The head of the Alabama Hospital Association says he’s confident the state’s hospitals will not go over capacity in dealing with COVID-19 patients.

“I’m feeling optimistic that as long as we practice social distancing, we’re going to be okay as a state,” said Dr. Donald Williamson, president and CEO of the association.
The nonprofit investigative news organization ProPublica analyzed data from Harvard University researchers and the American Hospital Association to see what kind of strain the pandemic would put on the nation’s hospital systems. ProPublica found that if 40% of Alabamians were infected with COVID-19 over a 12-month period, the hospitals in the state’s four largest cities would need about double the number of hospital beds and triple the number of ICU beds they have.
Williamson said that early in the pandemic some models predicted even more dire results, with the state being thousands of beds short.
“I didn’t believe those numbers, largely because the range of uncertainty was so great,” he said.
Williamson said that 48% of the state’s hospital beds were available, with about 35% availability for ICU beds, early last week. He also said Alabama had about 800, or 54%, of its ventilators available.
“Hospitalization numbers are going up, but they’re not exploding,” he said.

The Alabama Department of Public Health reported Sunday that 641 people in Alabama had been hospitalized with COVID-19 since March 13. The agency said 4,888 people in the state had been diagnosed with the disease, and 157 of those had died.
The numbers cited by Williamson are more in line with those from the University of Washington’s Institute for Health Metrics and Evaluation. This model predicts that Alabama’s hospitals will likely operate under capacity, with 299 beds needed for COVID-19 patients at a peak predicted for Tuesday, April 21.

Even the worst predictions from the model put the beds needed at 2,840 — well below the state’s total of 5,743.

In terms of ICU beds, the University of Washington study forecasts 89 beds will be needed, also below the state’s availability of 474.
Williamson said the state’s hospitals all have built-in surge capacity and surge plans. These plans have three phases:
• Phase 1: Cancellation of all elective admissions. Williamson said all of Alabama’s hospitals have done this.
• Phase 2: Reconfiguring space or equipment to expand capacity. For example, converting a surgery recovery room into an ICU bed. Williamson said a few hospitals have had to do this, most notably East Alabama Medical Center in Opelika.
• Phase 3: Moving patients to sites off campus. Williamson said no Alabama hospital has done this yet, though there are plans in place in the event this step is needed.
Asked how rural counties with no ICU beds will cope, Williamson said he recently met with rural hospital administrators, and some of them have ventilators and are prepared to use them.

Hospitals Can Adapt

But it’s not always about equipment, he said. Some hospitals may not have a doctor qualified to treat patients with severe COVID-19 symptoms.
What hospitals can do, though, is move patients with traditional ailments to those hospitals that can’t handle the more severe COVID patients, thereby lightening the load on the institutions dealing with high COVID caseloads.
“Part of the Phase 2 surge plan can be bidirectional,” Williamson said.
Meanwhile the University of Washington model predicts the United States will need 56,831 hospital beds to deal with the pandemic, creating a shortage of nearly 3,500. In terms of ICU beds, the researchers expect a need of 15,164 — creating a shortage of 7,369.
If there is good news in the model, it’s that it has been four days since the need for hospital resources peaked in the United States, and one day since the peak in daily deaths.