DENVER — Some hospitals in Colorado, both urban and rural, are issuing clear warning signs about the months to come.
Like many other areas of the United States, Colorado has noticed a significant uptick in COVID stats in recent weeks.
As of Thursday, COVID-19 numbers in the state remained high compared to any other time in the pandemic, with 5,200 new cases reported from the day prior and 1,183 hospitalizations. The positivity rate also climbed to near 12%. Health officials like to keep that figure below five.
The Colorado Dept. of Public Health and Environment (CPDHE) is asking people to limit social interactions through November and to continue wearing masks. The state hopes mitigation can ease the burden on health care providers and hospitals.
Dr. Eric France, chief medical officer for CDPHE, said Thursday that he's concerned about the scenario of having to decide who gets an intensive care unit (ICU) bed once capacity is met. Such decisions would be made under the state's crisis Standards of Care. If current trends continue, that situation could happen in December, France said.
Health officials at Denver Health and Lincoln Health gave us a look at what it's been like at their hospitals as the state deals with this surge of COVID-19 cases.
"I'm quite frankly frightened about the next month or so," Denver Health Chief Quality Officer Dr. Thomas MacKenzie told Next with Kyle Clark on Wednesday.
MacKenzie said the hospital was very close to its traditional capacity, referring to its current bed allocation.
"In the last wave, we didn't have as many non-COVID patients. Now we are full with non-COVID patients who require hospitalized care because of other conditions. And then we have to add to that a number of COVID patients," he said.
At any given time, the hospital has around 350 patients hospitalized for a variety of reasons; 60 current patients are being treated for the coronavirus.
With the increasing demand, MacKenzie said it's been challenging to find more health care professionals to take care of patients.
"[There is] an increase in hospitalized patients, not just in Denver but across the country," he said. "There are not as many nurses available to step up and come do shifts. Quite honestly, we've taxed our current staff a lot."
Denver Health already has a plan and infrastructure in place to quickly flip non-ICU spaces into ICU units, meaning they are transformed into ICU rooms with the proper beds and equipment like monitors, electrical plugs, ventilators and pumps.
"We've taken some beds that used to be for regular, medical, surgical care in a regular adult bed and converted those to ICU, and using those as ICU beds," MacKenzie said.
One entire unit of the hospital was also transformed to provide flexibility, as well.
"We ended up doing was creating a unit that is a lot more flexible than it used to be. So we can do ICU level care, regular floor level care and intermediate care in any of the beds in this 30-bed unit," MacKenzie said. "As demand changed, we've flexed up and down on the number of patients who are true ICU patients on that unit. For the last month or so we've had to increase the number of ICU patients in that unit."
If the trends continue and capacity is squeezed even more tightly, they will flip more regular beds into ICU beds. The hospital is also considering adding beds to some patient rooms that are built for one but can accommodate two patients when it's appropriate.
Having enough non-ICU and ICU beds is always important, especially now that COVID-19 treatment has improved, which means there is a new trend.
"Still having to put patients in the ICU, still on ventilators -- but the majority of hospitalized patients in our institutions are in non-ICU rooms," MacKenzie said.
Caring for all patients remains contingent on finding enough staff to keep up with the demand.
People are still falling sick and need medical care for non-COVID related issues, as well.
In addition to treating more people who have tested positive for COVID, Lincoln Health in Hugo has been getting nervous about staffing, according to Kevin Stansbury, the hospital's chief executive officer.
"Eight or nine people tested positive -- and key people," Stansbury told Next.
That group included nursing staff, some providers and paramedics who all had to be out for mandatory quarantining until the virus passed, putting a strain on remaining health care workers.
Those staff members have been coming back to work, and while the hospital had capacity Thursday, Stansbury said things can change quickly.
"A hundred more tests are out," he said. "Lincoln County has a small population. That's a lot for us."
The other concern has been about testing supplies. While they are OK now, Stansbury said they were worried about inventory and keeping supply levels where they would ideally like. He said it's a supply and demand issue with the current pandemic status.
Stansbury is looking outside of his hospital, as well. Even before the pandemic, patients would be transferred to hospitals that are better equipped to treat any particular condition.
The same goes for during the pandemic, though while patient transfers to metro area hospitals are still happening, Stansbury said the wait time can be longer depending on the receiving hospital's patient load.
He also said conversations have started about patient swaps so that Lincoln Health can take in patients they have the equipment and resources to treat while freeing up a bed at another hospital.
COLORADO HOSPITAL ASSOCIATION
When looking at capacity, it's not about looking at one or two hospitals but the system overall.
The Colorado Hopsital Association (CHA) said that across the state, there is still hospital capacity.
"Now compared to what happened in the spring, we are seeing more patients who have COVID hospitalized staying in the medical floor. They are sick. Sick enough to be in the hospital but not so sick they are needing intensive care," Dr. Darlene Tad-y told Next.
Tad-y said that's because treatments have improved.
She also mentioned staffing is an issue right now.
As of Thursday, the state said they were not activating the alternative care sites, hoping it will be the last resort. The Colorado Convention Center, along with two other sites in Pueblo and Westminster, are on stand by.
Along with patient transfers, a priority will be to expand capacity within hospitals.
If the alternative care sites are opened, the priority will be for recovering COVID-19 patients, as of now.
The Pueblo and Westminster sites will also be equipped to take in patients from long-term care facilities.
The idea is these sites would alleviate the pressure off hospitals and free up beds for both COVID and non-COVID patients.
The alternative care sites will not be a place people can walk into for care but a place patients have to be transferred to from another hospital.
The state said the plan to staff the alternative care sites include tapping traveling health care professionals, people out of state and asking people to come out of retirement to help.
NEXT QUESTION: What is the status of Colorado's field hospitals?
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