COVID-19 Stretching ICU Capacity of Alabama Hospitals

Medical professionals care for a COVID-19 patient at UAB Hospital. (Source: UAB Media Relations)

With the number of people being hospitalized with COVID-19 steadily rising, only 12% of the intensive care beds in Alabama hospitals are available for patients sick with the coronavirus and other illnesses, the head of UAB’s Infectious Disease Division said Thursday.

“At UAB we are seeing more sick people and seeing more people dying,” said Dr. Jeanne Marrazzo. “Right now, our COVID-care units are at full capacity, but we can absorb more people, and we will. The next couple of weeks are critical because we have not yet seen a decline in the rate of new cases.”

Alabama is averaging more than 1,500 new cases of COVID-19 daily, and the state’s positivity rate among those tested for the virus was 19.25% as of Wednesday. The World Health Organization states that positivity rates for COVID should remain at 5% or below for at least 14 days for the situation to be considered under control.

Marrazzo said officials “worry about our capacity being stretched. UAB is at full capacity, the ICU is full, and that is not optimal for us.” She said UAB is performing a balancing act, with the numbers of patients being admitted and patients being discharged every 24 hours about even.

“So far, we are OK, and we may be able to get through. This is not optimal for smaller hospitals in the state, because their reality is exactly the same,” Marrazzo said.

Earlier this week Huntsville Hospital, the state’s second-largest hospital, declined to take coronavirus patients from Georgia, Mississippi, Tennessee and south Alabama.

“We were unable to accept those patients because we are dealing with the patients we have here in north Alabama,” said David Spillers, CEO of the Huntsville Hospital Healthcare System.

Alabama is one of 21 states in the red zone for COVID-19, based on the high number of new cases being reported, and hospitals across the state are reeling under the influx of new cases. The Alabama Department of Public Health reported Wednesday that 9,893 people have been hospitalized for the virus since the pandemic began in March.

There was a 120% increase in the number of hospitalizations from coronavirus from June 29 to July 29, according to Health Department statistics.

UAB recently converted an emergency department waiting room into additional patient space, and Southeast Health Medical Center in Dothan plans to convert the first floor of a parking garage into a triage center to treat an increase in the number of COVID-19 patients.

The conversion can be done in four hours, said Dr. Fred Pich, emergency department director for the Dothan hospital. He said there are hand-washing stations and bright lights, along with power strips on the walls on the ground floor of the garage.

Extra ICU Beds Available in Jefferson County

On Friday, 296 people who had tested positive were in hospitals in Jefferson County; 118 were in ICUs, and 63 were on ventilators.

Jefferson County has 352 ICU beds, said Julie Cobb, county health care coalition coordinator. The number fluctuates because hospitals can pull ICU beds from other departments.

Cobb said the bed count does not include 55 hospital beds that the Jefferson County Commission bought in March for $80,750. Those beds are at the Birmingham Jefferson Civic Center, said Commission President Jimmie Stephens.

The BJCC Exhibition Hall will be used as a temporary hospital if necessary, and the nearby Sheraton Hotel would house hospital workers. “Thankfully,” Stephens said, “the beds have not been needed.”

Jefferson County Emergency Management Director Jim Coker said the pandemic is “the longest declared disaster in the county, and we do not know an end date.”

Spokesman Adam Pope said UAB Hospital had 118 COVID patients.

Converting the emergency department waiting room to patient space helped separate patients with COVID-19 symptoms from other patients, he said. At the beginning of the pandemic, Pope said, UAB designated an intensive care unit and an acute care unit for patients who had tested positive for COVID-19.

The number of beds allocated to each unit was based on projections of need. As the number of patients requiring hospitalization has increased over the past two months, UAB has designated additional beds for those who tested positive for COVID-19.

This primarily involves having appropriate staffing and medical equipment available to meet the unique needs of these patients. The downside of designating additional COVID beds is that it reduces the number of beds available for patients with non-COVID medical needs, Pope said.

A spokeswoman for Birmingham’s Brookwood Baptist Health System said the system has the capacity to handle patient needs.

There were 74 COVID-19 positive patients on Wednesday at the five hospitals in the system, said Laura Clark, communications manager at Tenet Healthcare.

“As a system, we have capacity, appropriate supplies and the ability to operationalize additional beds to increase our capacity, if needed,” Clark said.

The health system includes Brookwood, Princeton, Shelby (Alabaster), Walker (Jasper) and Citizens (Talladega) Baptist medical centers.

“We encourage our community not to delay care for new or chronic conditions requiring medical attention, which can lead to life-threatening illnesses, and we have taken the appropriate steps and implemented protocols to continue to provide safe care. It is important to continue to adhere to safe personal practices, masking, social distancing and frequent hand washing,” Clark said.

Grandview Medical Center has 402 licensed beds, and was treating 41 people who had tested positive for COVID.

“As a reminder, care for any individuals with suspected or confirmed COVID-19 is delivered in a restricted, separate area from other patients. We also have adequate ventilators and PPE at this time to meet the needs of our patients,” marketing director Leisha Harris said. “Patient numbers and unit bed availability are fluid throughout any day as patients are discharged and admitted.”

The five hospitals in the Ascension St. Vincent Health System are caring for 120 patients with COVID-19, said Chief Nursing/Chief Operating Officer Chris Moore.

“We continue to evolve and adapt our readiness plans as we respond to this pandemic,” Moore said. “Since we began treating patients with COVID-19, we have seen the number of patients being treated for this illness steadily rise. We have modified units within our hospitals to dedicate additional space for the treatment of COVID-19 patients.

“We currently have the capacity to treat all patients, including those with COVID-19, and are able to adapt quickly to the needs of our patients and to the healthcare demands of our community,” Moore said.

Ascension St. Vincent’s is comprised of St. Vincent’s in Birmingham, St. Vincent’s Blount (Oneonta), East (Birmingham), Chilton (Clanton) and St. Clair (Pell City).

The Huntsville Hospital Health System reported 214 COVID-19 patients.

That number includes Madison County data, as well as that from Athens Limestone Hospital, Decatur Morgan Hospital, Helen Keller Hospital in Sheffield, Red Bay Hospital, Marshall Medical Center North (Guntersville) and South (Boaz), Highlands Medical Center in Scottsboro and Lawrence Medical Center in Moulton.

East Alabama Medical Center in Opelika had 63 COVID-19 patients. The hospital has 339 beds, with 20 ICU beds and 18 progressive care beds for patients who need continuous monitoring and comprehensive nursing care.

DCH Hospital in Tuscaloosa was treating 109 COVID patients, along with 30 inpatients who tested positive for the virus and were being treated in the ICU; 15 of those patients were on ventilators.

In the Montgomery area, Jackson Hospital had 49 COVID patients; Baptist Medical Center East had 29, Baptist Medical Center South had 48 and Prattville Baptist had 14.

The Mobile County Health Department said numbers were not available on Friday and will be posted Monday.

‘Only a Vaccine Will End This’

Dr. Don Williamson, president of the Alabama Hospital Association, said he has not seen anything to make him think that “we have this under control.”

“The workers are mentally and physically fatigued with beds filling up. There are staff shortages. The staff is working longer hours,” he said.

“The staff has already seen one spike, and now we are looking at a second spike in Opelika, Tuscaloosa and Birmingham. Only a vaccine will end this,” Williamson said.

Jefferson County’s Cobb worked to formulate pandemic plans in 2007.

“We know from pandemic planning that resources are limited and outside help is not readily available, so we work to meet our local needs,” she said.