As Ohio logs hundreds of new coronavirus cases every day, concerns are growing about the state's hospital systems and their ability to handle an expected influx of patients.
When Gov. Mike DeWine and Ohio Department of Health director Dr. Amy Acton talk about "flattening the curve" — slowing the growth of infections and spreading them out over time — they’re hoping to reduce the load on Ohio hospital systems.
Early last week, the health department ordered medical centers to cancel elective surgeries and procedures. Acton says that was just one of many moves to try to prepare hospitals.
"We’re doing policies to relieve the health care system burdens. That was our trying to get rid of elective surgeries, getting our equipment from out in the field in, we're doing amazing things converting anesthesia machines to ventilators," she says. "But you should know, we will be having to build additional beds just like you’re seeing in places like New York."
Ohio isn’t quite there yet – Acton estimates that hospitals are currently at 60% capacity statewide.
The Ohio Department of Health on Wednesday reported 704 cases of coronavirus across the state, with 182 people hospitalized and 75 admitted into the ICU. Ten people have died from COVID-19 so far.
Locally, Andy Thomas, chief medical officer of the Wexner Medical Center, says hospitals are not yet working to expand past their current buildings, mostly due to the elective-surgery order.
"With the cancellation or postponement of elective, our hospital census city wide — not just Ohio State but all the systems — is significantly lower than it would be normally," Thomas says. "There are hundreds of beds open right now. We’re really not at any level of surge currently."
There are three possible levels of surge that hospitals are planning for, Thomas says. The first is utilizing all beds currently in the hospitals, including those that are often left empty.
The second is converting other hospital spaces like conference rooms or operating rooms into patient areas.
And the third, and last level of surge, is expanding to spaces outside the hospital entirely – dorms, nursing homes, lecture halls, arenas.
Thomas says none of those moves are necessary yet. Additional guidance from the CDC has made it easier to house COVID-19 patients, too.
Originally, hospitals were instructed to keep patients in a negative pressure room, which would pull air from the room through special filters and release it outside, to not contaminate other patients. That is no longer the case.
"That’s actually been a big step forward in terms of the CDC guidance," Thomas says. "Now that they have more science under their belt related to the care of these patients, there's not the concern that they need the type of isolation we would give a tuburculosis patient, this is actually much more along the lines of influenza."
Another concern is PPE, or personal protective equipment. That includes N95 masks, gloves and gowns that help prevent health care workers from being infected.
Cutting back on elective surgeries is preserving that supply for coronavirus patients. But Bruce Vanderhoff, chief medical officer at Ohio Health, says he’s still concerned.
"We’re also using in our everyday care more personal protective equiptment than historically we would have, and that means we have got to be mindful of that supply," Vanderhoff says. "That supply chain is also disrupted."
Several Ohio hospitals are working with Battelle, a research institute based in Columbus, to find ways to clean PPE so they can be reused.
Ohio Health, Wexner Medical Center and Mount Carmel are all working together to collect donations of PPE. They've opened drive-up drop-off sites that allow people to donate supplies without ever leaving their vehicles.
That’s not because they are running low, though: The hospitals set the system up after receiving a large number of calls from the community asking how they could donate.
On a national level, Sen. Sherrod Brown (D-Ohio) is pushing the Trump administration to commandeer factories under the Defense Production Act to meet the looming shortfall of PPE.
“They are ready to go to work to serve our country, they need coordination, guidance and support," Brown said in a press call Wednesday. "It mostly can’t come from the legislative branch, we’re trying, but it needs executive action that the administration should take immediately.”
In the meantime, hospitals in Central Ohio stand emptier than usual, ready for a boom of COVID-19 patients that experts assured them is coming.