit the number of COVID-19 cases here. Or “flatten the curve,” the now familiar shorthand.
Hospitals across America, meanwhile, have decided to postpone elective surgeries, adding capacity to address a possible surge in patients. That makes more beds and ventilators available and preserves more masks and other personal protective gear for doctors and nurses to use in critical care cases.
“Hopefully, all of these measures being implemented will flatten the curve,” said Steve Hoeger, co-chairman of a committee of hospitals that, through the Mid-America Regional Council, have adopted those strategies to better fight the disease.
“We’re actually all seeing a drop in our inpatient census,” said Hoeger, who represents Truman Medical Center on the MARC hospital committee. “Our day-to-day numbers are down, so that’s given us some capacity that we wouldn’t see ordinarily.”
Similar steps to add capacity are being taken in Springfield, Missouri, where three deaths from COVID-19 have been reported.
According to the Harvard Global Health Institute data, demand for Springfield-area hospital beds would be 239 percent of capacity if 20 percent of the population was infected over the course of six months.
In anticipation, Mercy Hospital there has freed up at least 200 beds.
“You can’t be too overcautious right now,” hospital administrator Craig McCoy recently told a Springfield TV station. “We would much rather be overcautious and go to the extreme than we need to than not be prepared.”
A similar calculation is influencing decisions 520 miles northwest of Springfield at Citizens Medical Center in Colby, Kansas.
Citizens Medical has just 25 beds. Rarely if ever are all of them filled. And as of Friday, there had not been a single COVID-19 case confirmed in Thomas County, where Colby is the county seat.
Same for neighboring Sherman County, which is served by Goodland Regional Medical Center, which has 21 beds, according to American Hospital Directory Inc.
Both hospitals are in Denver’s far-flung hospital referral region, in which demand for hospital beds is projected to be nearly three times normal capacity if the infection spreads over six months.
“Here at Goodland Regional Medical Center, we want our community to rest assured that our team has a plan in place to provide care in regards to COVID-19,” it says on the hospital’s Facebook page.
No further details were provided and a spokesman for Goodland Regional did not respond to a request for more information.
But Megan Carmichael at Citizens Medical said the hospital staff in Colby is preparing for worst-case scenarios.
“We have a (hospital) task force that meets every morning and a community-wide task force that meets once a week,” she said. The hospital, she said, has developed a plan to rank patients based on the severity of their conditions — low, moderate, high — and allocate resources accordingly.
Citizens Medical has just one intensive care unit bed and five ventilators in a county of nearly 8,000 residents.
“We want to be overprepared,” Carmichael said. “We are prepared for all situations.”
But no hospital can ever be ready for worst-case nightmare scenario, should things get as bad as some say they could.
Back in Kansas City, Steve Hoeger shudders when he thinks of those possibilities, should all this social distancing and hospital preparation fail.
“We don’t know what this is going to do.” he said. “This virus is only months old.”
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