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As Coronavirus Cases Surge, NPR Examines Hospital Capacity

STEVE INSKEEP, HOST:

How strained are hospitals in this country, really? We've heard about coronavirus hot spots - first New York, then Houston, some other places. Now, as new cases surge in almost every state, NPR has examined hospital capacity across the country. The question is, who is running short of available hospital beds? The reporting reveals problems in communities that are not in the headlines.

We're going to hear from reporter Will Stone, who is up early in Seattle. Will, good morning.

WILL STONE, BYLINE: Good morning.

INSKEEP: Rosemary Westwood is with our member station WWNO in New Orleans. Good morning to you.

ROSEMARY WESTWOOD, BYLINE: Good morning.

INSKEEP: And Sean McMinn, NPR's data editor, is with us also. Sean, good morning.

SEAN MCMINN, BYLINE: Hi, Steve.

INSKEEP: What did you guys do?

MCMINN: We took different areas of the country that people are likely to seek treatment in. They're called hospital referral regions. And we know how many beds there usually are in these regions, so we compare that to the number of new cases there. And what we saw was there was this huge variety in different areas of the country. Southwest Louisiana, where Rosemary reported from, had five times more new cases in the last few weeks than they do hospital beds.

INSKEEP: Wow.

MCMINN: So that gives you an idea of just how bad it could get in these hospitals.

INSKEEP: Well, what does that look like on the ground in southwest Louisiana, Rosemary?

WESTWOOD: There are two regions in the state in particular that are troubling. One is Lake Charles in the southwest bordering Texas and Lafayette a bit further east. In both, the major hospitals are at or near capacity, and that's after they've already dramatically expanded their ICU beds by taking over other space in the hospital. And they are running out of room for both COVID-19 patients and everyone else who needs care.

The key issue is staffing, though. Hospital officials told me more space can be found, even if it has to be a conference room or a waiting room, but they're running short of people to staff those beds. And that's in part because staff are getting sick, too.

INSKEEP: Wow. Well, I appreciate this update because we've, of course, heard about New Orleans. But now we're hearing about another part of Louisiana that's out of the news but in trouble. And I think there's a similar story in Washington state. We've certainly heard about Seattle, one of the early hot spots. But Will, you've been reporting on Yakima, Wash.

STONE: That's right. Yakima was in big trouble when the coronavirus started to surge there. This is a city a few hours east of Seattle. There about 250,000 people in the county, and in January, one of the major hospitals actually closed. So that left only one hospital for the entire city. And suddenly, they had lost half of their critical care beds. And Yakima is also a place where about 60% of workers are considered essential, so they couldn't necessarily go into a full lockdown like other places.

Then you fast-forward to June, and the virus was spreading uncontrollably in the community. Yakima had become not only the epicenter of Washington's outbreak but it actually had the highest rate of infections of anywhere on the West Coast. The hospital was filling up, on the verge of being totally overwhelmed.

INSKEEP: And unlike major metros, a lot of smaller cities and rural areas have had hospital closings in recent years and have a lot less capacity even before the pandemic. Now, Sean, how widespread is that capacity problem as the pandemic surges?

MCMINN: Unfortunately, it's impossible to know for sure because even though the federal government collects data on this, they don't release it all to the public. But what we do know based on our analysis is that one out of every 10 hospital regions in the country have quadruple the number of new cases as they do hospital beds. So that can certainly be a problem.

INSKEEP: Are hospitals adapting?

STONE: Yes. The remaining hospital in Yakima, Virginia Mason Memorial, had to do that. They doubled their critical care beds, they converted several floors to handle COVID patients, and they worked with hospitals in western Washington, around Seattle, to make sure they could transfer patients out to there. And at the peak, that's what they were doing. They were transferring on one day 17 patients, which was unprecedented - but would also say the community was a huge effort to get everyone to wear masks. The hospital and the health department blanketed the community with them. Here's Dr. Tanny Davenport with Virginia Mason Memorial Hospital.

TANNY DAVENPORT: So getting out into your communities and encouraging masking and let people know this really shouldn't be optional and that even places like Yakima that was No. 3 in the country, by masking up within six weeks, cut their coronavirus cases in half. The numbers don't lie. Masking works.

INSKEEP: What about southwest Louisiana, Rosemary, where you've been reporting?

WESTWOOD: Hospital leaders have seen this coming for weeks there, Steve. And they've prepared in a way because they built up their contingency plans back in the spring, when we saw New Orleans hospitals face that onslaught of COVID-19 patients. So they're finding space where they can inside their buildings, and there is a convention center in New Orleans that's been transformed to house patients recovering from COVID-19 from across the state.

There are also locations scouted in these regions that could be transformed into surge hospital space. But again, if they can't staff them, the space is useless. So hospital officials tell me they're really at the mercy of the public here to stop the virus's spread in order to truly relieve that pressure.

INSKEEP: Well, Sean, given the shortages, especially of staff, how long can hospitals improvise?

MCMINN: So like we just heard, when they start getting full, they do figure out emergency measures to cope. The problem is it doesn't seem like they're sustainable. Like, how many weeks in a row can you ask nurses to work overtime?

Doctor Ashish Jha is the director of Harvard's Global Health Institute and started looking at COVID-19 hospital capacity data way back in March. We used his numbers in our analysis. In March, he said there was this concern that a single huge wave would push our hospitals over the edge. But now he told me he's worried about this slow creep of hospitals running almost at capacity and being unable to maintain that.

INSKEEP: Sean McMinn, Will Stone and Rosemary Westwood, thanks to all of you.

WESTWOOD: Thank you.

MCMINN: You're welcome.

STONE: Thank you.

INSKEEP: And you can see a map of the cases in all the country's hospital referral regions by going to npr.org. Transcript provided by NPR, Copyright NPR.