Hospital bed capacity, including in I.C.U.s, is generally used to gauge a region’s health care infrastructure and the preparedness of its hospitals to respond to the coronavirus. Data showing I.C.U.s at full or near capacity have made headlines recently, but health experts say that attention to capacity does not paint an entirely accurate picture of the severity of the pandemic.
Regular beds are easily converted into I.C.U. capability, doctors and hospital experts say. The bigger challenge is having enough advanced practice nurses who are qualified to care for such patients and equipment such as ventilators.
Hospitals can “pivot enough space,” said Jay Wolfson, professor of public health at the University of South Florida. “The trick is going to be staffing. If you get people burned out, they get sick, then you lose critical care personnel.”
At the Medical University of South Carolina in Charleston, emergency room waiting times can last up to four hours before patients are seen by a physician. The hospital has set up large white tents outside to allow for social distancing, but patients are increasingly leaving the site before their treatment, unwilling to endure the wait.
As physicians and nurses fall ill with the coronavirus, much like their patients, fewer and fewer staff members have been available to accommodate the burgeoning number of sick people at their doorstep. Some emergency room doctors have taken on extra shifts, and the hospital plans to implement a new system where some doctors will be on-call, even on their days off, to respond to the surge.
Mohamed Ibrahim Ali, a critical care doctor at AdventHealth North Pinellas near St. Petersburg, Fla., one of the hospitals that have no more available I.C.U. beds, said that the system was clogged up by patients, sent from nursing homes, who had recovered but had not yet received the all-clear. He said nursing homes have refused to accept residents back unless they have tested negative, a period that could take days.
Roopa Ganga, an infectious disease specialist at two hospitals near Tampa, said that they lacked sufficient supplies of remdesivir, the antiviral drug, forcing her to choose which patients needed it the most. Patients were also being discharged “aggressively” — perhaps too early, she said. They sometimes return a few days later, she said, their symptoms worsened.